RESUMO
Severe QT interval prolongation >500ms occurs in one quarter of cardiac surgical patients in the perioperative period while moderate prolongation occurs in most of them. Prolonged QT interval may be associated with torsades de pointes and lead to sudden cardiac death. Because of the high incidence of prolonged QT in cardiac surgery patients and its perioperative adverse outcomes, it is vital to identify it early and take necessary precautions. We report and discuss the catastrophic events and management of two patients with long QT syndrome complicating mitral valve replacement.
Assuntos
Eletrocardiografia , Sistema de Condução Cardíaco/fisiopatologia , Doenças das Valvas Cardíacas/cirurgia , Implante de Prótese de Valva Cardíaca/efeitos adversos , Síndrome do QT Longo/etiologia , Valva Mitral/cirurgia , Torsades de Pointes/etiologia , Idoso , Humanos , Síndrome do QT Longo/fisiopatologia , Masculino , Complicações Pós-Operatórias , Torsades de Pointes/fisiopatologiaRESUMO
Focal atrial tachycardias (AT) in the right atrium (RA) tend to cluster around the crista terminalis, coronary sinus (CS) region, tricuspid annulus, and para-hisian region. In most cases, the AT focus can be identified by careful activation mapping, and completely eliminated by radiofrequency (RF) catheter ablation. However, RF ablation near the His bundle (HB) carries a risk of inadvertent damage to the atrioventricular (AV) conduction system. Here we describe a patient with an AT originating in the vicinity of the AV node, which was successfully ablated earlier from non-coronary aortic cusp (NCC), and recurred with an exit from para-hisian location. Respiratory excursions of the catheter were associated with migration to the area of HIs. This was successfully ablated during controlled apnoea, using 3D electroanatomic mapping.
Assuntos
Fascículo Atrioventricular/fisiopatologia , Ablação por Cateter , Taquicardia Supraventricular/fisiopatologia , Taquicardia Supraventricular/cirurgia , Eletrocardiografia , Feminino , Humanos , Pessoa de Meia-IdadeAssuntos
Bloqueio Atrioventricular/complicações , Bloqueio Atrioventricular/diagnóstico , Eletrocardiografia/métodos , Taquicardia por Reentrada no Nó Atrioventricular/complicações , Taquicardia por Reentrada no Nó Atrioventricular/diagnóstico , Adulto , Bloqueio Atrioventricular/cirurgia , Feminino , Humanos , Taquicardia por Reentrada no Nó Atrioventricular/cirurgia , Resultado do TratamentoRESUMO
We report on a case of triple-vessel coronary artery ectasia (CAE) in a young patient. This patient presented with anterior wall myocardial infarction (MI) with post-infarct angina. His coronary angiogram revealed coronary artery ectasia involving the left anterior descending, circumflex and right coronary arteries.
Assuntos
Infarto Miocárdico de Parede Anterior/etiologia , Aneurisma Coronário/etiologia , Síndrome de Linfonodos Mucocutâneos/complicações , Adulto , Aneurisma Coronário/diagnóstico por imagem , Aneurisma Coronário/patologia , Angiografia Coronária , Dilatação Patológica , Humanos , Masculino , Síndrome de Linfonodos Mucocutâneos/diagnóstico por imagem , Síndrome de Linfonodos Mucocutâneos/patologia , Índice de Gravidade de DoençaRESUMO
We report on a case of idiopathic dilated cardiomyopathy with aortic aneurysm involving the aortic root and thoraco-abdominal aorta. This patient presented with exertional chest pain and backache radiating to both the upper limbs. His echocardiogram revealed dilated cardiomyopathy with mild to moderate aortic regurgitation and a hugely dilated aortic root. His angiogram showed normal coronary arteries, a dilated aortic root and thoraco-abdominal aortic aneurysm.