Complete Heart Block Complicating Acute Rheumatic Fever

Abstract

group is largely empirical. Initial therapy is directed against staphylococci, streptococci and the HACEK organisms (Haemophilus species, Aggregatibacter actinomycetemcomitans, Cardiobacterium hominis, Eikenella species and Kingella kingae) should be started without delay. If there is no improvement in clinical status, the dosage of penicillin should be doubled. If still ineffective, the patient should be reevaluated for unusual pathogens and therapy should include a b-lactamase-resistant penicillin or vancomycin; if methicillin-resistant staphylococcal IE is suspected, vancomycin should be administrated. Patients with culture-negative endocarditis should be treated for a minimum of 4-6 weeks in consultation with an infectious diseases specialist. 1In summary, the survival of our patient was due to early diagnosis and prompt treatment with appropriate antibiotics in high doses, and the maintenance of normal tissue perfusion and blood pressure in the presence of overwhelming septicemia. We also have shown that with early diagnosis, recovery is possible.

Total atrioventricular block in patient with late onset acute inferior myocardial infarction

“…Total atrioventricular block (TAVB) occurred in 10.3% of patients with acute coronary syndrome (ACS). 4 Acute coronary syndrome is a serious clinical condition with high mortality rate and it is the leading cause of death worldwide. This is due to the loss of blood supply in the myocardium which causes damage to heart tissue due to a lack of oxygen.…”

“…The clinical presentation of patients with acute inferior myocardial infarction with total atrioventricular block often depends on the extent of myocardial damage and also the complications resulting from myocardial damage, such as heart failure, cardiogenic shock, arrhythmias and mechanical complications. 3,4 To diagnose a total atrioventricular block sometimes can be difficult because atrioventricular block sometimes can be no complaints at all, but for clinical signs and symptoms that generally appear include the presence of intolerance to exercise, weakness, dizziness, chest pain (angina) and syncope. When these complaints persist and there is a suspicion of Total AV block, the diagnosis can be obtained by looking at a standard 12 lead ECG, Holter ECG or external loop recorder (ELR) or implantable loop recorder (ILR) and an electrophysiology study (EPS).…”

“…3 TAVB is more common in inferior MI than anterior MI, but the mortality rate is higher in anterior MI with TAVB. 4 complained of nausea and vomiting. She thought that the complaint was due to acute gastritis.…”