ABSTRACT
Although many cases of peripartum cardiomyopathy have been reported in the literature, detailed data from left heart catheterization and contrast ventriculography are unavailable. A patient with peripartum cardiomyopathy had catheterization performed to clarify the diagnosis. Hemodynamics at rest and with exercise, angiographic volumes, and indices of left ventricular function are presented. The data indicate no serious abnormality of global systolic left ventricular function in this patient although a segmental wall motion abnormality was noted. Volume overload or diminished diastolic compliance may explain the symptoms of heart failure in some patients with this disease.
Subject(s)
Cardiomyopathies/diagnosis , Puerperal Disorders/diagnosis , Adult , Angiocardiography , Cardiac Catheterization , Female , Hemodynamics , Humans , Isometric Contraction , Pregnancy , RestABSTRACT
A 26-year-old woman was hospitalized with new-onset congestive heart failure. M-mode and two-dimensional echocardiography revealed abnormal motion involving the apex and posterolateral wall of the left ventricle. Cardiac catheterization was performed. The left ventriculogram demonstrated apical akinesis and an apical filling defect. The diagnosis of cardiac sarcoidosis was made from an open myocardial biopsy.
Subject(s)
Cardiomyopathies/diagnosis , Sarcoidosis/diagnosis , Adrenal Cortex Hormones/therapeutic use , Adult , Cardiac Catheterization , Cardiomyopathies/diagnostic imaging , Cardiomyopathies/drug therapy , Cardiomyopathies/pathology , Female , Heart Failure/diagnostic imaging , Heart Failure/etiology , Humans , Radiography , Sarcoidosis/drug therapy , Sarcoidosis/pathologyABSTRACT
We report the first two documented cases of the deliberate metoprolol overdose occurring in the United States, one of which eventually proved fatal. The potentially lethal cardiotoxic effects of this drug are illustrated and correlated with the blood and tissue levels of metoprolol. We emphasize the often sudden and rapid clinical deterioration which excessive ingestion of this drug may produce, and the need for close, careful supervision and monitoring of these patients.
