scholarly journals A case report of cardiac toxicity from barracuda ingestion in Mexico

2020 ◽  
Author(s):  
Alice Haouzi ◽  
Haitham Khraishah ◽  
Jamie Diamond ◽  
Duane S Pinto
Keyword(s):  
Heart Rate ◽  
Gastrointestinal Symptoms ◽  
Neurological Symptoms ◽  
Cardiac Complications ◽  
Permanent Pacing ◽  
Temporary Treatment ◽  
Symptomatic Bradycardia ◽  
Cardiac Manifestations ◽  
Electrocardiogram Ecg

Abstract Background Ciguatera toxicity is a fish-borne illness that initially manifests with gastrointestinal symptoms, followed by bizarre neurological symptoms including heat-cold sensation alteration, peculiar feeling of loose teeth, and peripheral neuropathy. However, cardiac manifestations are rare and underreported in the literature. Case summary A 73-year-old man presented with symptomatic bradycardia and hypotension after ingestion of barracuda fish in Mexico. He received atropine and dopamine with subsequent improvement in his symptoms, but continued to experience peripheral neuropathic and other odd sensations. Four of his family members ingested the same fish and had similar symptoms. He was managed conservatively and did not require temporary or permanent pacing. Within 1 week from toxin exposure, bradycardia had improved. Heart rate was 40–50 b.p.m. at rest, and he was discharged with an ambulatory monitor. Heart rate had increased to 77 b.p.m. at 1-month follow-up on repeat electrocardiogram (ECG). Discussion Although the predominant manifestations of ciguatera toxicity are neurological, cardiac complications tend to be more acute and require attention. Unlike neurological symptoms, bradycardia and hypotension are short-lived, often resolving within a week. Treatment continues to be largely supportive, and patients may require temporary treatment with positive chronotropic agents such as atropine or dopamine.

scholarly journals Autonomic dysfunction in post-COVID patients with and witfhout neurological symptoms: a prospective multidomain observational study

2021 ◽  
Author(s):  
Alex Buoite Stella ◽  
Giovanni Furlanis ◽  
Nicolò Arjuna Frezza ◽  
Romina Valentinotti ◽  
Milos Ajcevic ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Orthostatic Intolerance ◽  
Neurological Symptoms ◽  
Postural Tachycardia Syndrome ◽  
Symptom Scale ◽  
Autonomic Symptom ◽  
Postural Tachycardia ◽  
Ambulatory Services

AbstractThe autonomic nervous system (ANS) can be affected by COVID-19, and dysautonomia may be a possible complication in post-COVID individuals. Orthostatic hypotension (OH) and postural tachycardia syndrome (POTS) have been suggested to be common after SARS-CoV-2 infection, but other components of ANS function may be also impaired. The Composite Autonomic Symptom Scale 31 (COMPASS-31) questionnaire is a simple and validated tool to assess dysautonomic symptoms. The aim of the present study was to administer the COMPASS-31 questionnaire to a sample of post-COVID patients with and without neurological complaints. Participants were recruited among the post-COVID ambulatory services for follow-up evaluation between 4 weeks and 9 months from COVID-19 symptoms onset. Participants were asked to complete the COMPASS-31 questionnaire referring to the period after COVID-19 disease. Heart rate and blood pressure were manually taken during an active stand test for OH and POTS diagnosis. One-hundred and eighty participants were included in the analysis (70.6% females, 51 ± 13 years), and OH was found in 13.8% of the subjects. Median COMPASS-31 score was 17.6 (6.9–31.4), with the most affected domains being orthostatic intolerance, sudomotor, gastrointestinal and pupillomotor dysfunction. A higher COMPASS-31 score was found in those with neurological symptoms (p < 0.01), due to more severe orthostatic intolerance symptoms (p < 0.01), although gastrointestinal (p < 0.01), urinary (p < 0.01), and pupillomotor (p < 0.01) domains were more represented in the non-neurological symptoms group. This study confirms the importance of monitoring ANS symptoms as a possible complication of COVID-19 disease that may persist in the post-acute period.

