ABSTRACT
Gross and microscopic findings consistent with acute and healed myocardial injury without coronary artery disease have been described in autopsy studies of patients with sickle cell crisis. The present study was designed to determine whether serum levels of cardiac troponin I are elevated in sickle cell crisis. Cardiac troponin I levels were measured in 32 patients age>18 years with the admission diagnosis of sickle cell crisis. All patients had cardiac troponin I level drawn >24 h after the onset of symptoms. The clinical profile and electrocardiograms were analyzed. Out of 32 patients, 2 patients had serum cardiac troponin I elevated, both had presented with acute chest syndrome. Serum cardiac troponin I may be elevated during sickle cell crisis, possibly by myocardial ischemia resulting from microvascular coronary obstruction during sickle cell crisis.
Subject(s)
Anemia, Sickle Cell/blood , Biomarkers/blood , Myocardial Ischemia/blood , Troponin I/blood , Adolescent , Adult , Anemia, Sickle Cell/complications , Electrocardiography , Female , Humans , Male , Middle Aged , Myocardial Ischemia/etiologyABSTRACT
Hyperkalemia is a life threatening metabolic condition. The common risk factors for hyperkalemia include renal insufficiency, use of angiotensin converting enzyme inhibitors, potassium supplementation and excessive consumption of potassium containing diet. A mild to moderate increase in serum potassium causes an increase in myocardial excitability, but further increase leads to impaired myocardial responsiveness, including that to pacing stimulation. Hyperkalemia has been reported to cause failure of atrial capture due to pacemaker exit block. We report a case where hyperkalemia resulted in failure of both the atrial and the ventricular pacemaker capture.
Subject(s)
Heart Atria/physiopathology , Heart Rate/physiology , Heart Ventricles/physiopathology , Hyperkalemia/etiology , Kidney Failure, Chronic/complications , Pacemaker, Artificial , Sick Sinus Syndrome/therapy , Electrocardiography , Equipment Failure , Follow-Up Studies , Humans , Male , Middle Aged , Sick Sinus Syndrome/complications , Sick Sinus Syndrome/physiopathologyABSTRACT
We report a case of a 26-year-old female who after septic abortion developed tricuspid valve endocarditis with large vegetations, which subsequently resulted in embolism to right main pulmonary artery. Patient was treated with intravenous antibiotics and had a good recovery.
Subject(s)
Abortion, Therapeutic/adverse effects , Endocarditis, Bacterial/complications , Endometritis/complications , Pulmonary Embolism/etiology , Sepsis/complications , Staphylococcal Infections/etiology , Staphylococcus aureus/isolation & purification , Adult , Anti-Bacterial Agents/therapeutic use , Drug Therapy, Combination , Endocarditis, Bacterial/drug therapy , Endocarditis, Bacterial/microbiology , Female , Follow-Up Studies , Humans , Pregnancy , Pulmonary Embolism/drug therapy , Pulmonary Embolism/microbiology , Sepsis/microbiology , Staphylococcal Infections/drug therapy , Staphylococcal Infections/microbiologyABSTRACT
Diphenhydramine overdose in one of the frequent reported causes of acute poisoning. Patients with diphenhydramine overdose can present with central nervous system manifestations, anticholinergic manifestations and cardiovascular symptoms. The cardiovascular symptoms of diphenhydramine overdose include myocardial depression and refractory hypotension. Massive ingestions have been reported to cause myocardial depressant effect with widening of QRS complex and prolonged QT interval on electrocardiogram. We report an adolescent male with moderate diphenhydramine ingestion, who was found unresponsive with seizure like activity. Electrocardiogram on presentation showed wide complex tachycardia with right bundle branch block pattern and QT interval prolongation. These changes reverted to normal with treatment. Diphenhydramine overdose may occasionally result in prolongation of QT interval.
