Pacemaker-induced Superior Vena Cava Syndrome : Report of One Case and Review of the Literature

A 76-year-old man developed superior vena cava syndrome (SVCS) 20 months after the implantation of a dual chamber pacemaker, and was successfully treated with thrombolytic therapy followed by long-term anticoagulant therapy. The face and neck were markedly swollen, and superficial veins in the neck, upper arms and upper chest were prominently distended. Venography from bilateral cubital veins revealed a severe stenosis of the distal segment of the superior vena cava without the development of collateral channels. After an initial treatment with urokinase for 5 days followed by warfarin for 16 months, the symptoms and signs of the SVCS disappeared, and the digital subtraction angiography revealed a marked regression of the thrombotic stenosis. In view of the expected increase in the insertion of multiple leads in cases of dual chamber pacemakers or including fractured lead retention, more attention should be paid to the risk of the development of the SVCS in these cases

Successful Treatment of a Ruptured Spontaneous Dissecting Coronary Artery Pseudoaneurysm with a Covered Stent in a Patient with Cardiac Tamponade

The rupture of spontaneous dissecting coronary artery pseudoaneurysms is rare, and no standard therapy has yet been established for this condition. This report describes a case of a ruptured spontaneous dissecting coronary artery pseudoaneurysm in a patient with cardiac tamponade that was successfully treated with emergent implantation of a covered stent

Pacemaker-induced Superior Vena Cava Syndrome : Report of One Case and Review of the Literature

A 76-year-old man developed superior vena cava syndrome (SVCS) 20 months after the implantation of a dual chamber pacemaker, and was successfully treated with thrombolytic therapy followed by long-term anticoagulant therapy. The face and neck were markedly swollen, and superficial veins in the neck, upper arms and upper chest were prominently distended. Venography from bilateral cubital veins revealed a severe stenosis of the distal segment of the superior vena cava without the development of collateral channels. After an initial treatment with urokinase for 5 days followed by warfarin for 16 months, the symptoms and signs of the SVCS disappeared, and the digital subtraction angiography revealed a marked regression of the thrombotic stenosis. In view of the expected increase in the insertion of multiple leads in cases of dual chamber pacemakers or including fractured lead retention, more attention should be paid to the risk of the development of the SVCS in these cases

Successful Treatment of Heart Failure in an Adult Patient with Prader-Willi Syndrome

Prader-Willi Syndrome (PWS) is a rare genetic disorder characterized by physical, psychological and physiological abnormalities. Obesity and related cardiovascular diseases are a common problem in adult patients with PWS. This report describes a case of adult PWS with heart failure associated with marked obesity and sleep-disordered breathing that was successfully treated with oxygen therapy, adaptive servoventilation, medications, diet therapy and rehabilitation