RESUMO
Chinese herbal medicine is widely used globally. In many instances, it is associated with severe adverse outcomes. We report case of a Chinese herbal nephropathy occurring in a 43-year-old woman showing renal impairment, metabolic acidosis, Stokes - Adams syndrome, hypernatremia, and hypokalemia, characteristics not usually encountered in published cases.
Assuntos
Acidose/induzido quimicamente , Síndrome de Adams-Stokes/induzido quimicamente , Medicamentos de Ervas Chinesas/efeitos adversos , Fármacos para a Fertilidade Feminina/efeitos adversos , Hipernatremia/induzido quimicamente , Hipopotassemia/induzido quimicamente , Nefropatias/induzido quimicamente , Rim/efeitos dos fármacos , Acidose/diagnóstico , Acidose/fisiopatologia , Acidose/terapia , Síndrome de Adams-Stokes/diagnóstico , Síndrome de Adams-Stokes/fisiopatologia , Síndrome de Adams-Stokes/terapia , Adulto , Feminino , Humanos , Hipernatremia/diagnóstico , Hipernatremia/fisiopatologia , Hipernatremia/terapia , Hipopotassemia/diagnóstico , Hipopotassemia/fisiopatologia , Hipopotassemia/terapia , Rim/fisiopatologia , Nefropatias/diagnóstico , Nefropatias/fisiopatologia , Nefropatias/terapia , Resultado do TratamentoAssuntos
Síndrome de Adams-Stokes/etiologia , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Síndrome de Down/complicações , Comunicação Interventricular/cirurgia , Síndrome de Adams-Stokes/diagnóstico , Síndrome de Adams-Stokes/fisiopatologia , Síndrome de Adams-Stokes/terapia , Estimulação Cardíaca Artificial , Criança , Diagnóstico Diferencial , Síndrome de Down/diagnóstico , Eletrocardiografia , Feminino , Frequência Cardíaca , Comunicação Interventricular/complicações , Comunicação Interventricular/diagnóstico por imagem , Humanos , Valor Preditivo dos Testes , Convulsões/diagnóstico , Convulsões/fisiopatologia , Resultado do TratamentoAssuntos
Síndrome de Adams-Stokes/complicações , Síndrome de Adams-Stokes/diagnóstico , Serviços Médicos de Emergência/métodos , Síndrome do Nó Sinusal/complicações , Síncope/etiologia , Síndrome de Adams-Stokes/terapia , Eletrocardiografia , Evolução Fatal , Feminino , Humanos , Pessoa de Meia-Idade , Síncope/diagnósticoRESUMO
BACKGROUND: Acquired complete heart block, in pediatric age is mainly the results of direct injury to conduction tissue during cardiac surgery or cardiac catheterisation. It can also be observed in different clinical settings as infectious diseases, neoplasia, and inflammatory diseases. It has a wide range of presentation and in some settings it can appear a dramatic event. Although a rare finding during acute rheumatic fever, with a transient course, it may need a specific and intensive treatment. CASE PRESENTATION: We report the case of an Adams-Stokes attack in an adolescent with acute rheumatic carditis and complete atrio-ventricular block. The attack was the first symptom of carditis.We reviewed the literature and could find 25 cases of complete atrio-ventricular block due to rheumatic fever. Ten of the 25 patients experienced an Adams-Stokes attack. Nineteen of the 25 patients were certainly in the pediatric age group. Seven of the 19 pediatric cases experienced an Adams-Stokes attack. In 16/25 cases, the duration of the atrio-ventricular block was reported: it lasted from a few minutes to ten days. Pacemaker implantation was necessary in 7 cases. CONCLUSION: Rheumatic fever must be kept in mind in the diagnostic work-up of patients with acquired complete atrio-ventricular block, particularly when it occurs in pediatric patients. The insertion of a temporary pacemaker should be considered when complete atrio-ventricular block determines Adams-Stokes attacks. Complete heart block during acute rheumatic fever is rare and is usually transient. Along with endocarditis, myocarditis and pericarditis, complete atrio-ventricular block has been recognized, rarely, during the course of acute rheumatic carditis.
