RESUMEN
Spinal tuberculosis leading to paraplegia is uncommon in pregnancy and is a diagnostic and therapeutic challenge. We report a case of tubercular paraplegia presenting at 35 weeks of gestation. She was managed with Anti-tubercular drugs and did not require surgical intervention. Her neurological status improved and she was allowed to go in labour. She delivered a healthy term infant by cesarean. At three months follow-up, both mother and child are doing well.
Asunto(s)
Paraplejía/diagnóstico , Complicaciones Infecciosas del Embarazo/diagnóstico por imagen , Tuberculosis de la Columna Vertebral/diagnóstico por imagen , Adulto , Antituberculosos/uso terapéutico , Femenino , Humanos , Paraplejía/etiología , Embarazo , Complicaciones Infecciosas del Embarazo/tratamiento farmacológico , Tercer Trimestre del Embarazo , Tuberculosis de la Columna Vertebral/complicaciones , Tuberculosis de la Columna Vertebral/tratamiento farmacológicoRESUMEN
A 46-year-old woman presented with three episodes of presyncope in the previous two days. Electrocardiogram (ECG) showed sinus rhythm, relatively short QT interval (QTc of 340 msec) and prominent J-waves in the inferior leads. Biochemical evaluation revealed serum calcium of 17.4 mg/dL, phosphorus of 2.3 mg/dL and alkaline phosphatase of 533 IU/ml. She was managed with saline diuresis followed by elective parathyroidectomy. ECG became normal with the disappearance of J-waves after correction of hypercalcaemia. She was asymptomatic at six months of follow-up. The presence of J-waves (Osborne waves) in hypercalcaemia has rarely been reported.
Asunto(s)
Electrocardiografía , Hipercalcemia/diagnóstico , Hiperparatiroidismo Primario/diagnóstico , Síncope/etiología , Femenino , Mano/diagnóstico por imagen , Humanos , Hipercalcemia/complicaciones , Hipercalcemia/etiología , Hiperparatiroidismo Primario/complicaciones , Persona de Mediana Edad , Radiografía , Cráneo/diagnóstico por imagenRESUMEN
Adenosine, used to terminate paroxysmal supraventricular tachycardia (SVT), is often useful in understanding the mechanism of tachycardia. This case report describes induction of SVT with adenosine in a 36-year-old man presenting with recurrent palpitations. After a short run of conduction via both slow and fast pathways, SVT was induced following a long PR interval. The long PR interval resulted by conduction via the slow pathway due to the preferential conduction block by adenosine over fast pathway. The notching at the terminal part of QRS during antegrade slow pathway conduction and during tachycardia indicated activation of the atrium via retrograde fast pathway. This electrocardiographical feature confirmed the mechanism of the tachycardia as atrioventricular nodal reentrant tachycardia.
Asunto(s)
Adenosina , Antiarrítmicos , Técnicas Electrofisiológicas Cardíacas , Taquicardia por Reentrada en el Nodo Atrioventricular/diagnóstico , Adulto , Electrocardiografía , Humanos , MasculinoRESUMEN
The coexistence of rheumatic mitral stenosis, Ebstein's anomaly and Wolff-Parkinson-White syndrome is an uncommon entity. To our knowledge, the successful management of this combination of lesions has not been previously described. We report a 23-year-old woman with the combination of these abnormalities. She was managed with preoperative electrophysiological study, followed by mitral valve replacement and Danielson's repair of tricuspid valve. The management issues involved are discussed in detail.