Subject(s)
Bundle-Branch Block/diagnosis , Tachycardia, Ventricular/diagnosis , Ventricular Dysfunction, Left/diagnosis , Adult , Bundle-Branch Block/drug therapy , Calcium Channel Blockers/therapeutic use , Diagnosis, Differential , Electrocardiography/drug effects , Humans , Male , Tachycardia, Ventricular/drug therapy , Treatment Outcome , Ventricular Dysfunction, Left/drug therapy , Verapamil/therapeutic useABSTRACT
We present a case of patient with hypertrophic cardiomyopathy and an anomalous right coronary artery with left main artery origin and an interarterial course. The coexistence of these two different entities is extremely rare but of major clinical significance because both are associated with an increased risk of sudden cardiac death. In addition, a review of the literature comprising 14 other cases with this combination is provided.
Subject(s)
Cardiomyopathy, Hypertrophic/complications , Cardiomyopathy, Hypertrophic/diagnosis , Coronary Angiography/methods , Coronary Vessel Anomalies/complications , Coronary Vessel Anomalies/diagnosis , Coronary Vessels/diagnostic imaging , Echocardiography/methods , Diagnosis, Differential , Humans , Male , Middle AgedABSTRACT
Mechanical circulatory support (MCS) with short-term ventricular assist devices has been used as a bridge to high-risk percutaneous coronary interventions (PCI), as well as during interventions and in the post-procedural recovery period. Percutaneous extracorporeal membrane oxygenation (ECMO) is used when full cardiopulmonary support is necessary due to severe biventricular and pulmonary dysfunction. Prompted by two cases of high-risk rotablation of heavily calcified coronary arteries where ECMO was used as a bridge to intervention and post-intervention recovery, we reviewed the bibliography and the new guidelines on cardiac revascularization with regard to the utility of MCS devices in high-risk PCI cases.
Subject(s)
Calcinosis/complications , Calcinosis/surgery , Coronary Artery Bypass/methods , Coronary Artery Disease/etiology , Coronary Artery Disease/surgery , Extracorporeal Circulation/methods , Heart-Assist Devices , Combined Modality Therapy/methods , Humans , Male , Middle Aged , Risk FactorsABSTRACT
Both the forward and inverse problems of electrocardiography rely on the precise modelling of the anatomic and electrical properties of the thoracic tissues. This, in turn, requires good knowledge of the electrical anisotropy as well as conductivity inhomogeneity of the heart, lungs and the rest of the thorax. Cardiac electrical anisotropy is related to its microstructure (fibre length, density and orientation). We hereby present detailed three-dimensional (3D) meshes of the thorax and heart, using image data from contiguous 2D magnetic resonance (MR) imaging slices as well as a realistic 3D cardiac fibre orientation model that derives its data from high-resolution ex vivo human heart MR images and from histology specimens of heart tissue. Using specific software, we integrated the 3D thorax and heart meshes in one that addresses the related modelling requirements for the solution of the forward and inverse problems of electrocardiography.
Subject(s)
Automation , Heart/anatomy & histology , Magnetic Resonance Imaging/methods , HumansABSTRACT
We report the case of a patient with Brugada syndrome and a history of palpitations who presented with an episode of syncope and developed supraventricular tachycardia in the electrophysiological study. The patient was treated with radiofrequency ablation for the supraventricular tachycardia and an implantable cardioverter defibrillator for the Brugada syndrome. At 18 months following implantation of the defibrillator an electrical storm with ventricular fibrillation episodes occurred followed by appropriate discharges of the defibrillator.
Subject(s)
Brugada Syndrome/diagnosis , Brugada Syndrome/surgery , Electrocardiography/methods , Tachycardia, Atrioventricular Nodal Reentry/diagnosis , Tachycardia, Atrioventricular Nodal Reentry/surgery , Tachycardia, Supraventricular/diagnosis , Tachycardia, Supraventricular/surgery , Adult , Humans , Male , Treatment OutcomeABSTRACT
Interleukins IL-1beta, IL-6 and TNF are increased in plasma of patients with severe infections and septic shock. Our objective was the evaluation of IL-1beta, IL-6 and TNF in plasma and exudates of pleural fluid and their contribution to the diagnosis. We studied 44 patients, 27 men and 17 women with mean age 66.81 +/- 11.75 years; 16 with pneumonia and parapneumonic effusion, 14 with primary lung cancer and pleural effusion and 14 with tuberculous pleuritis. We measured IL-1beta, IL-6 and TNF in serum and pleural fluid with ELISA. In patients with pneumonia and parapneumonic effusion the mean value of IL-1beta IL-6 and TNF in plasma was 9.05, 19.24 and 21.34 pg/ml and in pleural fluid 10.34, 32.19 and 25.30 pg/ml. In patients with lung cancer the mean values of IL-1beta, IL-6 and TNF were 5.33, 11.74 and 11.51 pg/ml and 6.70, 13.13, 20.89 pg/ml, respectively. In those with tuberculous pleuritis the respective mean values were 10.33, 49.94, 21.27 pg/ml and 14, 56.59, 23.58 pg/ml. In conclusion, IL-1beta and IL-6 were found increased in plasma and tuberculous pleural fluid, indicating an inflammatory status.