Rev Esp Cardiol
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Cardiac contusion may cause disorders of impulse formation and propagation in the specific conduction system. Transient complete atrioventricular block following a nonpenetrating chest trauma is a rare complication. We describe the case of a patient who presented a transient complete atrioventricular block, and later a transient right bundle branch block and a left anterior hemiblock, following a nonpenetrating chest trauma due to a car accident. The difficulty for diagnosing myocardial contusion is pointed out, and the usefulness of the electrophysiological study for detecting baseline conduction system disorders is discussed.
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Case Reports
[Transesophageal echocardiographic diagnosis of a ruptured sinus of valsalva aneurysm with right atrium fistula].
Congenital aneurysms of the sinus of Valsalva are relatively rare, tending to be most frequent in adults. Untreated, there is a substantial risk of complication due to bacterial endocarditis and, if rupture occurs, rapid and progressive cardiac insufficiency is fatal at short term. ⋯ Catheterization and angiography were not definitive. Echocardiographic data are described and a bibliography of relevant research articles is provided.
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Morbidity and mortality in elective valve surgery is still significant. The main cause of death in these patients is cardiogenic shock, of which the most frequent etiology is acute myocardial infarction (AMI) with Q wave in the ECG. However, there are patients with cardiogenic shock without Q wave in the ECG and with rises in CK-MB enzyme that makes us suspect non-Q wave AMI. ⋯ This study suggest the possibility of in vivo identification of non-Q wave perioperative AMI, an entity with important morbidity and mortality in our series, with a simple determination of cardiac troponin I 14 hours after surgery.