ABSTRACT
We report a 56 years-old man presenting with chest pain with exercise, seven years after an orthotopic heart transplant. A coronary angiography showed an atherosclerotic lesion in the common left main coronary artery with more than 90 percent obstruction. The lesion was successfully treated with a transluminal angioplasty with stenting. A 131-1 metaiodobenylguanidine (MIBG) scan demonstrated sympathetic reinnervation. Sixteen months later, due to progression of allograft vasculopathy, coronary artery bypass was required.
Subject(s)
Humans , Male , Middle Aged , Angina Pectoris/etiology , Angioplasty, Balloon, Coronary , Coronary Artery Disease/complications , Coronary Artery Disease/therapy , Heart Transplantation , Heart/innervation , Stents , Angina Pectoris/surgery , Myocardial Revascularization , ReoperationABSTRACT
We report a 59 year-old woman who had recurrent episodes of paroxystic supraventricular tachycardia despite pharmacologic therapy. A previous electrophysiological study (EPS) was done two years earlier without induction of any sustained arrhythmia. A new EPS was performed, during which atrial and ventricular programmed stimulation failed to induce tachycardia, and only by fast ventricular stimulation during intravenous isoproterenol infusion, a typical atrio ventricular nodal reentrant tachycardia (AVNRT) was induced. We successfully ablated the slow nodal pathway. After ablation the tachycardia was not inducible. We comment the occasional difficulties to induce AVNRT and the importance of a complete induction protocol to avoid false negative studies during the EPS.
Subject(s)
Cardiac Pacing, Artificial , Tachycardia, Atrioventricular Nodal Reentry/diagnosis , Tachycardia, Supraventricular/diagnosis , Atrioventricular Node , Diagnosis, Differential , Female , Humans , Middle Aged , Recurrence , Stimulation, Chemical , Tachycardia, Atrioventricular Nodal Reentry/etiologyABSTRACT
We report a 59 year-old woman who had recurrent episodes of paroxystic supraventricular tachycardia despite pharmacologic therapy. A previous electrophysiological study (EPS) was done two years earlier without induction of any sustained arrhythmia. A new EPS was performed, during which atrial and ventricular programmed stimulation failed to induce tachycardia, and only by fast ventricular stimulation during intravenous isoproterenol infusion, a typical atrio ventricular nodal reentrant tachycardia (AVNRT) was induced. We successfully ablated the slow nodal pathway. After ablation the tachycardia was not inducible. We comment the occasional difficulties to induce AVNRT and the importance of a complete induction protocol to avoid false negative studies during the EPS.
Subject(s)
Female , Humans , Middle Aged , Cardiac Pacing, Artificial , Tachycardia, Atrioventricular Nodal Reentry/diagnosis , Tachycardia, Supraventricular/diagnosis , Atrioventricular Node , Diagnosis, Differential , Recurrence , Stimulation, Chemical , Tachycardia, Atrioventricular Nodal Reentry/etiologyABSTRACT
We report a 56 years-old man presenting with chest pain with exercise, seven years after an orthotopic heart transplant. A coronary angiography showed an atherosclerotic lesion in the common left main coronary artery with more than 90% obstruction. The lesion was successfully treated with a transluminal angioplasty with stenting. A 131-1 metaiodobenylguanidine (MIBG) scan demonstrated sympathetic reinnervation. Sixteen months later, due to progression of allograft vasculopathy, coronary artery bypass was required.
Subject(s)
Angina Pectoris/etiology , Angioplasty, Balloon, Coronary , Coronary Artery Disease/complications , Coronary Artery Disease/therapy , Heart Transplantation , Heart/innervation , Stents , Angina Pectoris/surgery , Humans , Male , Middle Aged , Myocardial Revascularization , ReoperationABSTRACT
Strumal carcinoid is an unusual form of monodermal ovarian teratoma with thyroid-like follicles mixed with typical carcinoid tumor patterns. We report a 49 years old woman presenting with an acromegaly. At the age of 45, an ovarian strumal carcinoid was excised and at three years of follow up, she complained of finger and feet growth. Laboratory showed an elevated serum IGF-1 and a sella turcica magnetic resonance imaging showed an 8 mm microadenoma. She was subjected to a transphenoidal excision and the pathological study disclosed a solid acidophilic pituitary adenoma. Two months after surgery, there was a significant decrease in serum IGT-I levels.
