1/15. Some hazards of invasive cardiology.Since the introduction of cardiac catheterization by Andre Cournand and Dickinson Richards, the valuable diagnostic and therapeutic device has encouraged many action-minded physicians to use cardiac catheterization to develop a new specialty, invasive cardiology. The data to be presented here derive from a catastrophe that occurred during an invasive treatment of a 54-year-old man who had experienced an ordinary myocardial infarction.- - - - - - - - - - ranking = 1keywords = catheterization (Clic here for more details about this article) |
2/15. Recurrent ventricular fibrillation in a marathon runner during exercise testing.We report a case of a marathon runner who presented with chest tightness, ST-segment depression, and ventricular fibrillation following treadmill exercise testing. At cardiac catheterization, the patient was found to have an isolated lesion in the left anterior descending (LAD) artery that was hemodynamically insignificant by accepted angiographic and coronary flow reserve standards. ventricular fibrillation was thought to be idiopathic, and an implantable cardioverter defibrillator was placed. chest pain and ST-segment depression followed by ventricular fibrillation was reproduced during follow-up treadmill testing, prompting reconsideration of the original diagnostic hypothesis. A coronary stent was deployed in the LAD artery. The patient has been asymptomatic and arrhythmia free during follow-up treadmill testing and recreational running.- - - - - - - - - - ranking = 0.5keywords = catheterization (Clic here for more details about this article) |
3/15. Detection of malignant right coronary artery anomaly by multi-slice CT coronary angiography.Coronary artery anomalies occur in 0.3-0.8% of the population and infer a high risk for sudden cardiac death in young adults. diagnosis is usually established during coronary angiography, which is hampered by poor spatial visualization. magnetic resonance imaging is an alternative, but it is not feasible in the presence of metal objects or claustrophobia. In this report, a 15-year-old boy experienced ventricular fibrillation and was successfully resuscitated. cardiac catheterization was inconclusive, and pacemaker implantation prohibited the use of MR imaging. Multi-slice CT coronary angiography revealed a malignant anomalous right coronary artery.- - - - - - - - - - ranking = 0.5keywords = catheterization (Clic here for more details about this article) |
4/15. survival after spontaneous coronary artery dissection presenting with ventricular fibrillation arrest.Spontaneous coronary artery dissection (SCAD) is a rarely documented etiology of myocardial infarction and sudden cardiac death (SCD). We present a case of a 37-year-old non-pregnant female who presented with a left anterior descending artery (LAD) dissection complicated by ventricular fibrillation arrest. After early diagnostic catheterization and medical management, our patient experienced a complete recovery, returning to her pre-SCD status without limitation. This case is unique in that the SCAD did not occur in the context of previously described associations. Also, this is only the second reported case of a patient with SCAD who survived documented SCD. Our case suggests that medical management is a reasonable option in patients with single-vessel non-left main/proximal LAD artery SCAD.- - - - - - - - - - ranking = 0.5keywords = catheterization (Clic here for more details about this article) |
5/15. ventricular fibrillation in two cases with dilated cardiomyopathy and mechanical alternans.Clinical implication of mechanical alternans is yet unclear. It may suggest the risk for sudden death in patients with chronic heart failure. Two cases with dilated cardiomyopathy showed mechanical alternans during diagnostic cardiac catheterization. They suddenly died due to ventricular fibrillation before the induction of beta-blocker therapy. patients with mechanical alternans should be treated under intense monitoring until the induction of beta-blocker therapy.- - - - - - - - - - ranking = 0.5keywords = catheterization (Clic here for more details about this article) |
6/15. Unrecognized anomalous origin of the left coronary artery from the pulmonary artery as a cause of ventricular fibrillation after patent ductus arteriosus ligation in an infant.We present a case of an infant who developed ventricular fibrillation after patent ductus arteriosus (PDA) ligation. The infant had unrecognized anomalous origin of the left coronary artery from the pulmonary artery before PDA ligation. Acute reduction in systemic pulmonary artery pressures after PDA ligation resulted in an abrupt reduction in left main coronary artery blood flow. After prompt resuscitation, cardiac catheterization confirmed the diagnosis of anomalous origin of the left coronary artery from the pulmonary artery. The infant subsequently underwent coronary artery translocation and recovered uneventfully.- - - - - - - - - - ranking = 0.5keywords = catheterization (Clic here for more details about this article) |
7/15. Basis for recurring ventricular fibrillation in the absence of coronary heart disease and its management.A 39-year-old man twice experienced ventricular fibrillation and exhibited numerous ventricular premature beats. Coronary arteries were normal, and no impaired cardiac function was found upon catheterization. Evidence was adduced that the ventricular premature beats were related to higher nervous activity. The patient had serious psychiatric problems; the ventricular premature beats were provoked by psychophysiologic stress, increased during REM sleep, were reduced by meditation, and were controlled by beta-adrenergic blockade, phenytoin and digitalization. We conclude that psychologic and neurophysiologic factors may predispose to life-threatening cardiac arrhythmia in the absence of organic heart disease. Effective management of the recurrent ventricular arrhythmia involved; acute drug testing for assessing antiarrhythmic efficacy; use of programmed trendscription to provide on-line information on drug action; a treatment program involving more than one agent; and use of measures to reduce sympathetic nervous activity.- - - - - - - - - - ranking = 0.5keywords = catheterization (Clic here for more details about this article) |
8/15. Protamine-induced fatal anaphylaxis. prevalence of antiprotamine immunoglobulin e antibody.Protamine is used widely to reverse the anticoagulant effects of heparin and to delay the absorption of insulin. Although adverse reactions to protamine are reported infrequently and are usually mild, we recently observed the first fatal case of type I anaphylaxis resulting from protamine. This patient had previously been sensitized to protamine during cardiac catheterization and had high levels of protamine-specific immunoglobulin e in the serum. In a prospective study, we found that 10 of 19 diabetic patients (53%) who had received insulin containing insulin also had high levels of antiprotamine immunoglobulin e. In contrast, none of 27 nondiabetic healthy normal controls or 10 diabetics who had never received protamine or protamine-containing insulin had levels of antiprotamine immunoglobulin e over background. This study underscores the risks of routinely administering protamine to susceptible individuals and the need for alternative therapies.- - - - - - - - - - ranking = 0.5keywords = catheterization (Clic here for more details about this article) |
9/15. ventricular fibrillation after intravenous atropine in a patient with atrioventricular block.A 69-year-old black woman with complete AV block developed ventricular fibrillation following an IV injection of 1 mg of atropine sulphate. After a successful DC countershock, the ECG showed a polymorphous ventricular tachycardia which subsided spontaneously. cardiac catheterization revealed a small left ventricular diverticulum and normal coronary arteries. This seems to be the first reported case of atropine-induced ventricular fibrillation in a patient with complete AV block. The fact that this occurred without previous change of the ventricular rate suggests that the adverse action of atropine was mediated through a mere vagolytic effect at the ventricular level.- - - - - - - - - - ranking = 0.5keywords = catheterization (Clic here for more details about this article) |
10/15. Postoperative electrophysiological studies with a modified radiofrequency system. Technical aspects and clinical usefulness.Two patients who underwent a ventricular aneurysmectomy for treatment of ventricular tachycardia are presented. In both patients, a radiofrequency pacemaker was implanted at surgery (for therapeutic use if surgery should fail). In both patients, electrophysiological studies were performed before discharge utilizing a radiofrequency pacemaker without recourse to repeat catheterization. This was possible by modifying the transmitter and coupling it to a commercially available programmable stimulator.- - - - - - - - - - ranking = 0.5keywords = catheterization (Clic here for more details about this article) |
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