The venous anomaly of a persistent left superior vena cava (PLSVC) affects 0.3%–0.5% of the general population. PLSVC with absent right superior vena cava, also termed as “isolated PLSVC,” is an extremely rare venous anomaly. Almost half of the patients with isolated PLSVC have cardiac anomalies in the form of atrial septal defect, endocardial cushion defects, or tetralogy of Fallot. Isolated PLSVC is usually innocuous. Its discovery, however, has important clinical implications. It can pose clinical difficulties with central venous access, cardiothoracic surgeries, and pacemaker implantation. When it drains to the left atrium, it may create a right to left shunt. In this case report, we present the incidental finding of isolated PLSVC in a patient who underwent aortic valve replacement. Awareness about this condition and its variations is important to avoid complications.
BACKGROUNDAtrial myxomas are the most common primary cardiac tumours. More than 90% of cases are solitary. A large myxoma occupying in the left atrium producing features of mitral stenosis and regurgitation was demonstrated by 2D echocardiographic images in this case. It remained asymptomatic for a long period with survival up to 60 years in an elderly man.
Ventricular Fibrillation (VF) is a Medical Emergency and Defibrillation is the definite treatment with DC shock. The correct application of energy by trained personnel is important for success and to avoid complications. We describe herewith an interesting case of several episodes of VF requiring emergency treatment. The patient survived the ordeal with several burns on the chest wall.
KEYWORDSVF, Defibrillation, Defibrillator Burn.
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INTRODUCTIONA young patient (ND) of 28 years male had some dysrhythmia from childhood and was on a pacemaker for last seven years. The history revealed the patient coming from rural areas, in his early adulthood, was having syncopal attack off and on. The general practitioner who examined him found him to have some irregularity in his pulse and referred him to the cardiologist for evaluation. The youngman was otherwise fit. His ECG had shown some abnormality, which he could not specify. A 24 hrs. Holter study at that time showed that he has more problem and was advised to put a pacemaker. After sometime he was given a pacemaker, which was implanted in right upper chest for last seven years. He was hale and hearty and there was no syncopal attack anymore for several years. For last three months, he was again having chest discomfort and blackout episodes and again seen by a different Cardiologist. This time it was found that the pacemaker is fully functional, but the patient is developing occasional chest discomfort due to ventricular fibrillation. As the incidence of attack increased in frequency, he was re-evaluated and it was also found that he has some degree of Cardiomyopathy too. So he was admitted to ICU.On admission he was afebrile, Pulse was 82/min with occasional extra beats. BP 116/80 mmHg. On clinical examination, he was anxious. His heart sounds were normally heard. There was no murmur. Breath sounds heard in all quadrant. Other systems were normal. CBC was within normal limits (Hb 11.4 gm%, TLC 8900). Blood Sugar 102 mg%, serum Urea 44 mg, Creatinine 0.8, Na 132 and K was 3.8 mEq/L. Liver function tests were within normal limits and x-ray chest showed the pacemaker in situ with pacemaker electrode in place,
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