ABSTRACT
OBJECTIVES: We retrospectively analyzed the predictive factors of successfully electrical cardioversion in patients with chronic atrial fibrillation. METHODS: We included 118 patients, 68 men and 50 women, with a mean age of 65.1 years and a length of arrhythmia evolution of 83.3 days. These patients consecutively underwent electrical cardioversion in our Cardiology Department with a follow-up of one year to determine relapses. Structural cardiopathy was observed in 63.6% of the patients and 43.7% presented a left atrium between 4 and 5 cms. We analyzed the clinical and echocardiographic factors which predict the acute and first year success of electrical cardioversion. RESULTS: The cardioversion was effective in 73.7% (CI 95%, 64.6%-81.1%) of the patients and 35.6% (CI 95%, 25.8%-46.6%) had a relapse within the first year. The inexistence of cardiomyopathy and therapy with amiodarone were predictive of acute success (p < 0.04 and p < 0.03, respectively). The length of arrhythmia evolution did not predict acute success but did so when relapses were analyzed. The size of the left atrium is predictive of both acute and long term success (p < 0.02 and p < 0.001, respectively). Logistic regression showed that the size of the left atrium and the patient's age were the only predictive factors of acute and first year success. CONCLUSIONS: Electrical cardioversion is very efficient in the short-term, despite numerous relapses. Patient age and the size of left atrium are associated with acute and long-term success of cardioversion.
Subject(s)
Atrial Fibrillation/therapy , Electric Countershock/statistics & numerical data , Aged , Analysis of Variance , Anti-Arrhythmia Agents/therapeutic use , Atrial Fibrillation/diagnostic imaging , Atrial Fibrillation/drug therapy , Chronic Disease , Echocardiography , Female , Follow-Up Studies , Humans , Male , Middle Aged , Recurrence , Regression Analysis , Retrospective StudiesABSTRACT
A case of 66-year-old woman with cardiac tamponade and bilateral pulmonary infiltrates is reported. These infiltrates were "pseudonodulars" and confluent. We practice pericardiocentesis and a hemorrhagic fluid is pulled out. Its cytology shown not neoplastic cells. She died and the necropsy shown an angiosarcoma of pericardium with multiple pulmonary and alone hepatic metastases.
Subject(s)
Heart Neoplasms/diagnosis , Hemangiosarcoma/diagnosis , Liver Neoplasms/secondary , Lung Neoplasms/secondary , Pericardium , Aged , Fatal Outcome , Female , Heart Neoplasms/pathology , Hemangiosarcoma/pathology , Humans , Liver/pathology , Liver Neoplasms/pathology , Lung/pathology , Lung Neoplasms/pathology , Pericardium/pathologyABSTRACT
We report a 28-year-old patient with an acute myocardial infarction, without previous symptomatology of ischemic heart disease, 5 hours after a delivery. We discuss the role of methylergometrine, used for avoid the bleeding postpartum, in its etiopathology and its specific therapy.
Subject(s)
Methylergonovine/adverse effects , Myocardial Infarction/chemically induced , Puerperal Disorders/chemically induced , Adult , Anticoagulants/therapeutic use , Cholestyramine Resin/therapeutic use , Drug Therapy, Combination , Female , Humans , Myocardial Infarction/diagnosis , Myocardial Infarction/drug therapy , Puerperal Disorders/diagnosis , Puerperal Disorders/drug therapyABSTRACT
A case of an asymptomatic 9-year-old girl is reported. She was diagnosed of aortic regurgitation by valvular prolapse without other systemic or valvular pathology associated. We discuss her etiology and physiopathology.
Subject(s)
Aortic Valve Insufficiency/diagnosis , Aortic Valve Prolapse/diagnosis , Aortic Valve Insufficiency/etiology , Aortic Valve Prolapse/complications , Child , Echocardiography, Doppler , Electrocardiography , Female , Humans , Radiography, ThoracicABSTRACT
We present a patient with swallowing syncope. The esophageal manometric examination showed a diffuse spasm. This induces a vagovagal reflex mediated by tensoreceptors from the esophageal wall, which block the AV and/or sinus nodes.
Subject(s)
Deglutition , Esophageal Spasm, Diffuse/complications , Heart Block/etiology , Syncope/etiology , Esophageal Spasm, Diffuse/physiopathology , Heart Block/physiopathology , Humans , Male , Middle Aged , Syncope/physiopathologyABSTRACT
We present an adult patient (25-years old), free of symptoms with a congenital heart disease very infrequent and survival to adulthood is exceptional, the truncus arteriosus. Who entered to the Emergency Care Unit because of paroxysmal tachycardia. We describe the case with special reference to echocardiographic findings and we detached the rarity of this congenital heart disease in adulthood.