Assuntos
Síndrome de Adams-Stokes/diagnóstico , Febre Reumática/diagnóstico , Doença Aguda , Síndrome de Adams-Stokes/terapia , Adolescente , Anti-Inflamatórios/uso terapêutico , Diagnóstico Diferencial , Ecocardiografia , Eletrocardiografia , Humanos , Masculino , Marca-Passo Artificial , Febre Reumática/terapiaRESUMO
In the early 1950s, Dr Aubrey Leatham established a cardiac unit at St. George's Hospital, Hyde Park Corner, London. He developed and taught the essential clinical skill of cardiac auscultation. Under his guidance a clinical department for the care of cardiac patients was developed and coupled to physiological academic research. He was a pioneer in cardiac pacing and, in 1961, Harold Siddons, O'Neal Humphries, and Aubrey Leatham implanted the first 'indwelling' pacemaker in the UK in a 65-year-old man with repeated Stokes-Adams attacks due to complete heart block. The nickel-cadmium 'accumulator', which powered the pacemaker, had to be recharged once a week.
Assuntos
Síndrome de Adams-Stokes/história , Estimulação Cardíaca Artificial/história , Cardiologia/história , Bloqueio Cardíaco/história , Síndrome de Adams-Stokes/terapia , Idoso , Feminino , Auscultação Cardíaca/história , Bloqueio Cardíaco/terapia , História do Século XX , Humanos , Masculino , Reino UnidoRESUMO
BACKGROUND: Symptomatic heart block is a treatable cardiac cause of death which occurs globally. In Nigeria it is increasingly diagnosed and treated with permanent artificial cardiac pacemaker insertion and pulse generator implantation, sometimes after a period of misdiagnosis and inappropriate treatment. METHODS: Twenty-three patients who were diagnosed with symptomatic heart block and surgically treated with permanent artificial cardiac pacemaker in National Cardiothoracic Centre, Enugu, between April 2001 and March 2006 had their case notes retrospectively reviewed and information entered into a proforma. This was analyzed. Patients diagnosed with symptomatic heart block but not treated with artificial cardiac pacemaker insertion were excluded from the study. There were eight such patients who could not afford the cost of surgical treatment during the period under review. RESULTS: The mean age of the patients was 70 years and the commonest presentation was shortness of breath (100%). Hypertensive heart disease was present in 65% of the patients and a history of chronic chloroquine usage was positive in 73% of the patients. Predominant pretreatment pulse rate was in the range of 30-40 per minute (43%) while 21% of the patients had pulse rate below 30 per minute. These categories of patients commonly had Stoke-Adams syndrome. Sixty-seven per cent of the patients had predominantly systolic hypertension on admission and 16% had hypotension. Third degree heart block was present in 65% of the patients and 89% of all patients needed pre-pacing haemodynamic stabilization with positive inotropic/chronotropic drug(s). Treatment consisted of permanent endocardial pacing in 65% and epicardial pacing in 35% of the patients with equally good response in symptoms, haemodynamic parameters and electrocardiographic features. CONCLUSION: Permanent artificial cardiac pacing is, the reliable treatment of symptomatic heart block and should be included in the National Health Insurance Scheme list.
Assuntos
Síndrome de Adams-Stokes/terapia , Estimulação Cardíaca Artificial/métodos , Síndrome de Adams-Stokes/diagnóstico , Síndrome de Adams-Stokes/fisiopatologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Bloqueio Cardíaco/diagnóstico , Bloqueio Cardíaco/fisiopatologia , Bloqueio Cardíaco/terapia , Frequência Cardíaca , Humanos , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Nigéria , Estudos RetrospectivosRESUMO
A case of a 16-year-old girl with left sided accessory pathway is presented. Following adenosine-induced termination of atrio-ventricular reentrant tachycardia the patient developed polymorphic ventricular tachycardia followed by preexcited atrial fibrillation with very rapid ventricular response and syncope. Arrhythmia was terminated by amiodarone infusion. Potential complications after adenosine injection are discussed.
Assuntos
Síndrome de Adams-Stokes/induzido quimicamente , Adenosina/efeitos adversos , Antiarrítmicos/efeitos adversos , Síndrome de Wolff-Parkinson-White/tratamento farmacológico , Síndrome de Adams-Stokes/diagnóstico , Síndrome de Adams-Stokes/terapia , Adolescente , Estimulação Cardíaca Artificial/métodos , Eletrocardiografia , Feminino , Humanos , Síncope/induzido quimicamente , Síndrome de Wolff-Parkinson-White/diagnósticoRESUMO
We report a case of Prinzmetal angina initially manifested with short losses of consciousness in a 55-year-old man hospitalized in the Department of Coronary Artery Disease, Institute of Cardiology, Jagiellonian University Medical College in Cracow. Clinical symptomatology of the presented case, causes and mechanism of loss of consciousness in variant angina as well as treatment methods are discussed.
