[show abstract][hide abstract] ABSTRACT: We report the case of a 57-year-old woman with anorexia nervosa showing evidence of "tako-tsubo" cardiomyopathy complicated by several syncopes due to recurrent episodes of torsades de pointes. Prolongation of QT interval and QT dispersion have been reported both in the "tako-tsubo" cardiomyopathy and in anorexia nervosa. The QT prolongation and the QT dispersion has been linked as risk indicators for sudden cardiac death. The combination of "tako-tsubo" cardiomyopathy with a condition associated with the prolongation of QT and/or with an increase of QT dispersion, such as anorexia nervosa, makes the acute and subacute prognosis of this disease much more severe than usual.
Internal Medicine 01/2010; 49(12):1133-7. · 0.97 Impact Factor
[show abstract][hide abstract] ABSTRACT: We report the case of a 71-year-old woman, with a dual chamber pacemaker (PM), in whom a PM syndrome, due to loss of atrial sensing and pacing, was associated with a tako-tsubo cardiomyopathy (TTC). The repositioning of the atrial lead immediately improved symptoms, whereas complete regression of left ventricular wall motion abnormalities occurred after 1 month. We hypothesize that haemodynamic and hormonal responses associated with a PM syndrome, such as increased levels of catecholamines, may account for TTC in our patient.
[show abstract][hide abstract] ABSTRACT: We report the case of a 77-year-old man, in whom accidental hypothermia was secondary to prolonged immobilization and malnutrition. The electrocardiogram showed typical Osborn waves, which disappeared with the rewarming of the patient. The diagnosis of hypothermia is easy in patients with a history of prolonged exposure to a cold environment but accidental hypothermia may also occur as a consequence of prolonged immobilization and malnutrition. ECG analysis is very important for a correct and fast diagnosis.
Journal of Cardiovascular Medicine 09/2009; 11(7):550-1. · 2.66 Impact Factor
[show abstract][hide abstract] ABSTRACT: The ECG recorded from a patient with DDD pacemaker showed variable responses of the pacing system to bigeminal ventricular extrasystoles, dependent on the coupling interval of premature beats. For relatively short coupling intervals, the premature spontaneous event was detected by the pacemaker, inhibiting both atrial and ventricular output, and resulting in a relatively long pacing pause. In slightly less premature end-diastolic extrasystoles, in contrast, the pacing system delivered an atrial spike that was superimposed upon the spontaneous premature QRS complex (pseudo-pseudofusion); under these circumstances, the atrial spike was followed, at the end of the programmed atrioventricular interval, by a ventricular spike falling on the extrasystolic T wave apex (competitive ventricular pacing). This phenomenon, however, did not express a sensing malfunction, but was due to post-atrial ventricular blanking (PAVB), a short period initiated by the atrial spike during which ventricular sensing is temporarily disabled, so that no signal can be detected. Finally, whenever premature end-diastolic impulses occurred after PAVB, during the brief interval defined ventricular safety pacing, the spontaneous event was sensed, being followed by an earlier-than-expected ventricular spike, whose prematurity was aimed at avoiding the occurrence of an artificial impulse upon the T wave of extrasystole. In conclusion, despite several not sensed ventricular extrasystoles and competitive pacing, no sensing malfunction was present. This case demonstrates how complex can be the electrocardiographic analysis of a DDD pacemaker, owing to the many complicating phenomena related to this pacing mechanism.
Giornale italiano di cardiologia (2006) 12/2008; 9(11):775-8.