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4.
Int J Cardiol ; 154(3): e47-9, 2012 Feb 09.
Artículo en Inglés | MEDLINE | ID: mdl-19419783

RESUMEN

Changing axis deviation has been reported also during atrial fibrillation or atrial flutter. Changing axis deviation has been also reported during acute myocardial infarction associated with atrial fibrillation too or at the end of atrial fibrillation during acute myocardial infarction. Left bundle branch block is usually associated with normal or left axis deviation. Rarely the ECG shows a LBBB with changing QRS morphology and changing axis deviation. There are several possible explanations for the intermittent shift in the QRS axis in the presence of complete left bundle branch block. The most plausible explanation is the coexistence of left posterior hemiblock and predivisional left bundle branch block. We present a case of a left bundle branch block with changing axis deviation in a 93-year-old Italian woman admitted to the Cardiology Unit with an acute myocardial infarction.


Asunto(s)
Bloqueo de Rama/fisiopatología , Infarto del Miocardio/fisiopatología , Anciano de 80 o más Años , Bloqueo de Rama/complicaciones , Electrocardiografía , Femenino , Humanos , Infarto del Miocardio/complicaciones
6.
Int J Cardiol ; 155(2): e19-21, 2012 Mar 08.
Artículo en Inglés | MEDLINE | ID: mdl-19923019

RESUMEN

Changing axis deviation has been reported also during atrial fibrillation or atrial flutter. Changing axis deviation has been also reported during acute myocardial infarction associated with atrial fibrillation too or at the end of atrial fibrillation during acute myocardial infarction. We present a case of revelation of changing axis deviation at the end of atrial fibrillation without acute myocardial infarction in a 74-year-old Italian man. Also this case focuses attention on changing axis deviation.


Asunto(s)
Fibrilación Atrial/diagnóstico , Electrocardiografía/métodos , Infarto del Miocardio , Anciano , Humanos , Masculino
7.
Int J Cardiol ; 156(1): e1-3, 2012 Apr 05.
Artículo en Inglés | MEDLINE | ID: mdl-20045206

RESUMEN

Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that subclinical hyperthyroidism is not associated with coronary heart disease or mortality from cardiovascular causes but it is sufficient to induce arrhythmias including atrial fibrillation and atrial flutter. Nowadays, there is growing interest regarding endogenous sublinical hyperthyroidism and the cardiovascular system. We present a case of acute myocardial infarction without significant coronary stenoses in a 75-year-old Italian woman with endogenous subclinical hyperthyroidism. Also this case focuses attention on the importance of a correct evaluation of endogenous subclinical hyperthyroidism.


Asunto(s)
Estenosis Coronaria/diagnóstico , Hipertiroidismo/diagnóstico , Infarto del Miocardio/diagnóstico , Anciano , Estenosis Coronaria/fisiopatología , Femenino , Humanos , Hipertiroidismo/complicaciones , Hipertiroidismo/fisiopatología , Infarto del Miocardio/etiología , Infarto del Miocardio/fisiopatología
8.
Int J Cardiol ; 155(3): e39-41, 2012 Mar 22.
Artículo en Inglés | MEDLINE | ID: mdl-20053467

RESUMEN

Changing axis deviation has been reported also during atrial fibrillation or atrial flutter. Changing axis deviation has been also reported during acute myocardial infarction associated with atrial fibrillation too or at the end of atrial fibrillation during acute myocardial infarction. Left bundle branch block is usually associated with normal or left axis deviation. Rarely the ECG shows a left bundle branch block with changing QRS morphology and changing axis deviation. We present a case of a left bundle branch block with changing axis deviation in an 86-year-old Italian man admitted to the Cardiology Unit with an acute myocardial infarction. Also this case focuses attention on left bundle branch block with changing axis deviation.


Asunto(s)
Bloqueo de Rama/fisiopatología , Electrocardiografía , Sistema de Conducción Cardíaco/fisiopatología , Infarto del Miocardio/complicaciones , Anciano de 80 o más Años , Bloqueo de Rama/etiología , Estudios de Seguimiento , Humanos , Masculino , Infarto del Miocardio/fisiopatología
11.
Int J Cardiol ; 152(2): e27-8, 2011 Oct 20.
Artículo en Inglés | MEDLINE | ID: mdl-19631397

RESUMEN

Alterations of main pulmonary artery have been described in literature. Main pulmonary artery aneurysm is very rare with few available published data. We present a case of echocardiographic finding of a main pulmonary artery aneurysm in a 78-year-old Italian woman.


