1/5. Hormonal and cardiovascular reflex assessment in a female patient with pure autonomic failure.We report the case of a 72-year-old female with pure autonomic failure, a rare entity, whose diagnosis of autonomic dysfunction was determined with a series of complementary tests. For approximately 2 years, the patient has been experiencing dizziness and a tendency to fall, a significant weight loss, generalized weakness, dysphagia, intestinal constipation, blurred vision, dry mouth, and changes in her voice. She underwent clinical assessment and laboratory tests (biochemical tests, chest X-ray, digestive endoscopy, colonoscopy, chest computed tomography, abdomen and pelvis computed tomography, abdominal ultrasound, and ambulatory blood pressure monitoring). Measurements of catecholamine and plasmatic renin activity were performed at rest and after physical exercise. Finally the patient underwent physiological and pharmacological autonomic tests that better diagnosed dysautonomia.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
2/5. Electrocardiographical case. Asymptomatic patient with ST-segment elevation.A 46-year-old man complained of recurrent episodes of giddiness which was not associated with chest pain or breathlessness. There was no family history of sudden death. Clinical examination was unremarkable.12-lead electrocardiogram (ECG) showed ST segment elevation in the right precordial leads, with coved ST segment elevation at its J point followed by a negative T wave with no isoelectric separation, specifically in V2. These ECG features are characteristic of the brugada syndrome. He underwent a flecanide challenge which produced further elevation of ST segment at its J point and spontaneous ventricular ectopy. Electrophysiological studies induced ventricular fibrillation with 3 extra stimuli. An implantable cardioverter-defibrillator was implanted for prevention of sudden cardiac death. The brugada syndrome is discussed.- - - - - - - - - - ranking = 12.135558746212keywords = chest pain, chest (Clic here for more details about this article) |
3/5. Exertional dizziness and syncope caused by anomalous left coronary artery origin from the right sinus of valsalva.Coronary anomalies are generally rare, but has fascinating congenital cardiac disease entities, recognized in less than 1.3% of all coronary angiograms. Left coronary artery arising from right sinus of valsalva RSOV represents an extremely uncommon subtype. Initial presentations include chest pain, myocardial infarction, arrhythmias, sudden death, and rarely exertional syncope. We report a case of exertional dizziness and syncope, diagnosed to have anomalous origin of left main coronary artery from RSOV. Surgical intervention was curative.- - - - - - - - - - ranking = 12.135558746212keywords = chest pain, chest (Clic here for more details about this article) |
4/5. Primary large B-cell cardiac lymphoma.Primary cardiac lymphomas are rare. They can be detected incidentally during echocardiography or cardiac operation. They can have various clinical manifestations. We report a case of primary cardiac large B-cell lymphoma in a 66-year-old man with symptoms of chest pain and light-headedness who was found to have a right atrial mass with echocardiography and without right ventricular outflow tract obstruction or pericardial involvement.- - - - - - - - - - ranking = 12.135558746212keywords = chest pain, chest (Clic here for more details about this article) |
5/5. Anginal attack following a sodium bicarbonate and hydrocortisone injection.A case of a 73-year-old man with variant angina who developed chest pain and shock following an injection of sodium bicarbonate and hydrocortisone is reported. The electrocardiogram (ECG) during the chest pain attack revealed ST elevation in leads II, III and aVF. It returned to a normal pattern 10 min later. coronary angiography, performed 2 hours after the anginal attack, showed no significant coronary arterial stenosis. One month later, an injection of ergonovine (16 micrograms) into the right and left coronary arteries induced spasms in segments 4 and 13, with ischemic ECG changes. Possible causes of the anginal attack are a coronary arterial spasm induced by the allergic reaction to hydrocortisone and/or serum alkalosis due to the sodium bicarbonate injection triggered by hyperventilation.- - - - - - - - - - ranking = 24.271117492424keywords = chest pain, chest (Clic here for more details about this article) |