Swiss medical weekly
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In a 20 year old woman, sudden death due to hemopericardium ensued on osteosynthesis with Kirschner wire of a dislocated sternoclavicular joint. The wire moved to the aorta ascendens and to the right auricle thus causing lethal bleeding into the pericardium. ⋯ Wandering after osteosynthesis due to dislocation of the sternoclavicular joint is particularly dangerous, whereas in the case of broken clavicle, dislocation of the acromioclavicular joint, fracture of the humereus or in the region of the hips, no serious complications occur as a rule. Present-day text-books on surgery do not make sufficiently detailed reference to the wandering wire syndrome.
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Clinical cases are presented on the general theme of cardiovascular syncope. A case is cited to illustrate the clinical picture of idiopathic hypertrophic obstructive cardiomyopathy, a frequently disguised and misinterpreted cause of syncope. Chief attention is focused on the concept of fascicular heart block causing syncope. ⋯ In this context the diagnostic, prognostic and therapeutic significance of His bundle electrocardiography is discussed. Finally, 2 cases are cited to illustrate the sick sinus syndrome as a major cause of syncope. The diagnostic procedure in patients with suspected lazy sinus node is discussed and the results are presented of 16 personally observed cases with this disorder.