scholarly journals Anticoagulation in patients with cardiac manifestations of Chagas disease and cardioembolic ischemic stroke

2018 ◽  
Vol 76 (1) ◽  
pp. 22-25 ◽  
Author(s):  
Jean M.C. Monteiro ◽  
Daniel L. San-Martin ◽  
Beatriz C.G. Silva ◽  
Pedro A.P. de Jesus ◽  
Jamary Oliveira Filho
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Chagas Disease ◽  
Retrospective Cohort ◽  
Cardiac Complications ◽  
Minor Bleeding ◽  
Warfarin Group ◽  
Cardiac Manifestations ◽  
Cis Methods

ABSTRACT Objectives To describe anticoagulation characteristics in patients with cardiac complications from Chagas disease and compare participants with and without cardioembolic ischemic stroke (CIS). Methods A retrospective cohort of patients with Chagas disease, using anticoagulation, conducted from January 2011 to December 2014. Results Forty-two patients with Chagas disease who were using anticoagulation were studied (age 62.9±12.4 years), 59.5% female and 47.6% with previous CIS, 78.6% with non-valvular atrial fibrillation and 69.7% with dilated cardiomyopathy. Warfarin was used in 78.6% of patients and dabigatran (at different times) in 38%. In the warfarin group, those with CIS had more medical appointments per person-years of follow-up (11.7 vs 7.9), a higher proportion of international normalized ratios within the therapeutic range (57% vs 42% medical appointments, p = 0.025) and an eight times higher frequency of minor bleeding (0.64 vs 0.07 medical appointments). Conclusion Patients with Chagas disease and previous CIS had better control of INR with a higher frequency of minor bleeding.

scholarly journals Heart Rate Monitor Instead of Ablation? Atrioventricular Nodal Re-Entrant Tachycardia in a Leisure-Time Triathlete: 6-Year Follow-Up

Diagnostics ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. 391 ◽  
Author(s):  
Robert Gajda
Keyword(s):  
Heart Rate ◽  
Diagnostic Tool ◽  
Leisure Time ◽  
Submaximal Exercise ◽  
Training Load ◽  
Heart Rate Monitor ◽  
Heart Rate Monitors ◽  
Amateur Athlete ◽  
Electrocardiogram Ecg

This study describes a triathlete with effort-provoked atrioventricular nodal re-entrant tachycardia (AVNRT), diagnosed six years ago, who ineffectively controlled his training load via heart-rate monitors (HRM) to avoid tachyarrhythmia. Of the 1800 workouts recorded for 6 years on HRMs, we found 45 tachyarrhythmias, which forced the athlete to stop exercising. In three of them, AVNRT was simultaneously confirmed by a Holter electrocardiogram (ECG). Tachyarrhythmias occurred in different phases (after the 2nd–131st minutes, median: 29th minute) and frequencies (3–8, average: 6.5 times/year), characterized by different heart rates (HR) (150–227 beats per minute (bpm), median: 187 bpm) and duration (10–186, median: 40 s). Tachyarrhythmia appeared both unexpectedly in the initial stages of training as well as quite predictably during prolonged submaximal exercise—but without rigid rules. Tachyarrhythmias during cycling were more intensive (200 vs. 162 bpm, p = 0.0004) and occurred later (41 vs. 10 min, p = 0.0007) than those during running (only one noticed but not recorded during swimming). We noticed a tendency (p = 0.1748) towards the decreasing duration time of tachycardias (2014–2015: 60 s; 2016–2017: 50 s; 2018–later: 37 s). The amateur athlete tolerated the tachycardic episodes quite well and the ECG test and echocardiography were normal. In the studied case, the HRM was a useful diagnostic tool for detecting symptomatic arrhythmia; however, no change in the amount, phase of training, speed, or duration of exercise-stimulated tachyarrhythmia was observed.

scholarly journals Management of adolescent anorexia with symptomatic bradycardia and frequent premature ventricular contractions: a case report

