Electrocardiographic Findings in Bitches Affected by Closed Cervix Pyometra

Pyometra is considered the most common disease in intact bitches, being associated with potentially life-threatening disorders. Myocardial damage is a potentially life-threatening consequence of pyometra. The aim of this study was to describe the electrocardiographic patterns in bitches affected by closed cervix pyometra, to assess the clinical relevance of electrocardiographic changes with the occurrence of pyometra, and to relate their severity with laboratory and clinical findings. A total of 39 bitches with closed cervix pyometra and 10 healthy female dogs were included in this study. During the hospitalization, bitches underwent a complete physical examination. An electrocardiographic examination before the ovariohysterectomy was performed. Blood samples for biochemical and hematological analysis were also evaluated. Bitches suffering pyometra at least one arrhythmia 31/39 (79.4%), sinus tachycardia (22/39, 56.4%), ventricular premature complexes (9/39, 23%), increased amplitude of T wave (7/39, 17.9%), ST depression (4/39, 10.2%), second-degree atrioventricular block (2/39, 5.1%), increase of QT interval (2/39, 5.1%), sinus bradycardia (2/39, 5.1%), and first-degree atrioventricular block (1/39, 2.5%). Some bitches were also detected with low wave amplitude (17/39, 43.5%). Cardiac arrhythmias associated with canine pyometra are frequent events. These data suggest that arrhythmias may be the consequence of one or more factors that can occur during pyometra, such as myocardial damage, electrolyte/metabolic disorders, and/or sepsis.

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Bradyarrhythmias

10.2310/em.4702 ◽

2016 ◽

Author(s):

Inna Leybell ◽

Liliya Abrukin

Keyword(s):

Atrioventricular Block ◽

Sinus Bradycardia ◽

Sinus Node ◽

Treatment Options ◽

Presenting Symptoms ◽

Threatening Condition ◽

Node Disease ◽

Life Threatening ◽

Sinus Node Disease ◽

Sinoatrial Block

Bradyarrhythmias can present as an incidental electrocardiographic (ECG) finding or a life-threatening condition requiring immediate intervention. They are caused by sinus node disease or atrioventricular block. This review covers pathophysiology, stabilization and assessment, diagnosis and treatment options, and disposition and outcomes for patients with bradycardia. Figures in the review demonstrate characteristic ECG tracings. Tables list classifications of sinus node dysfunction as well as of sinoatrial and atrioventricular blocks, presenting symptoms, important information to elicit on history taking, various causes of bradycardia, and specific interventions for toxicologic etiologies. Key words: atrioventricular block, atropine, bradyarrhythmia, bradycardia, first-degree atrioventricular block, second-degree atrioventricular block, sinoatrial block, sinus bradycardia, sinus node disease, tachycardia-bradycardia syndrome, third-degree atrioventricular block This review contains 9 highly rendered figures, 7 tables, and 92 references.

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Atypical Clinical Presentation of Laryngopharyngeal Reflux: A 5-Year Case Series

Journal of Clinical Medicine ◽

10.3390/jcm10112439 ◽

2021 ◽

Vol 10 (11) ◽

pp. 2439

Author(s):

Jerome R. Lechien ◽

Stéphane Hans ◽

Francois Bobin ◽

Christian Calvo-Henriquez ◽

Sven Saussez ◽

...

Keyword(s):

Clinical Presentation ◽

Laryngopharyngeal Reflux ◽

Case Series ◽

Clinical Findings ◽

Aerodigestive Tract ◽

Common Disease ◽

Upper Aerodigestive Tract ◽

Suppurative Otitis Media ◽

Adequate Treatment ◽

Atypical Clinical Presentation

Background: Laryngopharyngeal reflux (LPR) is a common disease in otolaryngology characterized by an inflammatory reaction of the mucosa of the upper aerodigestive tract caused by digestive refluxate enzymes. LPR has been identified as the etiological or favoring factor of laryngeal, oral, sinonasal, or otological diseases. In this case series, we reported the atypical clinical presentation of LPR in patients presenting in our clinic with reflux. Methods: A retrospective medical chart review of 351 patients with LPR treated in the European Reflux Clinic in Brussels, Poitiers and Paris was performed. In order to be included, patients had to report an atypical clinical presentation of LPR, consisting of symptoms or findings that are not described in the reflux symptom score and reflux sign assessment. The LPR diagnosis was confirmed with a 24 h hypopharyngeal-esophageal impedance pH study, and patients were treated with a combination of diet, proton pump inhibitors, and alginates. The atypical symptoms or findings had to be resolved from pre- to posttreatment. Results: From 2017 to 2021, 21 patients with atypical LPR were treated in our center. The clinical presentation consisted of recurrent aphthosis or burning mouth (N = 9), recurrent burps and abdominal disorders (N = 2), posterior nasal obstruction (N = 2), recurrent acute suppurative otitis media (N = 2), severe vocal fold dysplasia (N = 2), and recurrent acute rhinopharyngitis (N = 1), tearing (N = 1), aspirations (N = 1), or tracheobronchitis (N = 1). Abnormal upper aerodigestive tract reflux events were identified in all of these patients. Atypical clinical findings resolved and did not recur after an adequate antireflux treatment. Conclusion: LPR may present with various clinical presentations, including mouth, eye, tracheobronchial, nasal, or laryngeal findings, which may all regress with adequate treatment. Future studies are needed to better specify the relationship between LPR and these atypical findings through analyses identifying gastroduodenal enzymes in the inflamed tissue.

