International journal of cardiology
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Letter Case Reports
Instantaneous electrocardiographic changes and transient sinus rhythm restoration in severe hyperkalaemia.
Severe hyperkalaemia is a life threatening electrolyte abnormality that if not treated urgently, might cause electric death. Hyperkalaemia induced electrocardiogram (ECG) alterations vary according to the levels and rate of increase of potassium concentration ([K(+)]) in the extracellular milieu but the paradox is that not all these cases provide ECG changes. We describe the first case in the literature of transient sinus rhythm (SR) recovery despite severe hyperkalaemia in a 57-year-old (yo) male patient with impressive ECG changes considering the heart rhythm and QRS morphology. We also review the literature for the mechanism of ECG alterations induced by hyperkalaemia.
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Letter Case Reports
Stroke and Takotsubo cardiomyopathy: is there more than just cause and effect?
Takotsubo cardiomyopathy has been described as a consequence of stroke or a cardioembolic source of stroke. We present the case of a 43 year-old woman who suffered from Takotsubo cardiomyopathy and subsequently developed a large left cerebellar infarct without significant neurological deficits nor evidence of a cardioembolic cause. Catecholamine excess has been postulated to cause myocardial stunning in Takotsubo cardiomyopathy and some cases of cerebral ischaemia. In this case, the concurrent occurrence of Takotsubo cardiomyopathy and stroke without an identifiable source suggests that there may be a possible unifying pathogenetic mechanism.
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Comparative Study
Long-term prognosis in stable angina; medical treatment or coronary revascularization in patients younger than 70 years?
Literature on the appropriateness of coronary revascularization in chronic angina is still scanty. The study aimed to compare long-term effects of revascularization with those of medical therapy in stable angina. ⋯ In low-risk chronic angina coronary revascularization does not improve long-term prognosis unless inducible myocardial ischemia is present. This suggests considering coronary revascularization as an effective tool in treating coronary artery disease only when myocardial ischemia has been documented.