RESUMO
A 36-year-old Hispanic man with no prior cardiac history presented with chest pain and then ventricular fibrillation requiring defibrillation after a physical altercation. His ECG on presentation to the emergency room was suggestive of Brugada syndrome, which later normalized. Cardiac catheterization revealed anomalous origin of right coronary artery from the left coronary cusp (coursing between the pulmonary artery and the aorta) for which he underwent surgical reimplantation, and subsequent pharmacological challenge test did not provoke reappearance of a Brugada ECG pattern. A review of literature on Brugada syndrome and anomalous origin of the coronary arteries is presented.
Assuntos
Síndrome de Brugada/diagnóstico , Síndrome de Brugada/cirurgia , Procedimentos Cirúrgicos Cardíacos/métodos , Anomalias dos Vasos Coronários/cirurgia , Parada Cardíaca/terapia , Adulto , Cateterismo Cardíaco/métodos , Dor no Peito/diagnóstico , Dor no Peito/etiologia , Angiografia Coronária/métodos , Anomalias dos Vasos Coronários/diagnóstico por imagem , Cardioversão Elétrica/métodos , Eletrocardiografia , Serviço Hospitalar de Emergência , Seguimentos , Humanos , Masculino , Medição de Risco , Tomografia Computadorizada por Raios X/métodos , Resultado do TratamentoRESUMO
Lyme disease is the most common tick-borne infection in the Northern hemisphere. Cardiac manifestations of Lyme disease typically include variable atrioventricular nodal block and rarely structural heart pathology. The incidence of Lyme carditis may be underestimated based on current reporting practices of confirmed cases. This case of a 59-year-old man with Lyme carditis demonstrates the unique presentation of widespread conduction system disease, mitral regurgitation, and suspected ischemic disease. Through clinical data, electrocardiograms, and cardiac imaging, we show the progression, and resolution, of a variety of cardiac symptoms attributable to infection with Lyme. [Full article available at http://rimed.org/rimedicaljournal-2017-02.asp].