Food-Related Atrial Fibrillation? The Potential Role of Biogenic Amines in “Nutri-Arrhythmias” Genesis

Atrial fibrillation (AF) is the most common type of arrhythmia: a disorganized electrical atrial activity leading to irregular ventricular beats. Its most common risk factors include high blood pressure, congenital and valvular heart diseases, aging, heart failure and coronary heart diseases. Other risk factors include excessive alcohol intake, tobacco smoking, diabetes mellitus and thyrotoxicosis. However, many cases are not associated with any of these risk factors: probably, in these patients, immunological, functional and even dietary mechanisms may be responsible to induce cardiac arrhythmias. Several studies have focused on immunological and neurohumoral mechanisms; however, little information is available about the potential relationship between dietary patterns and atrial fibrillation episodes. This case report describes a potential correlation between biogenic amines in ingested food and recurrent atrial fibrillation onset in a 61-years old man in absence of a remarkable clinical history and of the most common risk factors. The nutritional team instituted a food protocol: a low calories diet and eliminating biogenic amines-rich foods. During the follow-up (16 months), there was a noticeable weight loss and no arrhythmic episodes happened again. This clinical case provides evidence for a possible new relationship between some kinds of food and heart conduction (defining the very novel field of arrhythmogenic foods and of “nutri-arrhythmias”), recognizing biogenic amines-rich foods abuse as the potential trigger and substrate for atrial fibrillation. Therefore, we suggested that clinical history in patients with new onset AF should also include questions concerning the ingestion of histamine-rich foodstuffs (or other amines-rich food) and alcohol consumption: their effects may result to be synergistic in the alteration of cardiac rhythm and may explain the recurrence of an unexplained atrial fibrillation

Struma ovarii with follicular thyroid-type carcinoma and neuroendocrine component: case report

Abstract Struma ovarii (SO) is a slow-growing ovarian neoplasm with thyroid tissue as its predominant component. It is an uncommon neoplasm, usually asymptomatic with an unknown risk of malignant transformation. Due to difficulties in assessing the rare biological nature and the discrepancies in the reported cases, a consensus on the appropriate treatment has not been definitively reached. A 50-year-old female was subjected to upper gut endoscopy which showed a 30-mm mass located in the gastric antrum, suggestive of mesenchimal tumor. Incidentally, a pelvic CT scan also documented a solid mass in the right adnexa, with morphological characteristics of ovarian neoplasm. The patient underwent gastrectomy, total hysterectomy, bilateral salpingo-oophorectomy with lymph node dissection, and omentectomy. Histology documented the presence of gastric cavernous angioma, and, in the right adnexa, foci of follicular thyroid-type carcinoma arising in SO with a well-differentiated neuroendocrine component. Here we report and discuss the clinical and morphological presentation of follicular thyroid-type carcinoma arising in SO. The neoplasm was discovered incidentally and had a favorable clinical outcome at 1-year follow-up.</p