Cases reported "Tachycardia"

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11/14. Morphologic effects of defibrillation: a preliminary report.

    A 72-yr-old man receiving more than 300 separate DC countershocks in 2 wk exhibited morphologic heart changes, including areas of coagulation necrosis in the subepicardium and areas of frank hemorrhage. In other sites the myocytes were pathologically contracted, a finding previously demonstrated in experimental animals as a result of defibrillation but not seen in man. We suggest that these changes may occur more often than has been previously supposed and thus may be of clinical importance.
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keywords = animal
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12/14. Effect of propranolol on fetal tachycardia in diabetic pregnancy.

    propranolol was administered during the last 20 days of pregnancy to a diabetic woman because of fetal tachycardia (heart rate approximately 200 beats/min). With a daily dose of 160 mg of propranolol, a fetal heart rat of 120 to 160 beats/min could be achieved. blood concentration of propranolol was measured in the mother and infant after birth. The level in the neonatal blood was 20 percent of the maternal sample, which is definitely higher than expected from animal experiments. No undersirable effect of propranolol treatment was detected. Postpartum, the infant demonstrated paroxysmal supraventricular tachycardia, and propranolol was again essential in maintaining a normal rate.
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keywords = animal
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13/14. Should oral amiodarone be used for sustained ventricular tachycardia in patients requiring open-heart surgery?

    A patient with sustained ventricular tachycardia was operated on after an unsuccessful trial of amiodarone. Profound myocardial depression and low cardiac output became evident as he was weaned from cardiopulmonary bypass. Despite inotropic support, use of the intra-aortic balloon pump and left heart assist device, he died. Because of this experience, the authors developed a canine model to determine the effects on left ventricular function of amiodarone given orally. Left ventricular stroke work, cardiac output, ventricular contractility (maximum dP/dt) and peripheral vascular resistance were measured in 12 mongrel dogs at a heart rate of 150 beats/min and at a constant preload of 10 mm Hg. Six animals received the drug orally and the remaining animals were used as sham-operated controls. Maximum dP/dt decreased from 2855 mm Hg/s to 1291 mm Hg/s (p less than 0.01) and left ventricular stroke work was reduced from 48.7 g-m/beat to 21.8 g-m/beat (p less than 0.05) after the administration of amiodarone. cardiac output and peripheral vascular resistance did not differ significantly. amiodarone severely depressed left ventricular function in this experiment. The prolonged half-life of this antiarrhythmic combined with its adverse effect on myocardial function suggests that it should not be used in patients with refractory life-threatening ventricular tachycardia who are good candidates for electrophysiologic evaluation and endocardial resection.
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keywords = animal
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14/14. bradycardia in toluene poisoning.

    BACKGROUND: Tachyarrhythmias are the classical manifestation of toluene cardiotoxicity. The presumed mechanism is sensitization of the myocardium to the potential arrhythmogenic effect of endogenous catecholamines, occasionally resulting in fatality. Bradyarrhythmias have been repeatedly shown in animal models, but have been reported only once in a human. case reports: Two patients with toluene intoxication presented with severe sinus bradycardia. One patient had also atrial-ventricular dissociation. In both cases cardiac rhythm returned to normal within several hours. CONCLUSION: We suggest that the spectrum of cardiotoxic symptoms associated with toluene intoxication in humans includes bradyarrhythmias as well as tachyarryhthmias.
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keywords = animal
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