2021 ◽  
Vol 49 (10) ◽  
pp. 030006052110501
Author(s):  
Fuxu Chen ◽  
Chao Feng ◽  
Jie Song ◽  
Shudong Xia
Keyword(s):  
Heart Rate ◽  
Anorexia Nervosa ◽  
Pacemaker Implantation ◽  
Premature Ventricular Contractions ◽  
Cardiac Intervention ◽  
The Past ◽  
Electrocardiographic Monitoring ◽  
Symptomatic Bradycardia ◽  
Mean Heart Rate

Syncope associated with bradycardia and ventricular arrhythmia is an indication of cardiac intervention. However, in adolescent patients with anorexia nervosa, the management of syncope and arrhythmia can be different. We present a case of a 17-year-old boy who was admitted to the hospital because of syncope during exercise. Electrocardiographic monitoring showed that his mean heart rate was 41 beats/minute, with many long pauses and frequent premature ventricular contractions. These results suggested that the syncope was probably caused by arrythmia. He had been on a diet and had lost 20 kg in the past 6 months, with a body mass index of only 15.3 kg/m2. He was diagnosed with anorexia nervosa. Pacemaker implantation or ablation was not performed. Refeeding therapy was performed with mirtazapine. A follow-up showed a stepwise increase in his heart rate and a stepwise decrease in premature ventricular contractions, with an increase in his body weight. The findings from this case show that vagal hyperactivity associated with anorexia nervosa might lead to multiple premature ventricular contractions and bradycardia.

scholarly journals Can Intradetrusor OnabotulinumtoxinA Injections Alter Heart Function in Patients with Cardiac Arrhythmia?

2018 ◽  
Vol 7 (9) ◽  
pp. 263
Author(s):  
Pawel Miotla ◽  
Pawel Olejniczak ◽  
Konrad Futyma ◽  
Andrzej Wrobel ◽  
Michal Tomaszewski ◽  
...  
Keyword(s):  
Heart Rate ◽  
Overactive Bladder ◽  
Cardiac Arrhythmia ◽  
Heart Function ◽  
Phone Call ◽  
Anticholinergic Drugs ◽  
Normal Range ◽  
Clinically Significant ◽  
Electrocardiogram Ecg

The prevalence of overactive bladder (OAB) increases with age and can be associated with other co-morbidities, such as cardiac arrhythmia. Unfortunately, commonly used anticholinergic drugs for OAB can affect the cardiovascular system, leading to tachycardia. However, there are no data, which consider the influence of intradetrusor onabotulinumtoxinA injections on heart function in idiopathic OAB patients. The aim of the present study was to evaluate the influence of intradetrusor onabotulinumtoxinA injections on electrocardiogram (ECG) parameters. Additionally, changes in ECG were analyzed in OAB patients without cardiac arrhythmia. Thirty-one patients with cardiac arrhythmia and 31 participants without irregular heart rate (HR) completed the study. ECG measurements were performed in supine positions 2 h before onabotulinumtoxinA injections, 1 h after treatment, and at 2 weeks of follow-up. At week 6, a phone-call survey was conducted to collect data about adverse events. OnabotulinumtoxinA injections were performed with rigid cystoscopy under local anesthesia. We did not observe any clinically significant changes in the analyzed ECG parameters between consecutive measurements. While a slight increase of HR was observed in patients without cardiac arrhythmia, it remained within normal range. Intravesical onabotulinumtoxinA injections are, hence, safe for female patients with cardiac arrhythmia and do not significantly influence changes in ECG.

Abstract 54: Preliminary Results With The Use Of Stat · Padz Pacing Electrode For Treatment Of Symptomatic Bradycardia In Emergency Department.

