No abstract

We report here the case of a 27-year-old woman with Noonan syndrome presenting with ventricular fibrillation. After successful defibrillation, echocardiography revealed hypertrophic cardiomyopathy associated with left ventricular outflow tract obstruction. Normal echocardiographic cardiac structure and function were reported 11 years ago. This case emphasises the importance of regular follow-up in patients with congenital disorders in which cardiac manifestations might develop in early adulthood or later.

No abstract

AimsTransoesophageal echocardiography (TEE) is an uncomfortable procedure for the majority of patients. In the current double-blind randomized prospective study, we sought to assess whether ondansetron would improve patient comfort, reduce the need for sedation, and increase tolerance during TEE, and we compared ondansetron, metoclopramide, and placebo. Methods and resultsOne hundred and fifty-six patients who underwent TEE were randomized into three groups receiving ondansetron HCl, metoclopramide, or placebo. Data concerning additional doses of midazolam, procedural time, recovery time in the outpatient ward, blood pressure values, percutaneous arterial oxygen saturation values, side effects of the medications used, and patient discomfort via a visual analogue scale (VAS) were collected and analysed. The ondansetron group received less additional midazolam than the metoclopramide and placebo groups (ondansetron group: 0.6 + 0.7 mg; metoclopramide group: 1.9 + 0.9 mg; and placebo group: 2.1 + 0.8 mg; P , 0,001). VAS was significantly lower in the ondansetron group than in the metoclopramide and placebo groups (4.0 + 1.6, 6.1 + 1.8, and 6.6 + 1.6, respectively; P , 0.001). Recovery time in the outpatient ward was shorter in the ondansetron group than in the metoclopramide and placebo groups (22.5 + 4.8, 30.9 + 6.6, and 30.4 + 5.0 min, respectively; P , 0.001). No adverse reaction to ondansetron was observed, whereas one patient developed mild spontaneously resolving dystonia due to metoclopramide. ConclusionOndansetron administration reduces the need for sedation during TEE and improves patient comfort.--

No abstract

No abstract

EECP seems to be a safe treatment modality in patients with implanted ICD and CRT-D devices. It should be kept in mind that in those patients with CRT-D, rate responsive mode is on; inappropriate sinus tachycardia can be seen during EECP therapy. Also in patients with CRT-D using a unipolar sensing mode, problems of QRS complex sensing by the EECP may occur and, therefore, this effects synchronization and success of EECP therapy.

We report the case of a 32-year-old male patient with symptoms of cerebrovascular accident manifesting with dysarthria. A transesophageal echocardiogram showed a floating mass localized in the ascending aorta, and a multislice computed tomography evaluation confirmed the diagnosis. With a comprehensive assessment of the mass, we decided on surgical intervention. A pedunculated and fragile mass was seen just near the right coronary ostium. The measured dimensions were 7.7 x 1.0 x 1.5 cm. The removed mass has been analyzed histopathologically and found to be the cause of the neurologic findings with an uncertain underlying etiology.