Kardiol Pol
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The authors describe a case of 44-year-old woman with severe cardiac failure due to chronic hypocalcemia caused by primary hypoparathyroidism with coexisting Fahr's disease. This type of cardiomyopathy was refractory to conventional therapy. Spectacular clinical improvement and normalisation of echocardiographic left ventricular parameters were observed following supplementation with calcium and alphacalcidol. The effects of calcium ions and parathyroid hormone on myocardial contractility, ECG changes and serum CK activity are discussed.
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A degree of reduction of heart rate (HR) and blood pressure (BP) values following beta-blocker administration has been shown to indicate beta-blockade effectiveness. Whether this parameter is also useful in the identification of patients with vaso-vagal syncope (VVS) who could benefit from beta-blocker therapy, has not yet been established. ⋯ Propranolol-induced changes in blood pressure values may predict the effectiveness of beta-blockade in preventing syncope during second TT performed after intravenous infusion of propranolol. A drug-induced reduction in systolic blood pressure of less than 5 mmHg may identify those who will benefit from beta-blocker therapy.