Acromegaly incidentally diagnosed at term in a pregnant woman presenting with ventricular premature complexes

Pituitary adenomas lead to increased growth hormone production and acromegaly. Pregnancy in acromegaly is rare as spontaneous conception is affected. We presented a case of 31 year old lady conceived by ovulation induction and presented at term gestation with ventricular premature complexes and was subsequently diagnosed with pituitary micro adenoma causing acromegaly. There has been no reported case of pregnancy with acromegaly presenting with premature ventricular complexes. Moreover, diagnosis of acromegaly in pregnancy is difficult and limited literature is available on its effects as well as management.

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.

Balloon dilation of a perforated cor triatriatum dexter in a Springer Spaniel: anaesthetic management

A four-month-old male Springer Spaniel presented for investigation of ascites of three weeks’ duration. On transthoracic echocardiogram, cor triatriatum dexter was diagnosed with associated right-sided congestive heart failure. Medical therapy consisting of furosemide, spironolactone and benazepril was initiated. On the day of surgery, the dog was premedicated with methadone 0.2 mg/kg intravenously, and general anaesthesia was induced with midazolam 0.2 mg/kg intravenously and propofol 25 mg. Anaesthesia was maintained with isoflurane in oxygen. Concurrently, constant rate infusions of fentanyl 0.2–0.3 µg/kg/minute and lidocaine 50 µg/kg/minute were administered. Ventricular premature complexes and ventricular tachycardia developed during the placement of the catheter and during the first balloon dilation. Antiarrhythmic therapy with lidocaine 2 mg/kg was required. At the end of the procedure, acepromazine 5 µg/kg intravenous and buprenorphine 20 µg/kg intravenous were administered. Recovery from general anaesthesia was uneventful.

A CORRELATIONAL STUDY BETWEEN COUPLING INTERVAL RATIO AND SYMPTOMS IN PATIENTS WITH IDIOPATHIC VENTRICULAR PREMATURE COMPLEXES IN 24 HRS HOLTER MONITORING

Background and objective:Ventricular premature complexes (VPCs) are the most common arrhythmia encountered in cardiology OPD. Patients with frequent VPCs are often symptomatic. Our study aims to identify the ECG predictors of symptoms in patients with idiopathic VPCs in 24 hours Holter monitoring. Subjects and methods: This study was conducted on 102 patients with VPCs during the period of February 2019 to December 2019 in cardiology OPD of our centre.All the patients were screened with transthoracic echocardiography.24 hours Holter monitoring was done, the measured parameters were QRS width (Both in sinus beat & VPC), coupling interval (CI),CI ratio (CL/sinus cycle length) and VPC burden (Number and percentage of VPCs per day). Results:Both group had similar categorical age group and gender.ORS width of both sinus beat (P = 0.389) and VPCs (P = 0.035), VPC CI (P=0.487) and VPC burden (P = 0.458) did not correlate with symptoms but VPC CI ratio were significantly higher in Group B(symptomatic) than in group A (P = 0.004) Conclusion:There is a relationship between VPC related symptoms and VPC CI ratio.