Kardiol Pol
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Mortality in acute myocardial infarction (MI) complicated by cardiogenic shock approaches 90%, regardless of the type of pharmacological treatment. ⋯ Invasive treatment of patients with STEMI complicated by cardiogenic shock significantly reduces mortality in this high-risk population. The mid-term results in patients discharged from hospital are good. Invasive treatment of acute MI should be accessible for all patients with extensive acute MI.
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Case Reports
[Intracranial hemorrhage complicated by recurrent polymorphic ventricular torsade de pointes tachycardia].
We present a case of a 65-year-old female admitted to the hospital due to severe intracranial hemorrhagia complicated by recurrences of polymorphic ventricular tachycardia of torsade de pointes type. ECG showed a marked prolongation of QT interval and giant U waves. ⋯ Intravenous lidocaine and magnesium caused a complete supression of arrhythmia. Unfortunately, the patient died three days later due to cerebral damage and respiratory failure.
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Gated single photon emission tomography (SPET) may simultaneously assess perfusion and function of the myocardium. ⋯ The post-stress LVEF with gated SPET may not reflect true resting measurements. The qualitative assessment of regional wall motion reversibility shows better correlation with the ischaemic scan pattern than the difference in the LVEF and may be helpful in assessing the significance of reversible myocardial ischaemia.
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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.