High-Bandpass Filters in Electrocardiography: Source of Error in the Interpretation of the ST Segment.

Introduction. Artifactual variations in the ST segment may lead to confusion with acute coronary syndromes. Objective. To evaluate how the technical characteristics of the recording mode may distort the ST segment. Material and Method. We made a series of electrocardiograms using different filter configurations in 45 asymptomatic patients. A spectral analysis of the electrocardiograms was made by discrete Fourier transforms, and an accurate recomposition of the ECG signal was obtained from the addition of successive harmonics. Digital high-pass filters of 0.05 and 0.5 Hz were used, and the resulting shapes were compared with the originals. Results. In 42 patients (93%) clinically significant alterations in ST segment level were detected. These changes were only seen in "real time mode" with high-pass filter of 0.5 Hz. Conclusions. Interpretation of the ST segment in "real time mode" should only be carried out using high-pass filters of 0.05 Hz.

Infección por Nocardia en pacientes trasplantados cardiacos / Nocardia infection in heart transplant recipients

Introducción. La incidencia de la infección por Nocardia en pacientes trasplantados oscila entre el 0,7–3% y conlleva una mortalidad elevada (26–63%). Este artículo pretende precisar las características epidemiológicas, clínicas y evolutivas de los pacientes con transplante cardiaco que desarrollan nocardiosis en nuestro medio. Métodos. Cohorte retrospectiva de 570 pacientes trasplantados cardiacos. Se revisan las historias clínicas de aquellos en los que se realizó el diagnóstico de infección por Nocardia durante el seguimiento y se registraron datos demográficos, antecedentes personales, régimen de inmunosupresión, profilaxis antibiótica, episodios de rechazo, infecciones asociadas, así como, lugar de la infección por Nocardia, tratamiento administrado y evolución. Resultados. Se identificaron 4 casos con nocardiosis (incidencia del 0,73%), siendo en 2 de ellos diseminada. En todos hubo afectación pulmonar. La mortalidad fue elevada (2 de los 4 pacientes). Conclusión. En pacientes trasplantados cardiacos la infección por Nocardia es poco frecuente y conlleva una elevada mortalidad. Sería necesario un diagnostico precoz para instaurar un tratamiento adecuado(AU)

Introduction. The incidence of Nocardia infection in transplant patients ranges between 0.7 and 3% with a high mortality (26–63%). This fact, together with a median time to diagnosis in about two weeks ago that the state of alertness is of vital clinical importance. Methods. From a cohort of 570 cardiac transplant patients, we reviewed the medical records of those who underwent the diagnosis of Nocardia infection during follow-up. Results. We identified four cases (incidence 0.73%), two scattered. In all, had pulmonary involvement. Mortality was high (2 of 4 patients). Conclusion. In cardiac transplant patients Nocardia infection is rare but has a high mortality, being necessary an early diagnosis to establish an appropriate treatment(AU)

[Nocardia infection in heart transplant recipients]. / Infección por Nocardia en pacientes trasplantados cardiacos.

INTRODUCTION: The incidence of Nocardia infection in transplant patients ranges between 0.7 and 3% with a high mortality (26-63%). This fact, together with a median time to diagnosis in about two weeks ago that the state of alertness is of vital clinical importance. METHODS: From a cohort of 570 cardiac transplant patients, we reviewed the medical records of those who underwent the diagnosis of Nocardia infection during follow-up. RESULTS: We identified four cases (incidence 0.73%), two scattered. In all, had pulmonary involvement. Mortality was high (2 of 4 patients). CONCLUSION: In cardiac transplant patients Nocardia infection is rare but has a high mortality, being necessary an early diagnosis to establish an appropriate treatment.

[Myocardial bridging as a cause of acute ischemia. Description of a case and review of the literature]. / Puente miocárdico como causa de isquemia aguda. Descripción del caso y revisión de la bibliografía.

Myocardial bridges consist of muscle fiber bundles lining an epicardial coronary artery for a variable distance. They are a relatively common finding, with incidence changing on the basis of the study method used (angiographic/necropsy). Although myocardial bridges are usually associated with a benign prognosis, being in many cases asymptomatic and only found by chance, their presence has also been considered a cause of angina, malignant arrhythmia, myocardial infarction and sudden death. They are diagnosed in vivo by angiography when a systolic compression of a coronary artery which disappears during diastole is evidenced. We report the case of a patient with electrocardiographic signs of severe ischemia in the territory of the anterior descending artery, which was initially assessed as myocardial infarction and treated as such. Eventually, the ECG returned to normal, and no new Q waves of necrosis occurred. An angiohemodynamic study confirmed the existence of an isolated muscular bridge over the middle third of the anterior descending artery, with no other associated coronary lesions.