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Maria Margarita Gonzalez ◽  
Luis Augusto Dallan ◽  
Rogerio B Ramos ◽  
Evelinda Trindade ◽  
Sergio Timerman ◽  
...  
Keyword(s):  
Emergency Department ◽  
Heart Disease ◽  
University Hospital ◽  
Temporary Treatment ◽  
Conventional Electrode ◽  
The Mean ◽  
Symptomatic Bradycardia ◽  
A Prospective Study ◽  
Ecg Leads ◽  
Electrocardiogram Ecg

Background: Since the mid-1980’s transthoracic pacing has been a common temporary treatment for arrhythmias. Present external pacing technology requires the application of both multifunction defibrillation electrodes and separate leads for electrocardiogram (ECG) monitoring. Separate ECG leads are required as the current from the pacing pulse creates artifact in the signal that prevents one from distinguishing between pace-captured and non-captured rhythms when using the defibrillation electrode alone. Hypotheses: We hyothezised that Stat· padz MWP electrode, a transthoracic electrode that integrates the ECG electrodes into the defibrillation and pacing pad woud be abble to reconize captured and non-captured rhythms in a typical clinical setting of the syntomatic bradycardia. Methods: We conducted a prospective study at Emergency Department of a University Hospital. During October 2006 to April 2007, 28 patients with symptomatic bradycardia were include in the study. Comparison between monitoring by conventional electrode and Stat· padz MWP electrode was performed. After that was selected Lead II, and adjusted pacing rate and milliamps for the stimulation. Records and comparison of electrical capture was performed with the three lead conventional electrodes and Stat· padz MWP electrodes. Results: The mean electrocardiographic diagnoses was third degree atrio-ventricular block in 50% of patients, and the principal symptoms were presyncope in 82 %, symptoms of reduced cardiac output in 79% and syncope in 43%. Previous diagnoses were Hypertension in 57%, Chagas’s heart disease in 21%, Valvar heart disease in 14% and Dilated Cardiomyopathy in 18 %. Monitoring of cardiac rhythm, electrical and mechanical capture were obtained in 100 % of patients. The mean energy for capture was 69±18 milliamps. When compared the records of electrocardiographic capture with Stat· padz MWP electrode, it was equal than conventional electrodes in 46 % and better in 54 %. Conclusion: The Stat· padz MWP electrode has the feasibility of recognise capture and non-capture rhythms and to perform pacing function effectively. It presents the possibility of providing rapid treatment in patients with syntomatic bradycardia avoiding monitoring by conventional electrodes.

Evaluation of Normal Heart Rate in Early Pregnancy Corresponding to Gestational Age between Six to Eight Weeks

Med Phoenix ◽  
2017 ◽  
Vol 2 (1) ◽  
pp. 34-37
Author(s):  
Akhilesh Kumar Jha ◽  
Bikranta Rimal ◽  
Tarannum Khatun
Keyword(s):  
Heart Rate ◽  
Early Pregnancy ◽  
Well Being ◽  
Clinical Decision ◽  
First Trimester ◽  
Normal Heart ◽  
Normal Heart Rate ◽  
First Trimester Of Pregnancy ◽  
Singleton Pregnancies

Background: Ultrasonography is the reliable and safe way for the evaluation of pregnancy. Heart rate can be detected more confidently from the Ultrasonography. Heart rate is an important parameter for the evaluation of early pregnancy. The purpose of this study was to evaluate the normal heart rate in embryos/fetuses between 6 and 8 weeks of gestation.Method: In our region people are poor and most of them do not know the benefit of regular follow up examination during pregnancy. So most of pregnant women come to our centre at late stage of pregnancy. The number of pregnancy cases is good in our centre but the number of early pregnancy cases coming to regular follow up examination is low. Thus the study was conducted in 51 normal singleton pregnancies undergoing routine ultrasound examination during the first trimester of pregnancy. The duration of study was 6 weeks.Result: Out of 51 singleton pregnancies, 20 cases (39.2%) heart rate were between 131-150 beat per minute and 25 cases (49.0 %) heart rate were between 151-170 beat per minute. However 4 cases (7.8%) were between 110-120 beat per minute and 2 cases (3.9%) were more than 171 beat per minute. There were zero cases above the 180 beat per minute.Conclusion: The result of this study will help to evaluate abnormal and normal fetal heart rate so that early clinical decision whether to continue the pregnancy or terminate it can be taken, as Ultrasonography is only the method used in screening fetal well being in most of the region of our country.Med Phoenix Vol.2(1) July 2017, 34-37

