Cases reported "Tachycardia"

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1/99. Incessant automatic atrial tachycardia: a reversible cause of tachycardiomyopathy.

    We describe the case of a 23-year-old man with incessant atrial tachycardia complicated with tachycardiomyopathy. Transseptal ablation of the arrhythmia focus, located between the ostia of the left and right inferior vena pulmonalis, resulted in a restoration of normal sinus rhythm and a complete regression of the signs of tachycardiomyopathy.
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ranking = 1
keywords = cardiomyopathy
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2/99. DDD-pacing-induced cardiomyopathy following AV node ablation for persistent atrial tachycardia.

    Ventricular rate control by catheter ablation of the AV node and pacing in patients with persistent atrial tachycardia has been reported to improve left ventricular function. However, this approach requires careful selection of the pacing mode. We report a patient who underwent AV node ablation for persistent multiple atrial tachycardias, and who then had a non-mode-switching pacemaker implanted. Because of an inappropriately programmed relatively high upper rate limit, the patient developed left ventricular dysfunction after 6 years. This resolved after programming the pacemaker to VVI at 70 bpm.
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ranking = 0.66666666666667
keywords = cardiomyopathy
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3/99. Radiofrequency ablation of focal atrial tachycardia and atrioatrial conduction from recipient to donor after orthotopic heart transplantation.

    After cardiac transplantation, atrial arrhythmias may develop in the residual recipient atrium and conduct to the donor heart. Radiofrequency (RF) ablation of the atrioatrial conduction may be effective in arrhythmia control, although the recipient atrium continues its tachycardia. We hypothesize that in patients with posttransplant atrial tachycardia, it is possible to ablate both the arrhythmogenic focus in the recipient atrium and the atrioatrial conduction. A 47-year-old patient who had orthotopic heart transplantation 9 months earlier underwent RF ablation procedure because of medically uncontrolled atrial arrhythmia. By conventional electrophysiologic mapping, we localized the focus of the atrial tachycardia in the recipient atrium and the electrical atrioatrial connection across the anastomotic suture line. Selective applications of RF energy eliminated both targets successfully. RF ablation of recipient atrial tachycardia and atrioatrial conduction from recipient to donor may lead to long-term success of arrhythmia control.
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ranking = 37.180847879673
keywords = arrhythmogenic
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4/99. tachycardia-induced cardiomyopathy secondary to thyrotoxicosis: a young man with previously unrecognized Graves' disease.

    A young man with previously unrecognized Graves' disease presented with atrial fibrillation and severe low-output heart failure due to dilated cardiomyopathy. The patient's cardiomyopathy resolved and cardiac function recovered shortly after hyperthyroidism and tachycardia were treated during hospitalization. The temporal relationship between heart rate and cardiac function during the recovery period suggests that chronic tachycardia may have been an important cause of his cardiac dysfunction. thyrotoxicosis seemed to be directly responsible for the development of sustained supraventricular tachycardia in this patient, which then led to tachycardia-induced cardiomyopathy causing severe low-output heart failure. Although relatively infrequent, this etiology should not be overlooked in patients thyrotoxicosis and heart failure. This is the first case in which the time course and the temporal relationship between the control of heart rate and the recovery of cardiac function are illustrated in a thyrotoxic patient.
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ranking = 1.1666666666667
keywords = cardiomyopathy
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5/99. pheochromocytoma presenting after cardiac transplantation for dilated cardiomyopathy.

    pheochromocytoma may present with a clinical picture indistinguishable from that of idiopathic dilated cardiomyopathy. We report 2 such patients who underwent cardiac transplantation following which we diagnosed and successfully treated pheochromocytoma.
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ranking = 0.83333333333333
keywords = cardiomyopathy
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6/99. Effect of chronic beta-adrenergic receptor blockade in congestive cardiomyopathy.

    Adrenergic beta-blocking agents were given to 7 patients with advanced congestive cardiomyopathy who had tachycardia at rest (98 plus or minus 13 beats/min). The patients were on beta-adrenergic receptor blockade for 2 to 12 months (average 5-4 months). One patient was given alprenolol 50 mg twice daily and the other patients were given practolol 50 to 400 mg twice daily. Virus infection had occurred in 6 of the patients before the onset of symptoms of cardiac disease. All patients were in a steady state or were progressively deteriorating at the start of beta-adrenergic receptor blockade. Conventional treatment with digitalis and diuretics was unaltered or reduced during treatment with beta-blocking agents. An improvement was seen in their clinical condition shortly after administration of the drugs. Continued treatment resulted in an increase in physical working capacity and a reduction of heart size. Noninvasive investigations including phonocardiogram, carotid pulse curve, apex cardiogram, and echocardiogram showed improved ventricular function in all cases. The present study indicates that adrenergic beta-blocking agents can improve heart function in at lease some patients with congestive cardiomyopathy. Furthermore, it is suggested that increased catecholamine activity may be an important factor for the development of this disease, as has been shown in animal experiments.
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ranking = 1
keywords = cardiomyopathy
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7/99. Peripartum cardiomyopathy and thromboembolism; anesthetic management and clinical course of an obese, diabetic patient.

