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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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.
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Comparative Study
Vagal impairment in elderly Chagas disease patients: a population-based study (the Bambuí study).
Chagas disease (ChD) will become predominantly a disease of the elderly, as a consequence of the effectiveness of control measures in many Latin American countries. The effects of the disease in old age have received little attention. We investigated the effects of ageing in the association between cardiac vagal impairment, a typical feature of ChD, and chronic Trypanosoma cruzi infection. ⋯ Disease-specific vagal cardiac dysfunction was observed in ChD individuals below 70. However, further ageing interferes significantly with vagal heart modulation, attenuating the difference of HRV indexes between ChD and non-ChD subjects.