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Digitalis and ekg

Abdulah Alrifai, Mohamad Kabach, Jonathan Nieves, Robert Chait
Background: Bidirectional ventricular tachycardia is a rare form of ventricular arrhythmia, characterized by a changing of the mean QRS axis of 180 degrees. Digitalis toxicity is the most common cause of bidirectional ventricular tachycardia; other causes include myocarditis, aconite toxicity, metastatic cardiac tumor, myocardial infarction, and cardiac channelopathies. Case Report: A 73-year-old male with hypertension and a pacemaker implanted for sick sinus syndrome presented with a complaint of substernal chest pressure for several days...
2018: Ochsner Journal
Abrar-Ahmad Zulfiqar, Paul Blazejczyk, Nadir Kadri, Jean Doucet
Digitalis remains a treatment that is difficult to manage, especially in the elderly. METHODS: A retrospective, unicentric study carried out within the unit of Internal medicine and geriatrics, Reims University Hospital Center, between January and June 2014. Collection of all patients hospitalized, after 75 years, receiving treatment with digitalis, either as soon as they enter (present on the usual prescription of the patient), during their hospitalization and on their exit. RESULTS: 20 patients were included...
June 1, 2018: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
W Grimm, A Grimm, K Grimm, E Efimova
A number of rare cardiac diseases can be recognized by electrocardiogram (ECG). This article illustrates the clinical importance of ECG as a key diagnostic tool to detect Wolff-Parkinson-White syndrome and channelopathies, which are frequently diagnosed late after one or more affected family members have become victims of sudden cardiac death. These channelopathies include long QT syndrome, short QT syndrome, Brugada syndrome, and catecholaminergic polymorphic ventricular tachycardia. In addition, typical ECG findings are frequently present in patients with idiopathic ventricular tachycardia, arrhythmogenic right ventricular dysplasia, digitalis intoxication, hyperkalemia, acute cor pulmonale due to pulmonary embolism, as well as severe left ventricular hypertrophy as in hypertrophic cardiomyopathy...
June 2018: Der Internist
I-Lin Wu, Jiun-Hao Yu, Chih-Chuan Lin, Chen-June Seak, Kent R Olson, Hsien-Yi Chen
CONTEXT: Accidental ingestion of foxglove (Digitalis purpurea) can cause significant cardiac toxicity. We report a patient who ingested foxglove mistaking it for comfrey and developed refractory ventricular arrhythmias. The patient died despite treatment with digoxin-specific antibody fragments (DSFab) and veno-arterial extracorporeal membrane oxygenation (VA-ECMO). CASE DETAILS: A 55-year-old woman presented to the emergency department with nausea, vomiting and generalized weakness eight hours after drinking "comfrey" tea...
August 2017: Clinical Toxicology
Laura Bonfanti, Giuseppe Lippi, Irene Ciullo, Fiorenza Robuschi, Rosalia Aloe, Sara Tarasconi, Riccardo Vassallo, Gianfranco Cervellin
A 58 years healthy old woman was admitted to the Emergency Department (ED) with cardiac arrest due to ventricular fibrillation (VF). Appropriate cardiopulmonary resuscitation (CPR), multiple DC shocks and oro-tracheal intubation (OTI) were effective to induce recovery of spontaneous circulation (ROSC). After ROSC was achieved, the electrocardiogram (ECG) showed an idio-ventricular rhythm with atrioventricular dissociation. A transcutaneous pacing was hence applied and the patient was administered with isoproterenol...
January 16, 2017: Acta Bio-medica: Atenei Parmensis
Sarfraz A Durrani, Raphael Sung, Melvin Scheinman
Bidirectional ventricular tachycardia (BDVT) is a well-known phenomenon since it was first described in 1922. Various mechanisms have been proposed for BDVT, including digitalis toxicity, hypokalemia, Anderson-Tawil syndrome, acute myocarditis, and catecholaminergic polymorphic ventricular tachycardia. It is characterized by rapid, wide complex electrocardiogram pattern with alternating QRS morphology and axis. The alternation of the QRS is usually right bundle branch block with 180° swings in the frontal plane axis or, less commonly, alternation of right bundle branch and left bundle branch forms...