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All-trans retinoic acid-induced, life-threatening complete atrioventricular block

Journal of the Chinese Medical Association ◽

10.1016/j.jcma.2014.05.018 ◽

2015 ◽

Vol 78 (5) ◽

pp. 316-319 ◽

Cited By ~ 3

Author(s):

Chen-Hsiang Shih ◽

Hung-Bo Wu

Keyword(s):

Retinoic Acid ◽

Atrioventricular Block ◽

Complete Atrioventricular Block ◽

Trans Retinoic Acid ◽

All Trans Retinoic Acid ◽

Life Threatening ◽

Complete Atrioventricular

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Pacemaker use for the treatment of reflex-mediated syncope: 40-year experience at a single paediatric institution

Cardiology in the Young ◽

10.1017/s1047951121004340 ◽

2021 ◽

pp. 1-6

Author(s):

Thomas Huang ◽

Edward O’Leary ◽

Mark E. Alexander ◽

Laura Bevilacqua ◽

Francis Fynn-Thompson ◽

...

Keyword(s):

Young Adults ◽

Atrioventricular Block ◽

Sinus Bradycardia ◽

Pacemaker Implantation ◽

Complication Rates ◽

Single Centre Experience ◽

Procedural Complications ◽

Children And Young Adults ◽

Dual Chamber Pacemakers

Abstract Introduction: Reflex-mediated syncope occurs in 15% of children and young adults. In rare instances, pacemakers are required to treat syncopal episodes associated with transient sinus pauses or atrioventricular block. This study describes a single centre experience in the use of permanent pacemakers to treat syncope in children and young adults. Materials and methods: Patients with significant pre-syncope or syncope and pacemaker implantation from 1978 to 2018 were reviewed. Data collected included the age of presentation, method of diagnosis, underlying rhythm disturbance, age at implant, type of pacemaker implanted, procedural complications and subsequent symptoms. Results: Fifty patients were identified. Median age at time of the first syncopal episode was 10.2 (range 0.3–20.4) years, with a median implant age of 14.9 (0.9–34.3) years. Significant sinus bradycardia/pauses were the predominant reason for pacemaker implant (54%), followed by high-grade atrioventricular block (30%). Four (8%) patients had both sinus pauses and atrioventricular block documented. The majority of patients had dual-chamber pacemakers implanted (58%), followed by ventricular pacemakers (38%). Median follow-up was 6.7 (0.4–33.0) years. Post-implant, 4 (8%) patients continued to have syncope, 7 (14%) had complete resolution of their symptoms, and the remaining reported a decrease in their pre-syncopal episodes and no further syncope. Twelve (24%) patients had complications, including two infections and eight lead malfunctions. Conclusions: Paediatric patients with reflex-mediated syncope can be treated with pacing. Complication rates are high (24%); as such, permanent pacemakers should be reserved only for those in whom asystole from sinus pauses or atrioventricular block has been well documented.

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Congenital sinus bradycardia combined with congenital total atrioventricular block

European Journal of Nuclear Medicine ◽

10.1007/bf00480600 ◽

1977 ◽

Vol 125 (3) ◽

pp. 219-224 ◽

Cited By ~ 4

Author(s):

H. Stopfkuchen ◽

B. -K. J�ngst

Keyword(s):

Atrioventricular Block ◽

Sinus Bradycardia ◽

Total Atrioventricular Block

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A modern approach to the combination treatment of allergic rhinitis

Medical Council ◽

10.21518/2079-701x-2018-20-92-95 ◽

2018 ◽

pp. 92-95

Author(s):

S. A. Karpischenko ◽

G. V. Lavrenova ◽

E. I. Muratova

Keyword(s):

Allergic Rhinitis ◽

Disease Incidence ◽

The Body ◽

Bronchial Obstruction ◽

Common Disease ◽

Nasal Breathing ◽

Modern Approach ◽

Life Threatening ◽

Adults And Children ◽

Consistent Increase

Allergic rhinitis is a common disease that significantly worsens the patient’s quality of life. In some cases, the disease can be life threatening. Severe attacks of bronchial obstruction may occur in patients with allergic rhinitis. The widespread prevalence of allergic rhinitis in adults and children, consistent increase in disease incidence constitutes a great medical and social issue. Treatment for allergic rhinitis should be aimed at reaching increased remission duration, preventing the exacerbation of the disease and educating patients to maintain control over the symptoms of the disease. A challenge that otolaryngologists and allergists face is to restore nasal breathing in patients with allergic rhinitis. The updated approach to the challenge is to suggest treatment that takes into account the pathophysiological mechanisms that occur not only in the mucous membrane of the nasal cavity, but throughout the body, in particular, in the intestine.

