The combination of risk factors for sudden death in a resuscitated elderly patient with an exceptional cause of left ventricular hypertrophy.

The work-up of a previously asymptomatic 72-year-old man presenting with sudden cardiac death revealed a coarctation of the aorta as the cause of arterial hypertension, severe left ventricular hypertrophy, in combination with coronary artery disease with an apical myocardial infarction, severe autonomic dysfunction, and AV-nodal reentrant tachycardia. All these elements and their complex, probably synergistic interactions might have been involved in the development of sudden cardiac death.

Superior vena cava syndrome after implantation of a transvenous cardioverter defibrillator.

Superior vena cava syndrome is a rare, but nevertheless well known complication of permanent pacemaker implantation. Nowadays cardioverter defibrillators are also routinely implanted transvenously. A superior vena cava syndrome occurred in a 48-year-old female 2 years after implantation of cardioverter defibrillator. The clinical problem, in the presence of a predisposing thrombophilic condition (circulating lupus anticoagulant), resolved only partially after treatment with thrombolytics and oral anticoagulation. This syndrome should be recognized as a possible important complication of defibrillator therapy and requires lifelong anticoagulation.