ABSTRACT
A patient with a 456 Gram right atrial myxoma is described. Associated rheumatic mitral valvular heart disease obscured the presence of the tumor and only with presentation of bradyarrhythmias leading to pacemaker implantation was the diagnosis suspected. Successful surgical removal of the tumor and correction of the intracardiac valvular dysfunction were performed. The role of echocardiography in the early detection of these tumors is reinforced.
Subject(s)
Heart Neoplasms/complications , Mitral Valve Stenosis/complications , Myxoma/complications , Rheumatic Heart Disease/complications , Bioprosthesis , Cardiac Catheterization , Coronary Angiography , Echocardiography , Heart Atria , Heart Neoplasms/diagnosis , Heart Neoplasms/surgery , Heart Valve Prosthesis , Humans , Male , Middle Aged , Mitral Valve/surgery , Mitral Valve Stenosis/diagnosis , Mitral Valve Stenosis/surgery , Myxoma/diagnosis , Myxoma/surgery , Rheumatic Heart Disease/diagnosis , Rheumatic Heart Disease/surgery , Tricuspid Valve/surgeryABSTRACT
One hundred consecutive patients requiring propranolol hydrochloride before undergoing isolated aortocoronary bypass procedures were examined. In half the patients, propranolol therapy was discontinued, whereas the other half continued to receive intraoperative and postoperative propranolol regardless of clinical events. Although there were no preoperative differences in the apparent degree of coronary arterial disease or left ventricular function in the two groups, postoperative supraventricular arrhythmias were less frequent in the propranolol-treated group, most noticeably in those receiving less than 320 mg preoperatively. In patients who had received large preoperative doses (greater than or equal to 320 mg/day), there were no significant differences in postoperative supraventricular tachycardias. Continued propranolol therapy following isolated coronary bypass surgery appears to be a safe and efficacious method of decreasing the incidence of postoperative supraventricular tachycardias.
Subject(s)
Arrhythmias, Cardiac/drug therapy , Coronary Artery Bypass , Postoperative Complications/drug therapy , Propranolol/administration & dosage , Humans , Propranolol/therapeutic useSubject(s)
Acidosis/physiopathology , Coronary Disease/physiopathology , Myocardial Contraction , Acidosis/etiology , Animals , Coronary Disease/complications , Female , Hydrogen-Ion Concentration , In Vitro Techniques , Intracellular Fluid , Magnetic Resonance Spectroscopy , Mass Spectrometry , Oxygen Consumption , Perfusion , RabbitsSubject(s)
Body Fluids/metabolism , Hydrogen-Ion Concentration , Intracellular Fluid/metabolism , Myocardial Contraction , Adenosine Triphosphate/metabolism , Animals , Coronary Disease/metabolism , Female , In Vitro Techniques , Magnetic Resonance Spectroscopy , Mass Spectrometry , Myocardium/metabolism , RabbitsABSTRACT
A young woman with mitral valve prolapse and ventricular tachycardia refractory to numerous antiarrhythmics, received a trial of aprindine. During the course of treatment she developed a severe psychotic reaction that resolved after the drug was stopped. Her psychosis was unassociated with the other dose-related neurological side effects of aprindine, and occurred at borderline therapeutic levels of the drug.
