Archivos de cardiología de México
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We report the case of a 21 year-old patient with arrhythmogenic right ventricular dysplasia manifested by episodes of QRS tachycardia greater than 0.12 sec and isolated dysfunction of the right ventricle. The patient treated with amiodarone however, the tachycardia episodes persisted. The surface electrocardiogram showed left branch block with the axis down, which suggested a right ventricle origin, and was therefore considered an arrhythmogenic dysplasia. ⋯ An electrophysiology study was performed, stimulating the outflow tract of the right ventricle, which induced two types of ventricular tachycardias, one of them identical to that recorded clinical. The patient was treated with sotalol, and has been being free of ventricular tachycardia episodes for 18 months of follow-up. We consider that this entity should be studied in a systematic way in those patients with ventricular tachycardia originated in the outflow of the right ventricle and with primary cardiac illness.
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The authors present the case of a 26 years old female, 56 kg weight and 154 cm height, with a giant patent ductus arteriosus (2.4 cm of internal diameter), ventricular septal defect, discrete preductal narrowing of the aortic arch and pulmonary artery hypertension that did not diminished after 100% oxygen breathing. The authors speculate about the origin of the giant ductus here presented, based on hemodynamic and embryological data.
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Definite data in heart surgery with extracorporeal circulation during pregnancy is limited. This report analyzes our experience in this area. ⋯ Because of the fetal risks, open heart surgery during pregnancy should be advised only in extreme emergencies. Although pregnancy per se does not increase the maternal risk, a high maternal mortality results from the emergency nature of the surgical intervention. Fetal mortality remains high.