Persistent junctional reciprocating tachycardia [PJRT]

Persistent Junctional reciprocating tachycardia [PJRT] is an arrhythmia mostly seen in infants and children, but is reported in the older age group as well. It is an easy diagnosis with [awareness of the mind]. Once confirmed by electro-physiological study, the management is simplified. Radiofrequency ablation of the accessory pathway gives complete cure in almost all cases, especially so, for those with the persistent form. The tachycardia when untreated could induce the so called Tachycardia Induced Cardiomyopathy [TIC] which is reversible. We report the case of a 64-year-old lady with spontaneously relapsing and remitting PJRT which remained undiagnosed. Ultimately, a complete cure was achieved with the help of electro-physiology study and radiofrequency ablation

Infective endocarditis in the elderly: severe mitral regurgitation in acute coronary syndrome. A case report highlighting the changing patterns of endocarditis

Endocarditis is increasingly becoming a disease of the elderly. We report a case of a 70 year old man with coronary artery disease, who presented with chest pain and fever. His cardiac markers were elevated and an echocardiogram revealed large vegetation on the anterior leaflet of the mitral valve. He also had severe mitral regurgitation and hypokinesia of the posterior and inferior wall. The association of a mitral regurgitant valve secondary to myocardial infarction and bacterial endocarditis has not been reported in the literature making this case unique and interesting. A discussion on the changing patterns of infective endocarditis reveals interesting facts which are useful in the management of such cases