ABSTRACT
Inadvertent insertion of a defibrillation lead in the left ventricle is a rare complication generally underdiagnosed after device implantation. Management is not strictly codified due to the small number of observed cases. We report the case of a 78 year-old man in whom the diagnosis has been performed lately during an echocardiography.
Subject(s)
Defibrillators, Implantable/adverse effects , Foramen Ovale, Patent , Heart Ventricles/diagnostic imaging , Aged , Echocardiography , Humans , Male , Medical ErrorsABSTRACT
Recording of a regular wide QRS tachycardia is often source of panic and anxiety for the young clinician who has to make the differential diagnosis between ventricular tachycardia and supraventricular tachycardia with aberration associated with fundamentally different vital prognosis. Most of the time, a rigorous approach and a systematic analysis of the electrocardiogram associated with clinical examination allow to obtain the correct diagnosis.
Subject(s)
Electrocardiography , Tachycardia, Ventricular/diagnosis , Aged , Humans , MaleABSTRACT
Androgens, via aromatization in estrogens, stimulate growth hormone secretion. Their influence on IGF1 (insulin-like growth factor 1, or somatomedin C) are not so clear. Some studies have observed an increase of IGF1 with testosterone therapy and some other not. The way of administration, per os or transdermic, may have an influence, like the hormonal substitutive therapy of postmenopausal women. Oral estrogen therapy decreases IGF1 levels in postmenopausal women and increases GH secretion. IG1 level is variably reduced, unaffected or increased by transdermal estrogen. High dose transdermal estrogen did not affect basal level of IGF1, but reduced the response of IGF1 to GH stimulation. Low dose transdermal estrogen did not alter either baseline or peak IGF1 level.
