Clinical cardiology
-
Clinical cardiology · Jul 1993
Case ReportsAnomalous inferior vena cava mimicking aortic dissection on transesophageal echocardiography.
Transesophageal echocardiography (TEE) is considered an excellent method for the diagnosis of aortic dissection, especially that involving the descending aorta. It has also proved useful in the evaluation of conditions mimicking aortic dissection, usually disclosing in these situations other types of severe aortic disease. We are not aware of any report dealing with venous abnormalities which presented diagnostic problems in a patient evaluated with TEE because of a suspected aortic dissection.
-
Clinical cardiology · Jun 1993
Case ReportsHypothyroid cardiac tamponade presenting with severe systemic hypertension.
Hemodynamic data are presented which not only depict typical tamponade physiology, but demonstrate that hypotension may not necessarily be present with slow accumulation of pericardial fluid in myxedema patients. This case is unique in that severe hypertension, as part of the presentation of hypothyroid tamponade, has never been reported.
-
Clinical cardiology · Jun 1993
Case ReportsStress-induced polymorphous ventricular tachyarrhythmias in two brothers: unusual pattern of inheritance in the long QT syndrome.
Two brothers, 10 and 9 years old, are reported who were treated for years with antiepileptic drugs until the cardiac origin of their syncopal attacks was discovered. Our findings are consistent with the diagnosis of long QT syndrome, although no other family members are affected and only intermittent and mostly borderline QT prolongation could be found. Diagnostic difficulties and genetic implications are discussed.
-
Clinical cardiology · Feb 1993
Randomized Controlled Trial Multicenter Study Clinical TrialVentricular arrhythmias in patients recovering from myocardial infarction: do residual myocardial ischemia and anti-ischemic medical intervention influence the one-month prevalence? The Danish Study Group on Verapamil in Myocardial Infarction.
The relationship between myocardial ischemia revealed by exercise testing and ventricular arrhythmias on Holter monitoring, and the effect of anti-ischemic intervention on the incidence of ventricular arrhythmias in patients with residual ischemia were studied in 125 patients recovering from myocardial infarction. Prior to discharge exercise testing and 24-h Holter monitoring were carried out. In patients with ST-segment depression (n = 34), ventricular arrhythmias on Holter monitoring were seen in 7 (21%) compared with 20 (22%) patients without ST-segment depression (NS). ⋯ A significantly increased prevalence of ventricular arrhythmias was found in patients with either heart failure or non-Q-wave infarct. In these patients myocardial ischemia during exercise did not correlate with ventricular arrhythmias either. ST-segment depression during pre-discharge exercise testing correlated with neither the prevalence nor the incidence of ventricular arrhythmias, and anti-ischemic intervention with verapamil did not influence the incidence of ventricular arrhythmias in both patients with and without myocardial ischemia.