ABSTRACT
Syncope is a frequent medical problem that causes much difficulty in order to explain its etiology. Recently, tilt table testing became an investigation of choice in patients presenting with unexplained syncope. To present a series of patients presenting an unexplained syncope, investigated with a tilt test and to compare our results to the literature. 257 patients [mean age of 42.7 +/- 15.4 years] presenting an unexplained syncope between 1997 and 2002 were assessed with a usual tilt test, then in case of negative test a sensitization with iso-proterenol intravenously or sublingual trinitrin was realized. 88 patients [34.2%] had spontaneous positive test, 79 patients [30.8%] had positive test after sensitization and 90 patients [35%] had negative test in spite of sensitization. With a diagnostic return of 65% in this series, the tilt test seems to be the non-invasive investigation of choice in unexplained syncope
Subject(s)
Humans , Risk Factors , Insulin Resistance , Hyperlipidemias , Albuminuria , Syndrome , Diabetes Mellitus , Cholesterol , Coronary Disease , Stroke , Renal InsufficiencyABSTRACT
We report two cases of coronary artery fistula discovered accidentally during coronary-angiography. One case between the left anterior descending and the pulmonary artery and another case between the circumflex and the left ventricule. Both cases were associated with hypertrophic cardiomyo-pathy. There was a spontaneous closure of the fistula in the first case. A brief review of the literature is presented because this anomaly is being discovered frequently because of the possibility of diagnosis with transesophageal echocardiography
Subject(s)
/therapy , Thoracic SurgeryABSTRACT
Objectives: to assess complications of single chamber pacemaker VVI. Materials and methods: we reviewed the medical files of 278 patients implanted with VVI pacemaker at saint joseph hospital, bawchrieh, Lebanon, between 1978 and 1988. We looked for complications that have been reported by the patients. We compared these complications to different factors: age, indication, retrograde conduction ECG aspect before implant. Results: 36 patients [12.9%] reported at least once one of these complications: fatigue, headache, neck pain, palpitations, confusion, dyspnea, angina, chest pain, pulmonary oedema, pedal oedema, atrial fibrillation, cerebrovascular accident. These complications were more frequent when the indication was an atrial disease compared to AV block. The retrograde conduction was frequent in patient with complications. Heart failure was aggravated by stimulation, but not induced by it. Conclusions: The single chamber VVI is complicated by symptoms which could be minor, moderate and major. VVI is an acceptable mode of stimulation when the indication is AV block. The dual chamber pacemaker should consider the cost effectiveness
Subject(s)
Heart Diseases/therapy , HeartABSTRACT
We report a case of pericarditis following aorto coronary by-pass surgery which gradually developed into chronic constrictive pericarditis. The disease was a long time ignored because symptoms are not specific. In our case the clinical presentation looked like a cirrhosis especially that our patient developed an hepatitis after blood transfusion. In this occasion criteria of diagnosis are reminded. Hemodynamic investigation is still the best method of diagnosis and the only treatment is surgical and consists of pericardial decortication