RESUMO
In a 45-year-old woman with syncope, an electrocardiogram revealed intermittent asymptomatic type I second degree atrioventricular block, right bundle branch block and left anterior fascicular block. An echocardiogram documented concentric left ventricular hypertrophy and right ventricular dilatation and hypokinesia. Because the patient did not have second degree atrioventricular block at the time of an electrophysiological study, the atrioventricular node, the left posterior fascicle, and the His bundle all remain potential sites for the type I second degree atrioventricular block on her initial electrocardiogram.
Assuntos
Bloqueio Atrioventricular/diagnóstico , Comunicação Interventricular/cirurgia , Bloqueio Atrioventricular/fisiopatologia , Cateterismo Cardíaco , Diagnóstico Diferencial , Ecocardiografia , Eletrocardiografia , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
A young woman, who presented with what appeared to be subacute pericarditis, was found to have primary angiosarcoma of the heart, a condition that is nearly always fatal regardless of the therapy.
Assuntos
Neoplasias Cardíacas/diagnóstico , Hemangiossarcoma/diagnóstico , Pericardite/diagnóstico , Diagnóstico Diferencial , Diagnóstico por Imagem , Eletrocardiografia , Evolução Fatal , Feminino , Neoplasias Cardíacas/patologia , Neoplasias Cardíacas/cirurgia , Hemangiossarcoma/patologia , Hemangiossarcoma/cirurgia , Humanos , Pericardite/patologia , Pericardite/cirurgia , Adulto JovemAssuntos
Dor no Peito/diagnóstico , Pericardite/diagnóstico , Taquicardia Sinusal/diagnóstico , Doença Aguda , Adulto , Anti-Inflamatórios/uso terapêutico , Dor no Peito/etiologia , Dor no Peito/patologia , Feminino , Humanos , Hipertensão/tratamento farmacológico , Lisinopril/uso terapêutico , Pericardite/complicações , Pericardite/tratamento farmacológico , Prednisona/uso terapêutico , Taquicardia Sinusal/etiologia , Taquicardia Sinusal/patologiaRESUMO
A 43-year-old man came to the hospital because of increasing dyspnea for two weeks. At age nine months the patient was evaluated for failure to thrive, and a diagnosis of valvular aortic stenosis was made. At operation the aortic stenosis was found to be supravalvular, and the ascending aorta was enlarged with a Teflon patch, the proximal end of which was placed in the noncoronary sinus of Valsalva. The aortic valve was bicuspid but otherwise appeared normal. Postoperatively the patient did well until six years ago when he developed increasing dyspnea on exertion, orthopnea, and paroxysmal nocturnal dyspnea. Echocardiography revealed a peak systolic pressure gradient across the aortic valve of 80 mmHg, severe aortic regurgitation, and moderate mitral regurgitation thought to be functional. Coronary arteriograms were normal. The patient underwent aortic valve replacement with a 23 mm Hancock 2 porcine heterograft prosthesis. He again did well postoperatively until a year before the current admission when dyspnea on exertion developed and culminated in two weeks of severe orthopnea and paroxysmal nocturnal dyspnea. The electrocardiogram (ECG) recorded on admission is shown in the Figure.