[Neurogenic stunning of left ventricle following epileptic seizures in a patient with aortic regurgitation and Niemann-Pick disease]. / Neurogenne ogluszenie miesnia sercowego po napadach padaczkowych u chorej z niedomykalnoscia zastawki aortalnej i choroba Niemanna-Picka.

A case of a 19 year-old female with the Niemann-Pick disease and transient left ventricular dysfunction following epileptic seizures is presented. Electrocardiographic features and differentid diagnosis of this condition are presented.

[Long QT syndrome in the postpartum period]. / Wrodzony zespól dlugiego QT u mlodej kobiety rozpoznany w okresie poporodowym.

The postpartum period can unmask LQTS. We described a case of 22-year-old woman with episode of lost of consciousness 6 months after delivery. Holter monitoring showed episodes of QTc prolongation, max. QTc - 618 ms, medium QTc - 538 ms with different morphology types of T wave. Beta-blocker (BB) therapy (metoprolol was initiated) and titrated up to 200 mg daily. The patient was out of symptoms. After 2 years during the second pregnancy she reduced BB to 50 mg/day. In the postpartum period, 3 months after delivery she had syncopal episodes. Holter monitoring showed polymorphic ventricular tachycardia. The cardioverter-defibrillator was implanted.

[Massive pulmonary embolism during pregnancy treated with streptokinase and complicated by massive haemorrhage--a case report]. / Masywny zator tetnicy plucnej u mlodej kobiety w pierwszym trymestrze ciazy. Skuteczne leczenie streptokinaza. Powiklanie masywnym krwawieniem z dróg rodnych.

A case of a 27-year-old pregnant female (first trimester) is described. The patient was hospitalised due to pregnancy complications and immobilised for 3 weeks. At the end of this period patient's clinical condition rapidly deteriorated and she developed shock, followed by cardiac arrest. Echocardiography was consistent with acute pulmonary embolism and the patient received streptokinase. This treatment was complicated by a massive bleeding due to the rupture of the uterus. She underwent hysterectomy and recovered thereafter.

Fast and slow torsade de pointes--electrocardiographic characteristics.

BACKGROUND: Clinical value of electrocardiographic features of torsade de pointes (TdP) has not yet been well established. AIM: To compare the mode of onset and ECG characteristics of slow (s-TdP) and fast (f-TdP) episodes of TdP. METHODS: 54 episodes of TdP recorded in 6 patients (5 females, one male, mean age 64.4 years) with acquired long QT syndrome were analysed. Baseline rate of TdP (V-V), ventricular rate variability (VRV), coupling interval (CI) at the onset of TdP, prematurity index (PI) and the first cycle length (FCL) were compared between 31 s-TdP (<200 beats/min) and 23 f-TdP (> or =220) episodes of TdP. RESULTS: Episodes of f-TdP were preceded by a significantly faster basal rhythm than s-TdP (R-R interval: 922 ms vs 1062 ms, p=0.03). QT interval was almost identical in both groups (517 ms vs 515 ms, NS, respectively). No significant differences were noted in the CI of the initiating beat (488 ms vs 472 ms, NS) nor in the PI (0.53 vs 0.47, NS). TdP was most frequently spontaneously terminated by a gradual slowing of the tachycardia rate; 58% of s-TdP and 39% of f-TdP episodes stopped in this way. An acceleration of ventricular rate before termination of TdP was noted in 32% of s-TdP and in 26% of f-TdP episodes. Episodes of f-TdP were longer than s-TdP episodes (mean of 19.7 vs 6.7 ventricular complexes per one episode, p=0.0003). There were significant differences in the VRV parameter (p=0.0005) and FCL (p=0.004) between both types of TdP. Faster TdP were characterised by lower ventricular rate variability (VRV - 19.5 msec) than s-TdP (VRV - 39.4 msec). Of 54 episodes of TdP, 9 (16.6%) degenerated into VF and required DC shock. Of 31 s-TdP episodes, one (3.2%) degenerated into VF compared with 8 (34.7%) episodes of f-TdP (p<0.04). CONCLUSIONS: Episodes of fast TdP were characterised by a longer duration, shorter first cycle of the arrhythmia and lower ventricular rate variability than episodes of slow TdP. Fast episodes of TdP were preceded by faster baseline rhythm before TdP. Faster TdP more frequently degenerated into VF than slower episodes.