Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Feb 1992
Case Reports[The echocardiographic demonstration of a right atrial thrombus and its embolization into the lung].
A 43-year-old man was hospitalized because of extensive bilateral pulmonary tuberculosis. After several weeks of tuberculostatic treatment--at first applied orally, then because of nausea and vomiting parenterally via a central venous catheter--he acutely developed nocturnal dyspnoea and symptoms of shock requiring artificial ventilation. ⋯ Despite anticoagulation and immediate operation the patient died 2 days later of protracted shock. The thrombus was found to have been formed in the superior vena cava after placement of the central venous catheter.
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Dtsch. Med. Wochenschr. · Jan 1992
Case Reports[Transient complete AV block as a sequela of Borrelia myocarditis].
A 49-year-old man suddenly developed dyspnoea, sweating, fever (up to 38.5 degrees C), vertigo and angina. After emergency admittance to hospital the ECG showed 3 degrees A-V block, requiring temporary pacemaker insertion. The patient reported that a month before he had been bitten, probably by a tick. ⋯ This suggested Borrelia infection as the cause of the complete A-V block. Under treatment with broad-spectrum antibiotics for 15 days the fever subsided and the ECG became normal. Shortly before discharge, an elevated pulmonary wedge pressure on 150 W exercise indicated persistence of mild left-ventricular failure.
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Dtsch. Med. Wochenschr. · Jan 1992
Case Reports[Successful multiple resuscitation in flecainide poisoning].
After a family quarrel a 37-year-old woman swallowed, with suicidal intent, a large number of flecainide tablets (exact amount unknown) together with alcohol. On admission to hospital some hours later her pupils were fully dilated, fixed and of irregular outline; she was unconscious and in cardiorespiratory failure. Nine hours after admission several episodes of ventricular fibrillation and asystole occurred, two of them lasting for 2 and 3 hours, respectively, before successful resuscitation (after defibrillation). ⋯ The tachyarrhythmias, at times torsades de pointes, were successfully treated with high doses of lidocaine (4 g daily) after repeated defibrillations. As a late complication the patient went into acute left ventricular failure with pulmonary edema and pneumonia. There were no recognizable permanent sequelae on discharge 37 days after admission.