Acta cardiologica
-
The Brugada syndrome is an inherited cardiac disorder initially described in 1992 by Pedro and Josep Brugada, with variable electrocardiographic features characteristic of right bundle-branch block, persistent ST-segment elevation in the precordial leads (VI-V3) at rest and sudden cardiac death. The genetic abnormalities that cause Brugada syndrome have been linked to mutations in the ion channel gene SCN5A which encodes for the alpha-subunit of the cardiac sodium channel. ⋯ Two specific types of ST-segment elevation, coved and saddleback, are observed in the Brugada syndrome, the former of which is reported to relate to a higher incidence of ventricular tachycardial ventricular fibrillation (VTNF) and sudden cardiac death. The objective of this paper is to review the genetics and the molecular biology behind the Brugada syndrome, the diagnostic criteria, including clinical and electrocardiographic characteristics, and current management.
-
Case Reports
Very late drug-eluting stent thrombosis in the perioperative period of endoscopic choledocholithotomy.
Very late stent thrombosis is an uncommon but life-threatening complication after drug-eluting stent implantation in patients with coronary artery disease. Discontinuation of antiplatelet therapy is reported to be the most powerful predictor of stent thrombosis. This article reports on a case of very late stent thrombosis 54 months after implantation of a drug-eluting stent, in a patient who discontinued dual antiplatelet therapy only 11 days before endoscopic choledocholithotomy, and argues in favour of continuing aspirin therapy perioperatively in surgical patients with low bleeding risk, even if dual antiplatelet therapy has been followed more than 12 months after stent implantation.