ABSTRACT
In many instances the diagnosis and management of aortic stenosis (AS) is straightforward. In others; however; the diagnosis and management of AS can be extraordinary difficult. Clinicians need to be aware of the pitfalls in diagnosis and management. Diagnosis and assessment of disease severity begins with a detailed history and physical examination. Echocardiography in experienced hands is the standard investigation of choice to confirm the diagnosis and to assess its severity. While the treatment of symptomatic severe AS is surgery; asymptomatic patients with severe aortic disease and concomitant disease; like hypertension; requires an individualised approach
Subject(s)
Aged , Aortic Valve Stenosis/diagnosis , Cardiac Catheterization , Echocardiography , Signs and SymptomsABSTRACT
Pacemaker-mediated tachycardia (PMT) is an arrhythmia seen in patients implanted with dual-chamber pacemakers. It occurs when ventricular contraction is followed by retrograde conduction to the atrium; which is sensed by the pacemaker; leading to ventricular triggering. A vicious re-entry cycle is set up; leading to incessant tachycardia unless appropriately terminated. A common precipitant is a premature ventricular contraction (PVC). Although PVCs are frequently generated during ventriculography; PMT is an extremely rare event during cardiac catheterisation despite the fact that a large number of patients with implanted pacemakers do undergo the procedure. We report on a case and hope to highlight the possibility of PMT occurring during catheterisation; as well on therapeutic options
Subject(s)
Cardiac Catheterization , Case Reports , Tachycardia , Ventricular Premature ComplexesABSTRACT
De 1977 a 1988; 24 communications interauliculaires (CIA) de type ostium secundum chez l'adulte ont ete operees a l'Institut de Cardiologie d'Abidjan. Il y avait 13 hommes et 11 femmes avec un age moyen de 31;2 ans. Tous les patients etaient symptomatiques. Le rapport cardio-thoracique etait modere et severe dans 40 pour cent des cas; une fibrillation auriculaire existait dans 12;5 pour cent des cas. Le catheterisme cardiaque notait un QP/QS superieur a 2 dans 75 pour cent des cas avec une pression pulmonaire moyenne a 25 mmHg en moyenne. La fermeture par suture directe a ete realisee le plus souvent. On a deplore 3 deces (12;5 pour cent) et des troubles du rythme postoperatoire chez 7 patients (29;1 pour cent). Le suivi postoperatoire clinique; radiographique et electrique des patients met en evidence le benefice du traitement chirurgical