ABSTRACT
Slowing of the tachycardia with increase in cycle length and increase in VA time with ipsilateral bundle branch block is a characteristic feature of accessory pathway mediated AVRT. Contralateral bundle branch block has no effect on the tachycardia as it is not a part of the tachycardia circuit. We present an interesting phenomenon in which contralateral bundle branch block resulted in tachycardia slowing in a case of WPW syndrome.
Subject(s)
Atrioventricular Node/physiopathology , Bundle of His/physiopathology , Bundle-Branch Block/physiopathology , Tachycardia, Atrioventricular Nodal Reentry/physiopathology , Wolff-Parkinson-White Syndrome/physiopathology , Accessory Atrioventricular Bundle , Action Potentials , Adult , Bundle-Branch Block/diagnosis , Electrocardiography , Electrophysiologic Techniques, Cardiac , Heart Rate , Humans , Male , Tachycardia, Atrioventricular Nodal Reentry/diagnosis , Time Factors , Wolff-Parkinson-White Syndrome/diagnosisABSTRACT
We present two cases of mitral valve lesions that manifested with unilateral blindness caused by central retinal artery occlusion (CRAO): Case 1. A 68-year-old woman was admitted to our clinic for sudden blindness. Retinal artery angiogram showed CRAO. Transthoracic and transesophageal echocardiography (TEE) documented a mass attached to the ventricular side of the posterior mitral leaflet, which at pathology was identified as a blood cyst. Case 2. A 67-year-old man was admitted for a sudden unilateral painless loss of vision. Retinal angiogram documented CRAO, and TEE showed a highly mobile, spherical, lesion on the atrial side of anterior mitral leaflet. In this case, the pathological finding was a degenerated calcified thrombosis. We report on two cases of very rare abnormalities of the mitral valve presenting with a very rare embolic complication, i.e., CRAO. Like for cryptogenic stroke, transesophageal echocardiography plays a central role in the diagnosis of cardiogenic embolic sources.