Asunto(s)
Aneurisma/diagnóstico por imagen , Arteria Pulmonar/diagnóstico por imagen , Anciano , Tos/etiología , Disnea/etiología , Femenino , Humanos , Ultrasonografía
12.
Int J Cardiol ; 146(3): e56-7, 2011 Feb 03.
Artículo en Inglés | MEDLINE | ID: mdl-19185930

RESUMEN

Heart muscle involvement associated with human immunodeficiency virus (HIV) infection may present as myocarditis, dilated cardiomyopathy or as isolated left or right ventricular dysfunction. Histopathological and ultra structural findings with different degrees of cardiac-chamber dilation have been described and an important role of the cytokines tumor necrosis factor-alpha (TNF-alpha), interleukin-1 (IL-1) and IL-6 has been suggested. We present a case of myocarditis in a 47-year-old woman with HIV associated cardiomyopathy, focussing attention on heart muscle involvement in HIV disease.


Asunto(s)
Cardiomiopatías/virología , Infecciones por VIH/complicaciones , Miocarditis/virología , Femenino , Humanos , Persona de Mediana Edad
13.
Int J Cardiol ; 147(2): e26-8, 2011 Mar 03.
Artículo en Inglés | MEDLINE | ID: mdl-19201497

RESUMEN

Dissimilar electrocardiographic patterns associated with right bundle branch block have been described. The prognosis of right bundle branch block in the absence of underlying cardiac disease is good but it may be poor in other cases, particularly coronary artery disease. Changing bundle branch block, new right bundle branch block, right bundle branch conduction disturbances have been reported in literature. Changing axis deviation has been reported alone or during acute myocardial infarction also associated with atrial fibrillation. Intermittent right axis deviation has been rarely reported in the presence of left bundle branch block also during atrial fibrillation and with acute myocardial infarction too. Isolated left posterior hemiblock is a very rare finding and transient right axis deviation associated with a left posterior hemiblock pattern has been also rarely described associated with acute myocardial infarction. We describe a case of changing axis deviation with intermittent right bundle branch block in a patient admitted with acute myocardial infarction. Also this case focuses attention on changing axis deviation and intermittent right bundle branch block during acute myocardial infarction.


Asunto(s)
Bloqueo de Rama/diagnóstico , Bloqueo de Rama/etiología , Electrocardiografía , Infarto del Miocardio/complicaciones , Infarto del Miocardio/diagnóstico , Anciano , Humanos , Masculino
14.
Int J Cardiol ; 148(2): e31-3, 2011 Apr 14.
Artículo en Inglés | MEDLINE | ID: mdl-19321213

RESUMEN

Many patients with acute coronary syndrome (ACS) had no culprit lesion. Coronary spasm is a frequent cause of ACS and should regularly be considered as a differential diagnosis. Prostate-specific antigen (PSA) is an established marker for detection of prostate cancer. Both elevated as well as diminished PSA have been reported during acute myocardial infarction(AMI) and our preliminary observations have concluded that when elevation of PSA occurs during AMI, coronary lesions are frequent and often more severe than when a diminution of PSA occurs. Moreover, our preliminary observations have concluded also that when elevation of prostate-specific antigen occurs during AMI, it seems to relate to a higher occurrence of major adverse cardiac events in the first 8 days after AMI than when a diminution of PSA occurs. We present a case of ST-segment elevation in a patient with diminution of PSA, coronary spasm and without significant coronary stenoses. Our report extends the evaluation of PSA during ACS.


Asunto(s)
Síndrome Coronario Agudo/diagnóstico , Estenosis Coronaria/diagnóstico , Vasoespasmo Coronario/diagnóstico , Antígeno Prostático Específico/sangre , Síndrome Coronario Agudo/metabolismo , Vasoespasmo Coronario/metabolismo , Diagnóstico Diferencial , Electrocardiografía , Humanos , Masculino , Persona de Mediana Edad
15.
Int J Cardiol ; 151(1): e1-3, 2011 Aug 18.
Artículo en Inglés | MEDLINE | ID: mdl-19339062

RESUMEN

Changing axis deviation has been rarely reported also during atrial fibrillation or atrial flutter. Changing axis deviation has been also rarely reported during acute myocardial infarction associated with atrial fibrillation too or at the end of atrial fibrillation during acute myocardial infarction. We present a case of changing axis deviation in a 77-year-old Italian woman admitted to the Cardiology Unit with an acute myocardial infarction. Also this case focuses attention on changing axis deviation and acute myocardial infarction.


Asunto(s)
Fibrilación Atrial/diagnóstico , Fibrilación Atrial/fisiopatología , Electrocardiografía , Infarto del Miocardio/diagnóstico , Infarto del Miocardio/fisiopatología , Anciano , Femenino , Humanos
16.
Int J Cardiol ; 153(1): e1-2, 2011 Nov 17.
Artículo en Inglés | MEDLINE | ID: mdl-19356809

