RESUMO
A 57-year-old man with diabetes mellitus, systemic arterial hypertension, and end-stage kidney disease came to the hospital because his arteriovenous fistula used for hemodialysis had clotted. His blood hemoglobin level was 12.8 g/dL (reference, 13.5-17.5); and serum chemistry levels were creatinine 6.7 mg/dL (0.7-1.3), sodium 132 mEq/L (136-146), potassium 4.0 mEq/L (3.5-5.1), chloride 94 mEq/L (98-106), carbon dioxide 24 mEQ/L (23-29), calcium 9.1 mg/dL (8.4-10.2), and phosphorus 9.1 mg/dL (2.7-4.5). An electrocardiogram was recorded (Figure 1).
Assuntos
Complexos Atriais Prematuros/diagnóstico , Obstrução do Cateter , Diálise Renal/efeitos adversos , Trombose/complicações , Dispositivos de Acesso Vascular/efeitos adversos , Complexos Atriais Prematuros/etiologia , Seguimentos , Humanos , Falência Renal Crônica/diagnóstico , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Remissão Espontânea , Diálise Renal/métodos , Trombose/fisiopatologiaRESUMO
A man with a history of drug abuse was found down at home and was asystolic. Following restoration of sinus rhythm, a hypothermia protocol brought his temperature to 32.5°C (90.5°F), and large Osborn waves appeared on his electrocardiogram. With rewarming the electrocardiographic signs of hypothermia diminished. Due to hypoxic brain injury during the arrest, the patient remained unresponsive and died on the fourth hospital day.
Assuntos
Reanimação Cardiopulmonar/métodos , Eletrocardiografia/métodos , Parada Cardíaca/fisiopatologia , Frequência Cardíaca/fisiologia , Hipotermia Induzida/métodos , Adulto , Parada Cardíaca/terapia , Humanos , MasculinoRESUMO
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
Severe hypokalemia in the absence of other electrolyte abnormalities, the result of diarrhea, caused striking electrocardiographic changes, generalized weakness, flaccid paralysis of the lower extremities, and biochemical evidence of mild skeletal and cardiac rhabdomyolysis in a 33-year-old man. Repletion of potassium reversed all abnormalities in 24 hours.
Assuntos
Eletrocardiografia , Hipopotassemia/complicações , Paralisia/etiologia , Potássio/sangue , Adulto , Diagnóstico Diferencial , Humanos , Hipopotassemia/sangue , Hipopotassemia/fisiopatologia , Extremidade Inferior , Masculino , Paralisia/sangue , Paralisia/diagnóstico , Levantamento de PesoRESUMO
The last issue of the Journal contains a continuing medical education article on reperfusion therapy in acute ST-segment elevation myocardial infarction (STEMI), and this article completes the sequence by discussing other aspects of the management of acute STEMI.