Assuntos
Síndrome de Adams-Stokes/complicações , Síndrome de Adams-Stokes/diagnóstico , Angina Pectoris Variante/complicações , Angina Pectoris Variante/diagnóstico , Síndrome de Adams-Stokes/terapia , Angina Pectoris Variante/terapia , Eletrocardiografia , Humanos , Masculino , Pessoa de Meia-Idade , Marca-Passo Artificial , Inconsciência/etiologiaAssuntos
Síndrome de Adams-Stokes/diagnóstico , Bloqueio de Ramo/diagnóstico , Eletrocardiografia , Síncope/etiologia , Síndrome de Adams-Stokes/fisiopatologia , Síndrome de Adams-Stokes/terapia , Fascículo Atrioventricular/fisiopatologia , Bloqueio de Ramo/fisiopatologia , Bloqueio de Ramo/terapia , Diagnóstico Diferencial , Ecocardiografia , Teste de Esforço , Feminino , Humanos , Pessoa de Meia-Idade , Marca-Passo Artificial , Recidiva , Síncope/fisiopatologia , Síncope/prevenção & controleRESUMO
Forty years have gone by since the first pacemaker implant; this fact had strong impact in the life of thousands of persons. The objective of this work is to report the case of definitive pacemaker malfunction with epicardiac lead and review the literature concerning the important aspects of the causes and diagnosis of pacemaker malfunction. We consider that physicians dealing with patients implanted these devices must be prepared to diagnose and treat them adequately.
Assuntos
Marca-Passo Artificial/efeitos adversos , Síndrome de Adams-Stokes/diagnóstico , Síndrome de Adams-Stokes/terapia , Idoso , Eletrocardiografia , Eletrodos/efeitos adversos , Falha de Equipamento , Feminino , Bloqueio Cardíaco/diagnóstico , Bloqueio Cardíaco/terapia , Humanos , RetratamentoRESUMO
A 70-year-old man had passed out three times in six years, and was suspected of having a rhythm or conduction disturbance. Repeated hospitalization with telemetric monitoring had not revealed any disease. An implantable ECG recorder finally revealed the occurrence of symptomatic sinus arrest (Adams-Stokes attack), a month after discharge from the hospital. The patient was treated with a pacemaker. The cause of recurrent syncope can be difficult to diagnose. There is always a danger of overdiagnosis or under-treatment. Prospective study and cost effectiveness analysis are needed to determine the proper place of the implantable ECG recorder in the diagnosis of this disease.
Assuntos
Síndrome de Adams-Stokes/diagnóstico , Síndrome de Adams-Stokes/terapia , Eletrocardiografia/métodos , Síncope/etiologia , Síndrome de Adams-Stokes/complicações , Idoso , Eletrodos Implantados , Humanos , Masculino , Marca-Passo Artificial , Resultado do TratamentoRESUMO
Three patients, aged between 12 and 17 years presented with Stokes-Adams attacks as a result of atrioventricular block, atrioventricular silence and ventricular arrhythmias, complicating acute myocarditis. All the patients required temporary pacing for a few days. One patient required hemodialysis for anuria. All the patients made complete recovery.
Assuntos
Síndrome de Adams-Stokes/diagnóstico , Miocardite/diagnóstico , Síndrome de Adams-Stokes/etiologia , Síndrome de Adams-Stokes/terapia , Adolescente , Estimulação Cardíaca Artificial , Criança , Ecocardiografia , Eletrocardiografia , Feminino , Humanos , Masculino , Miocardite/complicaçõesRESUMO
The paper reports a case of escaping pacemaker syndrome in a female with continuous endocardial ventricular pacing. The syndrome was provoked by defects in the electronic scheme because of weakening of pacemaker's battery.
Assuntos
Marca-Passo Artificial , Síndrome de Adams-Stokes/diagnóstico , Síndrome de Adams-Stokes/terapia , Fontes de Energia Elétrica , Eletrocardiografia , Emergências , Falha de Equipamento , Feminino , Ventrículos do Coração/fisiopatologia , Humanos , Pessoa de Meia-Idade , Síndrome do Nó Sinusal/diagnóstico , Síndrome do Nó Sinusal/terapia , SíndromeRESUMO
We studied the outcome of permanent pacing in those with a history suggestive of Stokes-Adams attacks but no electocardiographic evidence of bradyarrhythmia. Of 11 patients who fulfilled pre-defined inclusion criteria, over a mean follow-up period of 5.4 years, seven patients were free of symptoms and two were much improved following pacing. We suggest that in those with a clinical history of frequently recurrent Stokes-Adams attacks and a normal electrocardiogram, pacemaker insertion may be a reasonable course of action.