RESUMEN

Exercise-induced ST-segment elevation in lead aVR accompanied by ST-segment elevation in lead V1 might be a specific finding of left main coronary artery (LMCA) stenosis. Lead aVR and lead v1 ST segment elevation has been reported, during an attack of chest pain, in patients with LMCA disease with ST segment depression in leads V3, V4 and V5 (with maximal depression in V4). ST-segment elevation in lead aVR in patients with angina at rest can be related to transmural ischemia of the basal part of the interventricular septum, frequently due to LMCA or multivessel coronary disease too. 3-vessel coronary artery disease (CAD) and LMCA disease show a frequent combination of leads with abnormal ST segments during chest pain with ST-segment depression in leads I II V4-V6, and ST-segment elevation in lead aVR. When ST-segment status in lead aVR combines with troponin T, ST-segment elevation in lead aVR and positive troponin T on admission are useful predictors of LMCA or 3-vessel CAD. We present a case of acute myocardial infarction with significant left main coronary artery stenosis, significant 3-vessel coronary artery disease and elevated troponin I at admission in an 83-year-old Italian woman. Also this case focuses attention on the importance of the recognition of the patterns suspected for LMCA and/or 3-vessel coronary disease.


Asunto(s)
Enfermedad de la Arteria Coronaria/sangre , Estenosis Coronaria/sangre , Infarto del Miocardio/sangre , Admisión del Paciente , Troponina I/sangre , Anciano de 80 o más Años , Enfermedad de la Arteria Coronaria/complicaciones , Enfermedad de la Arteria Coronaria/diagnóstico , Estenosis Coronaria/complicaciones , Estenosis Coronaria/diagnóstico , Femenino , Humanos , Infarto del Miocardio/complicaciones , Infarto del Miocardio/diagnóstico
17.
Int J Cardiol ; 153(2): e25-8, 2011 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-19359055

RESUMEN

Rhythm disturbances have been described in immunological and connective diseases. Scleroderma is a fibrotic condition characterized by immunological abnormalities, vascular injury and increased accumulation of extracellular matrix proteins. The heart is one of the major organs involved in scleroderma, the involvement of which can be manifested by myocardial disease, conduction system abnormalities, arrhythmias, or pericardial disease. Additionally, scleroderma renal crisis and pulmonary hypertension lead to significant cardiac dysfunction secondary to damage in the kidney and lung. Changing axis deviation has been reported also during atrial fibrillation or atrial flutter. Changing axis deviation has been also reported during acute myocardial infarction associated with atrial fibrillation too or at the end of atrial fibrillation during acute myocardial infarction. We present a case of atrial flutter, ventricular tachycardia and changing axis deviation in a 61-year-old Italian woman with scleroderma. This case focuses attention on changing axis deviation and on the presentation of arrhythmias in scleroderma. The underlying arrhythmogenic mechanisms are probably multiple and intriguing, even though the myocardial fibrosis and immunological autoantibody-mediated mechanisms seem to play a pivotal role.


Asunto(s)
Aleteo Atrial/diagnóstico , Esclerodermia Sistémica/diagnóstico , Taquicardia Ventricular/diagnóstico , Aleteo Atrial/complicaciones , Aleteo Atrial/fisiopatología , Femenino , Humanos , Persona de Mediana Edad , Esclerodermia Sistémica/complicaciones , Esclerodermia Sistémica/fisiopatología , Taquicardia Ventricular/complicaciones , Taquicardia Ventricular/fisiopatología
18.
Int J Cardiol ; 149(1): 108-9, 2011 May 19.
Artículo en Inglés | MEDLINE | ID: mdl-19473714

RESUMEN

Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. Exogenous sublinical hyperthyroidism is a thyroid metabolic state caused by L-thyroxine administration. Endogenous subclinical hyperthyroidism is a thyroid metabolic state in patients with autonomously functioning thyroid nodule or multinodular goiter, various forms of thyroiditis, in areas with endemic goiter and particularly in elderly subjects. Endogenous subclinical hyperthyroidism is currently the subject of numerous studies and it yet remains controversial particularly as it relates to its treatment and to cardiovascular impact nevertheless established effects have been demonstrated. Recently, acute myocardial infarction without significant coronary stenoses and recurrent acute pulmonary embolism have been reported associated with subclinical hyperthyroidism without L-thyroxine administration. So, it is very important to recognize and to treat promptly also endogenous subclinical hyperthyroidism.


Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Hipertiroidismo/epidemiología , Tromboembolia/epidemiología , Humanos , Hipertiroidismo/terapia , Factores de Riesgo , Índice de Severidad de la Enfermedad
20.
Int J Cardiol ; 152(3): e45-6, 2011 Nov 03.
Artículo en Inglés | MEDLINE | ID: mdl-19700207

RESUMEN

Certain congenital cardiac defects may go undetected for several years due to lack of symptoms and signs.Ventricular septal defects can occur as part of more congenital cardiac malformations or as an isolate finding. The natural history of ventricular septal defects depends on the size of the defect and on the pulmonary resistance. We present a case of the chance finding of a ventricular septal defect in a 2-day-old newborn infant with an interatrial septal aneurysm.


Asunto(s)
Defectos del Tabique Interventricular/diagnóstico por imagen , Hallazgos Incidentales , Humanos , Recién Nacido , Masculino , Ultrasonografía
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