This paper discusses shortcomings of conventional Holter monitoring in paced patients and describes a new technique which permits reliable detection of intermittent pacemaker malfunction and counts pacemaker activity during the recording period. Evaluation of the system of 64 consecutive patients revealed 15 with unsuspected episodic pacemaker dysfunction.
Complete fracture and separation of a right coronary Judkins catheter during coronary angiography is presented. The possible mechanism underlying the separation and retrieval of the catheter fragment is described.
A case of arterial sheath kinking is reported. Radiographically, sheath kinking has some features which mimic sheath fracture. The radiographic appearance of sheath kinking is, however, distinctive and clearly separable from sheath fracture, the hallmark of which is extravasation of contrast at the fracture site.
Acute aortic dissection may present a clinical picture simulating myocardial infarction, including electrocardiographic changes. The mechanism underlying this mode of presentation has not heretofore been documented during life. We present here for the first time, a patient with acute aortic dissection and the clinical picture of acute myocardial infarction, where the mechanism of infarction has been demonstrated, by preoperative angiographic studies, probably to be due to compression of the extramural portion of the right coronary artery by the false channel of the dissecting hematoma.
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