ABSTRACT
A previously well 68-year-old man became confused and cyanotic after retrobulbar block for eye surgery. The symptoms resolved within 10 minutes. The author discusses the differential diagnosis of brain-stem anesthesia and proposes recommendations to reduce the incidence of this potentially fatal complication.
Subject(s)
Anesthesia, Local/adverse effects , Brain Stem/drug effects , Cyanosis/etiology , Aged , Cataract Extraction , Diagnosis, Differential , Humans , Lidocaine/administration & dosage , Male , Morphine/administration & dosageABSTRACT
A case of ventricular fibrillation with successful resuscitation is described in a patient with hypertrophic cardiomyopathy and a history of syncope. Patients with hypertrophic cardiomyopathy who are at risk for sudden death can be identified by electrocardiographic monitoring which demonstrates episodes of ventricular tachycardia. Therapy with amiodarone has been shown to abolish ventricular tachycardia and to reduce the incidence of sudden death. Amiodarone therapy eliminated malignant ventricular ectopic activity in this patient during 48 h of ambulatory electrocardiographic monitoring, yet the subsequent exercise stress test provoked an episode of ventricular fibrillation.
Subject(s)
Amiodarone/therapeutic use , Cardiomyopathy, Hypertrophic/complications , Death, Sudden/etiology , Ventricular Fibrillation/etiology , Adult , Cardiomyopathy, Hypertrophic/genetics , Cardiomyopathy, Hypertrophic/pathology , Death, Sudden/epidemiology , Exercise Test , Humans , Male , Ventricular Fibrillation/drug therapyABSTRACT
A 75-year-old woman presented with deep venous thrombosis and multiple pulmonary emboli. Course was complicated by pulmonary hypertension which caused central shunting of blood through an abnormal patent foramen ovale. Paradoxical embolus to the right coronary artery was demonstrated premorbidly and at autopsy.