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A Suspected COVID-19-associated Myocarditis Case Mimicking Life-threatening STEMI: a Shark Fin Appearance

Cardiovascular and Cardiometabolic Journal (CCJ) ◽

10.20473/ccj.v2i1.2021.23-29 ◽

2021 ◽

Vol 2 (1) ◽

pp. 23

Author(s):

Ratna Mariana Tamba ◽

Andika Sitepu

Keyword(s):

Chest Pain ◽

Rapid Test ◽

Myocardial Damage ◽

Ground Glass Opacity ◽

Normal Coronary Artery ◽

Proinflammatory Response ◽

Cardiac Biomarker ◽

Life Threatening ◽

History Of ◽

St Elevation

Some cases of myocarditis have been reported associated to Covid-19. The presence of proinflammatory response from immune cells suggested occurs by binding to membrane protein ACE-2 leading to myocardial damage. Our hospital got a refferal from a non-PCI-capable hospital with a 51-years-old woman chest pain and progressive heavy breath with history of fever two days ago. She was diagnosed with anterior STEMI and cardiogenic shock on vassopressors. Her electrocardiogram showed shark fin appearance suggesting life-threatening STEMI. Her rapid test for covid-19 are non-reactive for both IgM and IgG. Her NCCT-thorax showed ground glass opacity in both lungs. Her laboratories finding showed elevated inflammatory markers and elevated cardiac biomarker. We took her naso-oro-pharingeal swab in the same day and process her with emergency PCI. Surprisingly, her angiography showed normal coronary artery without any significant stenosis. From There was no SARS-CoV-2 detected. In myocarditis, patient can mimick the same symptoms as STEMI such as chest pain and heavy breath with elevated cardiac biomarker, but the electrocardiogram usually shows widespread concave ST-elevation with PR-segment depression. Shark fin appearance is usually seen in life-threatening STEMI. In our patient, the NCCT-thorax showed GGO suggested Covid-19 involvement. But, the first swab was negative for SARS-CoV-2. Unfortunately, the patient was discharged without doctor’s consent, so we can not process the second swab and echocardiography to evaluate the function of myocardium. We still can not confirmed this case if it is true myocarditis-associated covid-19 and how was the involvement of the myocardium creating a shark fin mimicking life-threatening STEMI.

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Thromboembolic complications of thyroid storm

Endocrinology Diabetes and Metabolism Case Reports ◽

10.1530/edm-13-0060 ◽

2014 ◽

Vol 2014 ◽

Cited By ~ 1

Author(s):

T Min ◽

S Benjamin ◽

L Cozma

Keyword(s):

Atrial Fibrillation ◽

Early Recognition ◽

Massive Pulmonary Embolism ◽

Clinical Findings ◽

Favourable Outcome ◽

Thyroid Storm ◽

List Type ◽

Chads2 Score ◽

Prompt Treatment ◽

Life Threatening

Summary Thyroid storm is a rare but potentially life-threatening complication of hyperthyroidism. Early recognition and prompt treatment are essential. Atrial fibrillation can occur in up to 40% of patients with thyroid storm. Studies have shown that hyperthyroidism increases the risk of thromboembolic events. There is no consensus with regard to the initiation of anticoagulation for atrial fibrillation in severe thyrotoxicosis. Anticoagulation is not routinely initiated if the risk is low on a CHADS2 score; however, this should be considered in patients with thyroid storm or severe thyrotoxicosis with impending storm irrespective of the CHADS2 risk, as it appears to increase the risk of thromboembolic episodes. Herein, we describe a case of thyroid storm complicated by massive pulmonary embolism. Learning points Diagnosis of thyroid storm is based on clinical findings. Early recognition and prompt treatment could lead to a favourable outcome. Hypercoagulable state is a recognised complication of thyrotoxicosis. Atrial fibrillation is strongly associated with hyperthyroidism and thyroid storm. Anticoagulation should be considered for patients with severe thyrotoxicosis and atrial fibrillation irrespective of the CHADS2 score. Patients with severe thyrotoxicosis and clinical evidence of thrombosis should be immediately anticoagulated until hyperthyroidism is under control.

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A premature low-birth-weight infant with congenital complete atrioventricular block and myocarditis successfully treated by staged pacemaker implantation

Cardiology in the Young ◽

10.1017/s1047951116000433 ◽

2016 ◽

Vol 26 (5) ◽

pp. 1029-1032

Author(s):

Tao Fujioka ◽

Masaki Nii ◽

Yasuhiko Tanaka

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Atrioventricular Block ◽

Pacemaker Implantation ◽

Myocardial Damage ◽

Ventricular Rate ◽

Complete Atrioventricular Block ◽

Low Birth Weight Infant ◽

Congenital Complete Atrioventricular Block ◽

Complete Atrioventricular

AbstractCongenital complete atrioventricular block is a known lethal condition. Although antenatal diagnosis and the technical advances of pacemaker treatment have reduced its mortality, treatment of premature babies with significant myocardial damage remains a challenge. In this paper, we report the case of a premature low-birth-weight infant with congenital complete atrioventricular block and extremely low ventricular rate, fetal hydrops, and myocarditis who was successfully treated with staged permanent pacemaker implantation.

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