ABSTRACT
AIMS: This is a case report of an athlete whose professional football career was transiently terminated because of the presumed diagnosis of hypertrophic cardiomyopathy. METHODS AND RESULTS: The diagnosis was based on electrocardiographic repolarisation changes. The ECGs, treadmill exercise tests (Bruce protocol) and echo examinations at the time of his active training and several years after termination of his professional career are discussed. No hypertrophic cardiomyopathy was documented by ultrasound examination. CONCLUSIONS: The distinction between physiological athlete's heart and pathological conditions has critical implications for professional athletes. Criteria and guidelines for screening of athletes in competitive sports are recommended.
Subject(s)
Cardiomegaly/diagnostic imaging , Cardiomyopathy, Hypertrophic/diagnostic imaging , Death, Sudden, Cardiac/prevention & control , Soccer , Adult , Cyprus , Diagnosis, Differential , Electrocardiography , Humans , Male , Referral and Consultation , Syndrome , UltrasonographyABSTRACT
Discrete subaortic stenosis (DSS) accounts for 8 to 20% of all cases of congenital left ventricular outflow tract obstruction. There have been few scattered reports of left ventricular obstructive lesions occurring in immediate family members of patients with DSS. This is a report of four cases of DSS in one family: one brother with a fibrous ring, and two sisters and the son of one of the sisters with a fibrous membrane. The occurrence of multiple cases of DSS in this family suggests an autosomal dominant mode of inheritance.
Subject(s)
Aortic Valve Stenosis/genetics , Genes, Dominant/genetics , Adolescent , Adult , Aortic Valve/diagnostic imaging , Aortic Valve Stenosis/physiopathology , Blood Flow Velocity , Cardiac Catheterization , Echocardiography, Doppler, Color , Electrocardiography , Female , Humans , Male , Middle Aged , Pedigree , Stroke VolumeABSTRACT
Sixteen patients who had manifested ST segment depression during episodes of paroxysmal supraventricular tachycardia (PSVT) were studied with exercise testing in order to detect coronary artery disease and myocardial ischaemia. No ST segment depression was observed during exercise testing in 15 out of the 16 patients tested. Paroxysms of supraventricular tachycardia associated with ST segment depression occurred during exercise testing in three cases. The ST segment depression was immediately apparent, remained constant throughout the supraventricular tachycardia and was almost instantly abolished following conversion to sinus rhythm. Patients with heart rates greater than 250 beats min-1 during PSVT had marked ST segment depression associated with the tachycardia. These results suggest that coronary artery disease and myocardial ischaemia are not involved in the genesis of ST segment depression during PSVT. Tachycardia per se may be the cause of ST segment depression by altering the slope of phase 2 of the ventricular action potential. Retrograde atrial activation may also induce ST segment shifts in some of the cases.
Subject(s)
Electrocardiography , Exercise Test , Tachycardia, Supraventricular/physiopathology , Adolescent , Adult , Coronary Disease/complications , Female , Humans , Male , Middle Aged , Tachycardia, Paroxysmal/physiopathologyABSTRACT
The effect of coronary artery bypass graft surgery (CABGS) on the prevalence of exercise-induced ventricular ectopic activity was studied in 43 patients (42 male, 1 female). Their age was 53 +/- 7.8 (mean +/- SD) years. Treadmill exercise test (TET) was performed within a month prior to and three months post-CABPGS. An average of 2.8 grafts per patient were used. Nine of the 43 patients (20.9%) had premature ventricular contractions (PVCs) related to effort prior to CABGS, while 12 out of the 43 (27.9%) had PVCs post-surgery. Seven patients (16.3%) had PVCs for the first time after successful revascularization, four of whom had previous myocardial infarction. The haemodynamic parameters of the total group during TET showed significant improvement in the duration of the exercise test (37%), the double product heart rate X systolic blood pressure (36%)M and the cardiorespiratory fitness (31%). Our data indicate that the ventricular ectopic activity induced by exercise in patients with coronary artery disease is not affected by successful revascularization. On the contrary, a significant number of patients develop new ventricular ectopy after CABGS where a pre-existing myocardial infarction appears to be a determining factor.
Subject(s)
Cardiac Complexes, Premature/etiology , Coronary Artery Bypass/adverse effects , Coronary Disease/surgery , Physical Exertion , Adult , Aged , Angiography , Arrhythmias, Cardiac/etiology , Coronary Disease/diagnostic imaging , Exercise Test , Female , Heart Ventricles , Humans , Male , Middle AgedABSTRACT
Three cases of left atrial myxoma were studied by echocardiography. In one case the atrial tumour was prolapsing through the mitral orifice into the left ventricular cavity; in the other two cases it was not. The angiocardiographic and operative findings correlated well with those from echocardiography. A systematic echocardiographic study is important; the suprasternal approach is useful in the echocardiographic exploration of the left atriu, especially for nonprolapsing tumours.
Subject(s)
Echocardiography/methods , Heart Neoplasms/diagnosis , Myxoma/diagnosis , Adult , Diagnosis, Differential , Female , Heart Atria , Humans , Middle Aged , Mitral Valve Stenosis/diagnosis , Myocardial ContractionABSTRACT
Bullet migration toward and within the pulmonary circulation occurred in a case of gunshot wound to the right upper abdominal quadrant. Difficulties in locating the missile were encountered during surgical attempts to remove it. Finally, a Swan-Ganz catheter was used for pulmonary angiography. The balloon of the catheter was inflated to prevent further migration of the missile until it could be surgically removed.