    PURPOSE: To describe the anesthetic management and clinical course of a patient with peripartum cardiomyopathy. We highlight the frequent occurrence of thromboembolic morbidity in this group of parturients, emphasizing the need for early consideration of prophylactic anticoagulation. Clinical features: A 38-yr-old, diabetic, obese parturient was admitted with pulmonary edema and severe orthopnea at 31 weeks gestation. The respiratory rate was 44 breaths x min(-1), blood pressure 110/70 mmHg, pulse 120 beats x min(-1) and rales were heard in both lung fields. The diagnosis of peripartum cardiomyopathy was made based on sinus tachycardia with no evidence of ischemia on the electrocardiogram, and global left ventricular hypokinesis with an ejection fraction of 40-45% noted on transthoracic echocardiography. Cesarean delivery was planned to improve maternal respiratory status and hemodynamics. General anesthesia with invasive monitoring was planned, and surgery and anesthesia proceeded uneventfully. Less than 24 hr postoperatively, she sustained a thrombotic cerebral infarct leaving her hemiparetic and dysarthric. Subsequent investigations revealed a thrombophilic state due to elevated anticardiolipin antibody. CONCLUSION: General anesthesia is an acceptable option in parturients with heart failure secondary to cardiomyopathy. Thromboembolic complications are common, and early consideration should be given to prophylactic anticoagulation.
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ranking = 1.1666666666667
keywords = cardiomyopathy
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8/99. Compound heterozygosity for mutations (W156X and R225W) in SCN5A associated with severe cardiac conduction disturbances and degenerative changes in the conduction system.

    Cardiac conduction defects associate with mutations in SCN5A, the gene encoding the cardiac Na channel. In the present study, we characterized a family in which the proband was born in severe distress with irregular wide complex tachycardia. His older sister died at 1 year of age from severe conduction disease with similarly widened QRS-complexes. Mutational analysis of SCN5A in the proband demonstrated compound heterozygosity for a nonsense mutation (W156X), inherited from the father, and a missense mutation (R225W), inherited from the mother. Genotyping on dna extracted from tissue from the deceased sibling revealed the same SCN5A genotype. Injection of cRNA encoding the W156X mutation in xenopus oocytes did not produce any current. The R225W substitution neutralizes the third Arg residue within the voltage-sensing segment of domain I. Expression studies showed that this mutation leads to a severe reduction in I(Na) and is also associated with gating changes. Histological examination of the heart from the deceased sibling revealed changes consistent with a dilated type of cardiomyopathy and severe degenerative abnormalities of the specialized conduction system. The occurrence of compound heterozygosity for these two mutations implies that the proband carries solely severely dysfunctional cardiac Na channels. This explains his severe phenotype and that of his deceased sister who had been a carrier of the same genotype. The morphological changes within the heart of the deceased sibling may have occurred secondary to the Na channel abnormality and contributed to the severity of the disorder in this individual.
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ranking = 0.16666666666667
keywords = cardiomyopathy
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9/99. tachycardia's toll: tachycardia induced cardiomyopathy--a case study.

    Cardiac arrhythmias are a well known cause of mortality for patients with heart disease. However, sinus tachycardia is a more unusual arrhythmia which can lead to serious heart damage or death. Even young patients with structurally normal hearts may become gravely ill. This case study outlines the condition of sinus tachycardia, and associated changes in heart function, altered cellular structure of the myocardium and compensatory mechanisms in the body. Treatment modalities, including electro-physiological studies and drug therapies to moderate the tachycardia and myocardial oxygen demand of the heart, are discussed. Fourteen year old 'Ben' was previously a well, active and outgoing youth who suddenly became critically ill. He endured weeks of hospitalisation, numerous serious complications including Torsade de pointes arrhythmia, Cheyne-Stokes respirations, nausea and dizziness during this acute phase. Despite challenges, Ben's severely compromised heart muscle recovered at a remarkable rate.
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ranking = 0.66666666666667
keywords = cardiomyopathy
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10/99. Hypertrophic non-obstructive cardiomyopathy caused by disorder of the myofiber texture.

    A case of hypertrophic non-obstructive cardiomyopathy caused by a disorder of the myofiber texture was observed in a 10 year old boy. The heart weighed 390 g and showed concentric hypertrophy of the left and right ventricles as well as of the ventricular septum. Additional findings consisted in an abnormal septum membranaceum and a accessory tricuspid valve leaflet. Severe cardiac hypertrophy was associated with prominent interstitial and subendocardial fibrosis, and pronounced intimal fibrosis of the intramural arteries. Electron microscopy revealed various degrees and stages of hypertrophy of the myocardial cells combined with severe degenerative changes. Additional changes of the sinus node and conduction system were responsible for a tachycardia-bradycardia syndrome, complete left bundle branch block and final total AV-block.
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ranking = 0.83333333333333
keywords = cardiomyopathy
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