The high diagnostic rate of implantable loop recorder in the everyday clinical practice is in accordance with the findings in prospective clinical studies. This observation supports the early application of loop recorder in the diagnostic algorithm of syncope.
The presented cases shed light to the fact that the apical dilatation of the left ventricle is only one of the possible presentations of stress induced cardiomyopathy. The main feature of this entity is not the tako-tsubo-like left ventricular dilatation, which is not always present, but the almost universal QT prolongation and negative T waves. These ECG features come a few days after the appearance of the reversible left ventricular dysfunction.
Összefoglaló. Egy 78 éves férfi széles-QRS-tachycardiás esetét
mutatjuk be. A betegnél a pitvar-kamrai disszociáció igazolta a ritmuszavar
kamrai eredetét, amelyet a Valsalva-manőverrel több alkalommal is átmenetileg
meg lehetett szüntetni. A szerzők ismertetik a manőver lehetséges
patomechanizmusait, illetve felhívják a figyelmet arra, hogy a vagusmanőverre
megszűnő reguláris tachycardia nem jelent feltétlenül supraventricularis
eredetet. Orv Hetil. 2021; 162(12): 468–470.
Summary. A 78-year-old man is presented with wide QRS tachycardia
(WQRST). The ventricular origin of WQRST was confirmed by atrioventricular
dissociation. The Valsalva maneuver terminated the tachycardia repeatedly. The
authors discuss the possible mechanisms of Valsalva maneuver in the arrhythmia
termination. This case highlights that Valsalva maneuver or carotid massage
terminated tachycardia are not necessarily supraventricular tachycardia. Orv
Hetil. 2021; 162(12): 468–470.
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