A Case of Acute Myocardial Infraction in Patients with Dextrocardia with Situs Inversus Treated by Percutaneous Translumnal Coronary Angioplasty

Dextrocardia with situs inversus is a rare congenital anomaly of development involving a left-handed malrotation of the visceral organs which affects approximately 1:10,000 patients. It is known that the prevalence of coronary atherosclerosis in patients with dextrocardia is similar to that of the general population. Successful coronary angiography and coronary angioplasty have previously been reported in patients with dextrocardia, but to our knowledge no report exist of a successful coronary angioplasty in a patient with dextrocardia with situs inversus in Korea. We performed a successful percutaneous transluminal coronary angioplasty of an infarct-related vessel in a acute myocardial infarction patient with dextrocardia with situs inversus.

A Case of Incessant Ventricular Tachycardia Abolished after Endomyocardial Biopsy

Ventricular tachycardia is an important tachyarrhythmia which is encountered commonly in clinical field. The accompanying manifestations could be variable just from palpitation to sudden cardiac death. The classification of this arrhythmia has not completly settled yet, but in a broad way this arrhythmia is classified according to the prescence or abscence or underlying heart disease, especially coronary artery disease. Recently, therapeutic modalities for this arrhythmia have been changed a lot from classical antiarrhythmic drugs to radiofrequency ablation or ICD implantation although there are still some problems to overcome. We experienced a case of 34-year-old female having an incessant ventricular tacycardia which was abolished after endomyocardial biopsy performed to differentiate underlying myocardial pathology.

Transesophageal Atrial Pacing in Atrial Flutter

Atrial flutter, a common rhythm disturbance, was first described over 80 years ago. Despite extensive investigations, several important issues remain unresolved concerning its exact mechanism and management. Present therapeutic strategies often appear effective to prevent and terminate atrial flutter. However, controlled trial and definitive studies comparing the various treatment options are surprisingly scarce. Here we report on a study of 9 episodes of spontaneous atrial flutter(AF)(flutter wave cycle length 224+/-39 msec) treatedd by transesophageal atrial pacing(TAP) in 9 patients(7 men and 2 women; mean age 56.9 yrs). TAP was effective in 5 patients : sinus rhythm resumption was immediate in 3 patients and followed a short period of atrial fibrillation in 2 patients. TAP was unsuccessful in 4 patients. All the patients tolerated the procedure well. These data strongly support the immediate first choice use of TAP in AF therapy.

A Primary Cardiac Angiosarcoma

Primary tumors of the heart are rare and the most are benign. Malignant tumors constitute less than 25% of primary cardiac tumors and angiosarcomas are the most commonly reported histologic type. At least 160 cases have been reported in the world, but no previous report in Korea. We reported a case of primary cardiac angiosarcoma located in right atrium.