RESUMEN
The authors report the case of a 65 year old patient with focal junctional tachycardia complicating infectious myocarditis which had a fatal outcome. The ECG recordings showed episodes of tachycardia alternating with junctional rhythm at 90/min. There were signs of retrograde conduction. The anatomopathological findings were typical of acquired myocarditic lesions in the lower part of the atrioventricular node with congenital abnormalities, in particular a bifid node and His bundle with an accessory paraseptal atrioventricular bundle. This is the first description, to the best of the authors's knowledge, of junctional tachycardia associated with a latent pre-excitation.
Asunto(s)
Sistema de Conducción Cardíaco/patología , Miocarditis/complicaciones , Taquicardia Ectópica de Unión/etiología , Anciano , Estimulación Cardíaca Artificial , Electrocardiografía , Sistema de Conducción Cardíaco/anomalías , Humanos , Masculino , Miocarditis/patología , Pronóstico , Taquicardia Ectópica de Unión/patología , Taquicardia Ectópica de Unión/terapiaRESUMEN
The authors report the case of a 68-year old woman treated since 1986 with flecaïnide acetate for atrial disease. She was admitted to hospital in January 1988 for syncopes due to torsades de pointe. The QTc interval reached 0.68 s without change in QRS duration. After flecaïnide was discontinued and water and salts disorders were corrected, the QTc interval returned to normal. Prolongation of QT under flecaïnide is exceptional, and to our knowledge the occurrence of torsades de pointe has not previously been reported with this drug.
Asunto(s)
Flecainida/efectos adversos , Taquicardia/inducido químicamente , Anciano , Arritmias Cardíacas/inducido químicamente , Electrocardiografía , Femenino , HumanosRESUMEN
To assess the prevalence of asymmetric septal hypertrophy (ASH) in hypertensive patients, 613 echocardiographic examinations performed over a period of one year were reviewed. Asymmetric septal hypertrophy (defined by an echocardiographic interventricular septum to left ventricular free wall thickness ratio of greater than or equal to 1.3 and by the presence of suggestive two-dimensional echocardiographic abnormalities) was found in 28 patients (5%). Clinical characteristics of asymmetric septal hypertrophy were assessed in 101 patients who underwent a complete evaluation. Patients with asymmetric septal hypertrophy (n = 9) were compared with patients with echocardiographic symmetrical left ventricle hypertrophy (n = 38) and without left ventricular hypertrophy (n = 54). Our results indicate that neither the severity of hypertension, nor the renin-angiotensin system nor sympathetic nerve activity appear to be the primary determinants in the development of asymmetric septal hypertrophy.