RESUMO
Myocarditis can have a variable clinical presentation, ranging from asymptomatic to full-blown fulminant heart failure with severe left ventricular dysfunction or acute coronary syndrome (ACS) even ST-Elevation Myocardial Infarction (STEMI). Clinically myocarditis mimicking STEMI can present physicians with a great diagnostic challenge, especially in the absence of pro-dormal flu-like symptoms or a recent viral illness. Cardiac MRI has demonstrated superiority in detecting myocardial abnormalities and differentiating patients with myocarditis and from those with true STEMI.
RESUMO
Local anesthetics are routinely used in the field of medicine during many procedures, to alleviate acute pain. Although they are relatively safe, they have the ability to produce undesirable neurotoxic and cardiotoxic symptoms when administered intravascularly. Examples of cardiotoxicity include myocardial depression, cardiac arrhythmias, and cardiovascular collapse. The case below describes the adverse events of severe bradycardia, PR prolongation with subsequent heart block, and sinus arrest following an elective knee replacement in a 73-year-old male who received bupivacaine and ropivacaine.
