ABSTRACT
Lactic acidosis associated with solid neoplasms is a rare complication; its occurrence is poorly described, and it is associated with a poor prognosis. We present the case of an 84-year-old woman who was admitted to the internal medicine department with a diagnosis of urinary tract infection accompanied by a blood gas analysis showing lactic acidosis. During her admission, an abdominal mass was evidenced and finally diagnosed as undifferentiated carcinoma. We wanted to emphasize the importance of correlating clinical and laboratory data at the time of making a diagnostic approach and also highlight other possible explanations of lactic acidosis that should be considered in addition to hypoperfusion due to sepsis, especially in the elderly who are at increased risk of malignancy.
ABSTRACT
BACKGROUND AND OBJECTIVE: Severe tricuspid regurgitation (TR) secondary to interference pacemaker (PM) cable is a rare cause of progressive right heart failure (HF), which can worsen patient outcomes. MATERIAL AND METHODS: We present 3 clinical cases of right HF secondary to TR after PM implantation. RESULTS: In these patients the clinic is right HF, which can appear early, as in our second patient, or after years of implementation of the PM, as in the first and third patients. The diagnosis is confirmed by echocardiography, the most accurate 3D, followed by transesophageal. The 2D transthoracic can not detect it, because it has low sensitivity for TR associated with PM. Medical treatment is always the first choice, since any other procedure carries significant morbidity and mortality. CONCLUSIONS: Probably this is a condition that we will diagnose with increasing frequency, because there are more and more patients with devices and, at the same time, the diagnostic tools are improving.