RESUMO
A case of patent foramen ovale opening was observed concomitantly to a defibrillation threshold determination in the setting of an internal cardioverter defibrillator implantation. The subsequent transient right-to-left shunt was confirmed by a peroperative transoesophageal echocontrast study. The underlying mechanism of this incident may be related to a transient reversal of the interatrial gradient, due to the pre-existence of pulmonary hypertension and tricuspid regurgitation, associated with ongoing mechanical ventilation and modifications of intracardiac pressures regimen secondary to the succeeding ventricular tachyarrhythmia and defibrillation. Paradoxical embolism can be an aetiology for neurologic injury during internal cardioverter defibrillator implantation.
Assuntos
Desfibriladores Implantáveis/efeitos adversos , Comunicação Interatrial/complicações , Taquicardia Ventricular/complicações , Taquicardia Ventricular/terapia , Intervalo Livre de Doença , Ecocardiografia Transesofagiana , Seguimentos , Comunicação Interatrial/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco , Taquicardia Ventricular/diagnóstico por imagem , Resultado do TratamentoRESUMO
A case of acute poisoning by oral ingestion of fenthion is reported. The different clinical signs, especially the delayed and prolonged symptomatology, are described. The various types of therapeutic measures (gastric lavage with charcoal, administration of atropine, Toxogonine, lyophilized human cholinesterase, and fresh plasma and exchange transfusion) are discussed. Correlation studies between clinical signs and plasma and erythrocyte cholinesterase activities are presented together with plasma fenthion levels and the anticholinesterase capacity of the patient's plasmas.