ABSTRACT
A patient with Prinzmetal's variant angina (PVA) developed a cardiac arrest due to coronary vasospasm and subsequent myocardial infarction. After resuscitation postanoxic brain injury was diagnosed. After an initial improvement of consciousness he deteriorated rapidly on the seventh day after admission due to severe brain ischaemia apparently caused by cerebral vasospasm, until ultimately brain death was diagnosed. To our knowledge, the association between PVA and cerebral vasospasm has never been described. The combination suggests that this patient had a generalized vasospastic disorder.
Subject(s)
Angina Pectoris, Variant/etiology , Vasospasm, Intracranial/complications , Angina Pectoris, Variant/diagnosis , Cerebral Angiography , Diagnosis, Differential , Electrocardiography , Fatal Outcome , Humans , Male , Middle Aged , Tomography, X-Ray Computed , Vasospasm, Intracranial/diagnosisABSTRACT
OBJECTIVE: To determine whether magnetic resonance (MR) can give additional information in prenatal diagnosis of congenital anomalies, when the ultrasound (US) analysis is not conclusive. METHODS: Ultrafast MR scanning examined 39 pregnant women with 41 fetuses in whom US was suspicious of fetal congenital abnormalities. Two techniques were used namely (1) HASTE inversion recovery sequence and (2) FISP 2D. RESULTS: Thirty-nine patients with 41 fetuses were referred for MR because of an equivocal US with regard to brain, spine, skeletal and miscellaneous anomalies. In 1 twin pregnancy, 1 co-twin has not been examined with MRI because of its demise. In 22 of them, additional information was obtained by MR. In 9 the MR was confirmative with the US examination. Four were false negative, comparing with the postnatal diagnosis. Three failed because of maternal claustrophobia and in 2 a diagnosis could not be made. From the 40 fetuses in this study, 38 were examined postnatally by MR, US, plain X-ray or autopsy was performed to confirm the prenatal diagnosis. CONCLUSION: The use of MRI in obstetrics has been limited, until recently. With fast MRI sequences it is not necessary to sedate the fetus. It is advisable in cases where US is equivocal concerning congenital anomalies of the fetus to use MR with fast or ultrafast scan technique, especially when the central nervous system is concerned.
Subject(s)
Brain/abnormalities , Magnetic Resonance Imaging/methods , Spine/abnormalities , Ultrasonography, Prenatal/methods , Brain Diseases/congenital , Brain Diseases/diagnostic imaging , Brain Diseases/pathology , Female , Humans , Pregnancy , Spinal Diseases/congenital , Spinal Diseases/diagnostic imaging , Spinal Diseases/pathology , Time FactorsABSTRACT
At 21 weeks of gestation, a 37-year-old woman was referred to our hospital. The fetus showed bradycardia and arrhythmia. Because of glaucoma the woman had previously been treated with timolol eye drops. In this paper a possible association between the timolol eye drops and the fetal cardiac arrhythmia is discussed.
