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Tachycardia and dyspnea with exercise

Mike V Richardson, Amy Nordon-Craft, LeeAnne Carrothers
The incidence of postural orthostatic tachycardia syndrome (POTS) is estimated to be at least 500,000 in the United States and is most commonly found in premenopausal females. This syndrome shares clinical features with orthostatic hypotension (OH); however, the inclusion criteria and clinical features for POTS are not well known. The purposes of this case report are to: 1) describe the common clinical features of POTS and highlight the differences to orthostatic hypotension and 2) discuss physical therapy management of patients with POTS using exercise...
August 2017: Physiotherapy Theory and Practice
Fulvio Cacciapuoti, Venere Delli Paoli, Anna Scognamiglio, Federico Cacciapuoti
Esophageal achalasia is a motility disorder characterized by impaired relaxation of the lower esophageal sphincter and dilatation of the distal two-thirds of the esophagus. This condition may be a non-frequent reason of extrinsic compression of left atrium. In turn, this can be a cause of some hemodynamic changes such as chest discomfort, dyspnea or reduced exercise tolerance, systemic hypotension and tachycardia. We describe a case of a patient with esophagus achalasia compressing the left atrium and inducing hemodynamic compromise...
April 2014: Journal of Cardiovascular Echography
Lars Lindholm Sorensen, Hsin-Yueh Liang, Aurelio Pinheiro, Alex Hilser, Veronica Dimaano, Niels Thue Olsen, Thomas Fritz Hansen, Peter Sogaard, Alexandra Nowbar, Chiara Pisanello, Iraklis Pozios, Susan Phillip, Xun Zhou, Roselle Abraham, Theodore P Abraham
BACKGROUND: Exercise echocardiography in the evaluation of hypertrophic cardiomyopathy (HCM) provides valuable information for risk stratification, selection of optimal treatment, and prognostication. However, HCM patients with left ventricular outflow tract gradients ≥30mm Hg are often excluded from exercise testing because of safety considerations. We examined the safety and utility of exercise testing in patients with high-gradient HCM. METHODS: We evaluated clinical characteristics, hemodynamics, and imaging variables in 499 consecutive patients with HCM who performed 959 exercise tests...
February 2017: American Heart Journal
Logan Mills, Chris Harper, Sophie Rozwadowski, Chris Imray
Mills, Logan, Chris Harper, Sophie Rozwadowski, and Chris Imray. High altitude pulmonary edema without appropriate action progresses to right ventricular strain: A case study. High Alt Med Biol. 17:228-232, 2016.-A 24-year-old male developed high altitude pulmonary edema (HAPE) after three ascents to 4061 m over 3 days, sleeping each night at 2735 m. He complained of exertional dyspnea, dry cough, chest pain, fever, nausea, vertigo, and a severe frontal headache. Inappropriate continuation of ascent despite symptoms led to functional impairment and forced a return to the valley, but dyspnea persisted in addition to new orthopnea...
September 2016: High Altitude Medicine & Biology
Dierk Thomas, Lars Eckardt, Heidi L Estner, Malte Kuniss, Christian Meyer, Hans-Ruprecht Neuberger, Philipp Sommer, Daniel Steven, Frederik Voss, Hendrik Bonnemeier
Typical, cavotricuspid-dependent atrial flutter is the most common atrial macroreentry tachycardia. The incidence of atrial flutter (typical and atypical forms) is age-dependent with 5/100,000 in patients less than 50 years and approximately 600/100,000 in subjects > 80 years of age. Concomitant heart failure or pulmonary disease further increases the risk of typical atrial flutter.Patients with atrial flutter may present with symptoms of palpitations, reduced exercise capacity, chest pain, or dyspnea...
March 2016: Herzschrittmachertherapie & Elektrophysiologie
Martino Annamaria, Pier Paolo Lupo, Sara Foresti, Guido De Ambroggi, Ermenegildo de Ruvo, Luigi Sciarra, Riccardo Cappato, Leonardo Calo
BACKGROUND: Inappropriate sinus tachycardia (IST) often causes palpitations, dyspnea, and exercise intolerance, that are generally treated with beta blockers and non-dihydropyridine calcium-channel antagonists. Ivabradine, a selective inhibitor of cardiac pacemaker If current, has recently emerged as an effective and safe alternative to conventional drugs for IST. METHODS: We performed a systematic overview of clinical studies on the therapeutic yield of ivabradine in patients with inappropriate sinus tachycardia, published in MEDLINE database from January 2000 to March 2015...
June 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Michael S Donovan, David Kassop, Robert A Liotta, Edward A Hulten
Sinus venosus atrial septal defects (SV-ASD) have nonspecific clinical presentations and represent a diagnostic imaging challenge. Transthoracic echocardiography (TTE) remains the initial diagnostic imaging modality. However, detection rates have been as low as 12%. Transesophageal echocardiography (TEE) improves diagnostic accuracy though it may not detect commonly associated partial anomalous pulmonary venous return (PAPVR). Cardiac magnetic resonance (CMR) imaging provides a noninvasive, highly sensitive and specific imaging modality of SV-ASD...
2015: Case Reports in Medicine
Daan Cottens, Ben Corteville, Annick Vanvinckenroye, Marc Schepens, Luc Missault, Philippe Debonnaire
No abstract text is available yet for this article.
March 7, 2015: European Heart Journal
Cem Sahin, Ozcan Basaran, Yasar Topal, Fatih Akin
Although marked improvements have been observed in the life expectancy of patients with thalassaemia by regular blood transfusion and strict iron chelation therapies in recent years, these patients still have to deal with several complications, mainly cardiovascular. One of the life-threatening complications is the chronic hypercoagulable state and thromboembolic events which develop due to haemostatic alterations in patients with thalassaemia, although they are more frequently seen in those with thalassaemia intermedia...
2014: BMJ Case Reports
Kyun Hee Kim, Dong Heon Yang, Chang-Yeon Kim, Nam Kyun Kim, Won Suk Choi, Myung Hwan Bae, Jang Hoon Lee, Hun Sik Park, Yongkeun Cho, Shung Chull Chae
A 30-year-old female patient with known hypertrophic cardiomyopathy (HCMP) was admitted for recurrent syncope episodes. Electrocardiogram (ECG) showed 2 : 1 atrioventricular (AV) block. Stress echocardiography with bicycle showed high grade AV block at high stage of the exercise associated with exercise intolerance and dyspnea. Twenty-four hour ECG monitoring also revealed high grade AV block and 1 episode of non-sustained ventricular tachycardia. Implantable cardioverter/defibrillator-pacemaker (ICD-P) was inserted...
September 2013: Journal of Cardiovascular Ultrasound
Enrique Velázquez-Rodríguez, Horacio Rodríguez-Piña, Alex Pacheco-Bouthillier, Luz María Deras-Mejía
A 12-year-old girl with symptoms of fatigue, decreased exercise tolerance and progressive dyspnea (New York Heart Association functional class III) with a possible diagnosis of dilated cardiomyopathy secondary to viral myocarditis. Because of incessant wide QRS tachycardia refractory to antiarrhythmic drugs, she was referred for electrophysiological study. The diagnosis was idiopathic left ventricular tachycardia involving the posterior fascicle of the left bundle branch. After successful treatment with radiofrequency catheter ablation guided by a Purkinje potential radiological and echocardiographic evaluation showed complete reversal of left ventricular function in the first 3 months and no recurrence of arrhythmia during 2 years of follow up...
July 2013: Archivos de Cardiología de México
Magdalena Garncarz, Marta Parzeniecka-Jaworska, Michał Jank, Magdalena Łój
BACKGROUND: Chronic mitral valve disease is frequently seen in the Dachshund. Dachshunds (n=207) made up 11.73% of the dogs admitted to the Cardiology Service at the Small Animal Clinic, Warsaw University of Life Sciences, Poland (first visits only). RESULTS: Of these, 35 dogs had no clinically detectable heart disease while 172 had chronic valve disease with the mitral valve affected most often (130 dogs), both mitral and tricuspid valves infrequently (39 dogs) and rarely the tricuspid valve (3 dogs)...
2013: Acta Veterinaria Scandinavica
Chiara Ripa, Maria Cristina Melatini, Fabiola Olivieri, Roberto Antonicelli
During a stress test, an asymptomatic 40-year-old man showed an ST depression above 4 mm and a horizontal ST depression above 2 mm in the V3 to V6 precordial leads during the recovery phase, without symptoms related to myocardial ischemia. After several days, he experienced recurrent episodes of oppressive retrosternal pain with radiation to the interscapular region, associated with stress dyspnea. Stress myocardial scintigraphy using technetium sestamibi was performed, which showed a modest push-pull deficit of perfusion in the septal-anterior basal area associated with a small deficit of perfusion in the apical region...
2007: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
Servet Altay, Huseyin Altug Cakmak, Serhan Ozcan, Erkan Ilhan, Betul Erer
A 59-year-old man with a known history of nonobstructive hypertrophic cardiomyopathy and chronic atrial fibrillation was admitted to our clinic with weakness, palpitation, and exertional dyspnea. Electrocardiogram showed atrial fibrillation with high ventricular rate (120 beats per minute), intraventricular conduction delay, and left ventricular (LV) hypertrophy with ST-segment depression and inverted T waves. A transthoracic echocardiogram showed massive LV concentric hypertrophy. Although there was no gradient increase in the LV outflow tract, marked turbulent flow was seen in midventricular region by colored Doppler echocardiography...
May 2012: American Journal of Emergency Medicine
Sandro V Schons, Taciane L de Mello, Franklin Riet-Correa, Ana Lucia Schild
The aim of this study was to determine the cause of sudden deaths in sheep in the Anari Valley of the state of Rondônia, in northern Brazil. In one outbreak, sheep were placed in an area where the owner had cut Amorimia (Mascagnia) sepium and let it dry for two days. Fourteen out of 35 sheep died with few outward clinical signs observed over a period of about 10 h after the ingestion of the dry plant. Dry A. sepium was administered experimentally to 9 sheep. Five died after the ingestion of single doses of 3-6...
April 2011: Toxicon: Official Journal of the International Society on Toxinology
Joanne L Thanavaro, Kristin L Thanavaro
BACKGROUND: Postural orthostatic tachycardia syndrome (POTS) is an autonomic disorder characterized by an exaggerated increase in heart rate that occurs during standing, without orthostatic hypotension. Women are most frequently affected, and may present with palpitations, chest discomfort, shortness of breath, weakness, exercise intolerance, lightheadedness, presyncope, and syncope. METHODS: We present three cases of POTS in otherwise healthy women, and discuss the clinical management of different types of this orthostatic intolerance...
November 2011: Heart & Lung: the Journal of Critical Care
Alexander Kushnir, Andrew R Marks
According to the American Heart Association it is estimated that the United States will spend close to $39 billion in 2010 to treat over five million Americans suffering from heart failure. Patients with heart failure suffer from dyspnea and decreased exercised tolerance and are at increased risk for fatal ventricular arrhythmias. Food and Drug Administration -approved pharmacologic therapies for heart failure include diuretics, inhibitors of the renin-angiotensin system, and β-adrenergic receptor antagonists...
2010: Advances in Pharmacology
Stephan Zellerhoff, Martin Hinterseer, Bastian Felix Krull, Eric Schulze-Bahr, Larissa Fabritz, Günter Breithardt, Paulus Kirchhof, Stefan Kääb
Inappropriate sinus tachycardia (IST) is characterized by paroxysmal tachycardia originating in the sinus nodal area. IST predominately affects young, female patients. Current antiarrhythmic drug treatment (ß-blockers, calcium antagonists), frequently complicated by side effects, is often not successful. Ivabradine, approved for angina pectoris, selectively reduces heart rate by blocking the "funny current" in the sinus node. We therefore evaluated the effect of ivabradine in patients with symptomatic IST...
December 2010: Naunyn-Schmiedeberg's Archives of Pharmacology
Chung-Ming Tu, Kai-Ming Chu, Cheng-Chung Cheng, Shu-Mung Cheng, Wei-Shiang Lin
The diagnosis of Wolff-Parkinson-White syndrome is typically reserved for patients who experience ventricular pre-excitation and symptoms that are related to paroxysmal supraventricular tachycardia, such as chest pain, dyspnea, dizziness, palpitations, or syncope. Herein, we report the case of a 38-year-old woman who presented at our outpatient department because of exercise intolerance. Cardiac auscultation revealed a grade 2/6 pansystolic murmur over the left lower sternal border. Twelve-lead electrocardiography showed sinus rhythm at a rate of 76 beats/min, with a significant delta wave...
2010: Texas Heart Institute Journal
Kenneth J Mack, Jonathan N Johnson, Peter C Rowe
Orthostatic intolerance (OI) refers to a group of clinical conditions, including postural orthostatic tachycardia syndrome (POTS) and neurally mediated hypotension (NMH), in which symptoms worsen with upright posture and are ameliorated by recumbence. The main symptoms of chronic orthostatic intolerance syndromes include light-headedness, syncope or near syncope, blurring of vision, headaches, problems with short-term memory and concentration, fatigue, intolerance of low impact exercise, palpitations, chest pain, diaphoresis, tremulousness, dyspnea or air hunger, nausea, and vomiting...
June 2010: Seminars in Pediatric Neurology
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