December 2016: Cardiac Electrophysiology Clinics
Gerrit Frommeyer, Peter Milberg, Jochen Schulze Grotthoff, Dirk G Dechering, Simon Kochhäuser, Jörg Stypmann, Michael Fehr, Günter Breithardt, Lars Eckardt
AIMS: Interaction between dronedarone and digitalis has been discussed as a possible cause for increased mortality in the presence of dronedarone observed in the PALLAS trial. The aim of this study was to assess possible proarrhythmic effects of dronedarone in combination with digitalis in an experimental whole heart model. METHODS AND RESULTS: Twenty-six female rabbits underwent chronic oral treatment with dronedarone (50 mg/kg/day for 6 weeks). Twenty-four rabbits received placebo...
August 2015: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Irina Iuliana Costache, D M Alexandrescu, Diana Cimpoeşu, O R Petriş, A O Petriş
UNLABELLED: Patients with heart failure are, by definition, hemodynamically unstable. This condition may be accentuated by medication (digitalis, diuretics, antiarrhythmics), so that they become more sensitive to electrolyte disturbances. Hyponatremia is the most common electrolyte disorder, particularly common in the intensive care unit. AIM: The evaluation of the incidence of hyponatremia in patients diagnosed with chronic heart failure in order to establish a correlation with the evolution, prognosis and therapeutic implications...
April 2014: Revista Medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti Din Iaş̧i
Carlos Iribarren, Alfred D Round, Jonathan A Peng, Meng Lu, Arthur L Klatsky, Jonathan G Zaroff, Taylor J Holve, Amit Prasad, Paul Stang
BACKGROUND: Short QT syndrome (QTc ≤ 300 ms) is a novel hereditary channelopathy linked to syncope, paroxysmal atrial fibrillation, and sudden cardiac death. However, its epidemiological features remain unsettled. OBJECTIVES: (1) To assess the prevalence of short QT in a large population-based sample; (2) to evaluate its demographic and clinical correlates and; (3) to determine its prognosis. METHODS: A database of 6.4 million electrocardiograms (ECGs) obtained between 1995 and 2008 among 1...
September 2014: Annals of Noninvasive Electrocardiology
Shigeki Kobayashi, Wakako Murakami, Takeki Myoren, Hiroki Tateishi, Shinichi Okuda, Masahiro Doi, Tomoko Nao, Yasuaki Wada, Masunori Matsuzaki, Masafumi Yano
OBJECTIVE: Recently, we reported that low-dose landiolol (1.5 µg·kg(-1)·min(-1)), an ultra-short-acting β-blocker, safely decreased the heart rate (HR) in patients with acute decompensated heart failure (ADHF) and sinus tachycardia, thereby improving cardiac function. We investigated whether low-dose landiolol effectively decreased the HR in ADHF patients with rapid atrial fibrillation (AF). METHODS: We enrolled 23 ADHF patients with rapid AF (HR ≥120 beats·min(-1) and New York Heart Association class III-IV) and systolic heart failure (SHF: n = 12) or diastolic heart failure (DHF: n = 11) who received conventional therapy with diuretics, vasodilators, and/or low-dose inotropes...
2014: Cardiology
Shinichiro Fujishima, Noboru Murakami, Yoshie Haga, Eiji Nyuta, Yuuki Nakate, Shiro Ishihara, Shigeru Kaseda, Tokushi Koga, Takao Ishitsuka
BACKGROUND: The underlying cause of a high cardiovascular event rate in the population with low diastolic blood pressure (DBP) has not been fully elucidated. METHODS AND RESULTS: The relationship between DBP and ischemia-like findings on electrocardiography (ECG) was investigated in 187 patients who underwent coronary angiography. Patients with conditions affecting ECG (e.g. patients taking digitalis or those with old myocardial infarction, complete right bundle branch block, or hypokalemia) were excluded from the analyses...
