COMPLETE ATRIOVENTRICULAR BLOCK ASSOCIATED WITH NON-PENETRATING CARDIAC TRAUMA IN A 40-YEAR-OLD MAN

Background: Myocardial contusion is a rare complication of blunt chest trauma. Transient conduction and rhythm problems, right ventricular dysfunction, or pulmonary embolism may occur after chest trauma, but these complications almost always occur early in the post-operative period. Objectives: The objective is to describe a case illustrating that trauma may induce high-grade atrioventricular block. Case Report: We report the case of a patient who developed delayed onset of complete atrioventricular block after transient complete atrioventricular block and alternating bundle branch block secondary to blunt chest trauma. Conclusion: Even with an injury that does not seem to be caused by direct penetrating trauma to the heart, maybe every trauma patient needs an electro-cardiographic evaluation. It is important to note that myocardial healing is a continuous process after trauma, and additional pathology may be revealed later in the course of healing from myocardial contusion. (C) 2013 Elsevier Inc

Successful Radiofrequency Ablation of Atrial Flutter Causing Hemodynamic Instability in a Patient with Recent Myocardial Infarction

Atrial flutter (AFL) is a common arrhythmia which may decrease cardiac output and may cause embolic events. Direct current (DC) cardioversion, medical cardioversion and radiofrequency (RF) ablation are therapeutic options, but over all RF ablation therapy has the longest event free period. Although development of AFL after myocardial infarction is quite common it may spontaneously recover or results in atrial fibrillation. Herein we report a patient with medical and electrical cardioversion resistant AFL which developed in the early post- myocardial infarction period causing hemodynamic instability, who was successfully treated with RF catheter ablation

Successful treatment of renal artery thromboembolism with low-dose prolonged infusion of tissue-typed plasminogen activator in a patient with mitral mechanical heart valve thrombosis under the guidance of multimodality imaging

This case report describes the use of low-dose prolonged infusion of tissue-typed plasminogen activator in the treatment of renal artery thromboembolism secondary to prosthetic valve thrombosis, under the guidance of multimodality imaging. Thromboembolic occlusion of renal arteries is a rare disorder with serious consequences. It is generally associated with cardiac diseases and arrhytmias. Four consecutive doses of low-dose prolonged infusion of tissue-typed plasminogen activator [25mg tissue-typed plasminogen activator (tpa) in 6 h] were administered to the patient. This case of renal artery thromboembolism secondary to mitral mechanical prosthetic valve thrombosis was successfully treated with low-dose prolonged infusion of tPA under the guidance of multimodality imaging with renal artery Doppler ultrasonography, multislice computerized tomographic angiography, renal angiography, two-dimensional and real-time three-dimensional transesophageal echocardiography. This case has demonstrated that low-dose prolonged infusion of tissue-typed plasminogen activator may be effective and well tolerated in the treatment of renal embolism. Blood Coagul Fibrinolysis 23: 663-665 (C) 2012 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins