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1.
Arch Mal Coeur Vaiss ; 79(7): 1100-4, 1986 Jun.
Article in French | MEDLINE | ID: mdl-3096234

ABSTRACT

We report a case of spontaneous incomplete rupture of the first segment of the ascending aorta presenting as aortic incompetence and acute tamponade confirmed by preoperative angiography in a 57 year old hypertensive woman. This patient underwent emergency conservative surgery with good results at 8 months' follow-up. This rare pathology occurs in the same terrain as dissection of the aorta. The diagnosis should be suspected not only when chest pain and/or aortic incompetence are associated or not with acute tamponade, contrasting with a normal electrocardiogram, but also in atypical presentations which necessitate angiography in multiple incidences in order not to miss the diagnostic signs which are often invisible in the standard projections. When there are no complications, this condition may pass undiagnosed. However, in most cases, it leads to acute tamponade due to intrapericardial rupture or to an aortic aneurysm or aortic incompetence. The latter complications are usually associated with severe regurgitation requiring surgical correction, which in some cases may be conservative.


Subject(s)
Aortic Rupture/diagnostic imaging , Aortic Valve Insufficiency/diagnostic imaging , Aorta/surgery , Aortic Rupture/pathology , Aortic Rupture/surgery , Aortic Valve Insufficiency/pathology , Aortic Valve Insufficiency/surgery , Aortography , Cardiac Tamponade/etiology , Cardiac Tamponade/surgery , Emergencies , Female , Humans , Middle Aged
3.
Arch Mal Coeur Vaiss ; 73(10): 1145-53, 1980 Oct.
Article in French | MEDLINE | ID: mdl-6778406

ABSTRACT

The authors review the literature on arrhythmias and ST changes, the principal causes of sudden death in the mid systolic click-late systolic murmur (SC-SM) syndrome, having recorded the ECG during sudden death of a patient with this syndrome by Holter monitoring. This would also appear to be the first reported case of sudden death recorded by this technique. It showed that death was caused by ventricular fibrillation which was preceded by a clinical and electrical episode of Prinzmetal angina. Hypotheses explaining the abnormalities of ventricular repolarisation and rhythm in so-called "idiopathic" SC-SM syndrome are reviewed. Special attention is paid to studies suggesting the participation of coronary spasm and autonomic nervous system disturbances. In conclusion, the authors underline: - the value of ambulatory electrocardiography in patients with the SC-SM syndrome and especially in a defined high risk group; - the value of testing for coronary spasm when coronary angiography is envisaged; - the need for better management with antiarrhythmic therapy. The indications of betablockade are discussed as these drugs are thought to favourise coronary spasm.


Subject(s)
Angina Pectoris, Variant/complications , Angina Pectoris/complications , Death, Sudden/etiology , Mitral Valve Prolapse/complications , Angina Pectoris, Variant/physiopathology , Arrhythmias, Cardiac/complications , Electrocardiography , Heart Ventricles , Humans , Male , Methods , Middle Aged , Mitral Valve Prolapse/physiopathology
4.
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