HEART COMPLICATIONS IN HYPERTHYROIDISM

2011 ◽  
pp. 7-17
Author(s):  
Hai Thuy Nguyen ◽  
Anh Vu Nguyen
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Heart Rate ◽  
Heart Diseases ◽  
Systolic Dysfunction ◽  
Oxygen Demand ◽  
Left Ventricular ◽  
Cardiac Contraction ◽  
Cardiac Complications ◽  
Cardiac Symptoms

Thyroid hormone increases the force of the contraction and the amount of the heart muscle oxygen demand. It also increases the heart rate. Due to these reasons, the work of the heart is greatly increased in hyperthyroidism. Hyperthyroidism increases the amount of nitric oxide in the intima, lead them to be dilated and become less stiff. Cardiac symptoms can be seen in anybody with hyperthyroidism, but can be particularly dangerous in whom have underlying heart diseases. Common symptoms include: tachycardia and palpitations. Occult hyperthyroidism is a common cause of an increased heart rate at rest and with mild exertion. Hyperthyroidism can also produce a host of other arrhythmias such as PVCs, ventricular tachycardia and especially atrial fibrillation. Left ventricular diastolic dysfunction and systolic dysfunction, Mitral regurgitation and mitral valve prolapsed are heart complications of hyperthyroism could be detected by echocardiography. The forceful cardiac contraction increases the systolic blood pressure despite the increased relaxation in the blood vessels reduces the diastolic blood pressure. Atrial fibrillation, atrial enlargement and congestive heart failure are important cardiac complications of hyperthyroidism. An increased risks of stroke is common in patients with atrial fibrillation. Graves disease is linked to autoimmune complications, such as cardiac valve involvement, pulmonary arterial hypertension and specific cardiomyopathy. Worsening angina: Patients with coronary artery disease often experience a marked worsening in symptoms with hyperthyroidism. These can include an increase in chest pain (angina) or even a heart attack.

Hypogastric Artery Stenting for Chronic Intermittent Spinal Cord Ischemia After Thoracic Endovascular Aortic Repair

2020 ◽  
Vol 27 (5) ◽  
pp. 801-804
Author(s):  
Catharina Gronert ◽  
Nikolaos Tsilimparis ◽  
Giuseppe Panuccio ◽  
Ahmed Eleshra ◽  
Fiona Rohlffs ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Ischemia ◽  
Thoracic Endovascular Aortic Repair ◽  
Neurological Symptoms ◽  
Endovascular Aortic Repair ◽  
Hypogastric Artery ◽  
Lower Extremity Weakness ◽  
Aortic Repair ◽  
The Right

Purpose: To report a case of chronic intermittent spinal cord ischemia (SCI) after thoracic endovascular aortic repair (TEVAR) and its successful treatment using hypogastric artery stenting. Case Report: A 79-year-old patient presented in May 2013 with a thoracic aortic aneurysm (TAA) and a contained rupture. He urgently underwent TEVAR that covered 274 mm of descending thoracic aorta without immediate postoperative signs of acute SCI. At 3-month follow-up, he reported repeating incidents of sudden lower extremity weakness leading to a fall with a humerus fracture. A neurological consultation revealed the tentative diagnosis of intermittent SCI caused by TEVAR and initially recommended a conservative approach. During the following year there was no clinical improvement of the symptoms. Computed tomography angiography showed a high-grade stenosis of the right hypogastric artery, which was stented in November 2014 to improve the collateral network of spinal cord perfusion. Following treatment, the patient had no further neurological symptoms; at 32 months after the reintervention, the imaging follow-up documented a patent stent and continued exclusion of the TAA. Conclusion: Intermittent neurological symptoms after TEVAR should be suspected as chronic intermittent SCI. The improvement of collateral networks of the spinal cord by revascularization of the hypogastric artery is a viable treatment option.

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