October 2013: Journal of Cardiology
Sanne Vibe Nielsen, Rasmus Hjelmar Petersen
Plant poisonings are rare in Denmark, but can have fatal consequences. We present a case in which a woman went into cardiac arrest after having ingested leaves from the foxglove plant. Sinus rhythm was not restored until Digibind was administered. Literature in this field is sparse, but we conclude that the following advice can be given: 1) assessment of the degree of poisoning should be based on clinical features and changes of the electrocardiogram; 2) activated charcoal should be given; 3) in case of malignant arrhythmia or cardiac arrest, the use of Digibind should be considered...
June 10, 2013: Ugeskrift for Laeger
Mehboob Ali, Javaid Arif Khan, Tariq Masood, Fahad Shamsi, Mushtaq Hussain Dero, Sulman Khan
A 45 years old male presented to the emergency department with palpitations, headache and apprehension. His electrocardiogram revealed bidirectional ventricular tachycardia. He remained vitally stable and responded to intravenous beta-blocker. Initially digitalis toxicity was suspected but history was negative for digitalis intake. The cause remained unidentified in patient despite detailed investigations. During a short follow-up (of 6 months) he remained asymptomatic and no cause was further identified during this period...
May 2013: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Irina Iuliana Costache, Diana Cimpoeşu, O Petriş, A O Petriş
UNLABELLED: Patients with heart failure are, by definition, hemodynamic unstable. Often, this condition may be accentuated by medication (digitalis, diuretics, antiarrhythmics), so that they become more sensitive to electrolyte disturbances, reacting sometimes violently with severe and life threatening rhythm troubles. AIM: the evaluation of the incidence of electrolyte disturbances in patients diagnosed with chronic heart failure in order to establish a correlation with the evolution, prognosis and therapeutic implications...
July 2012: Revista Medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti Din Iaş̧i
Abdo Asmar, Rajesh Mohandas, Charles S Wingo
Hypokalemia is common and can be associated with serious adverse consequences, including paralysis, ileus, cardiac arrhythmias, and death. As a result, the body maintains serum potassium concentration within very narrow limits by tightly regulated feedback and feed-forward systems. Whereas the consequences of symptomatic hypokalemia and severe potassium depletion are well appreciated, chronic mild hypokalemia can accelerate the progression of chronic kidney disease, exacerbate systemic hypertension, and increase mortality...
September 2012: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Kazim Serhan Ozcan, Damirbek Osmonov, Izzet Erdinler, Servet Altay, Ersin Yildirim, Ceyhan Turkkan, Hakan Hasdemir, Nazmiye Cakmak, Ahmet Taha Alper, Seckin Satilmis, Kadir Gurkan
BACKGROUND: Hypothyroidism is a reversible cause of atrioventricular (AV) block. Few reports have described reversible AV block caused by hyperthyroidism. However, it is unknown whether patients with AV block are expected to have a benign course after the initiation of appropriate therapy for thyroid dysfunction. METHODS: The study group consisted of patients with II or III degree AV block and bradyarrhythmia (≤40bpm) excluding patients with myocardial infarction, electrolyte abnormalities, digitalis toxicity, and vasovagal syncope...
October 2012: Journal of Cardiology
Saurabh Rajpal, Jagan Beedupalli, Pratap Reddy
A 53-year-old woman presented with digitalis toxicity caused by acute overdose that manifested as atrial tachycardia with block, sinus pauses, and competing AV junctional rhythm with atrial fibrillation. Patient admitted to overdosing with digoxin 15-20 h before presentation with intent to commit suicide. Serum digoxin level was 35.6 ng/ml and renal function was normal. Patient was treated with 1,040 mg of digoxin-specific antibody Fab fragment with prompt resolution of arrhythmias and restoration of sinus rhythm...
December 2012: Cardiovascular Toxicology
Tomas Ohrlander, Magnus Dencker, Nuno V Dias, Anders Gottsäter, Stefan Acosta
The aim of this study was to assess cardiovascular predictors for all-cause long-term mortality in patients undergoing standard endovascular aneurysm repair (EVAR) for infrarenal abdominal aortic aneurysm (AAA). Consecutive patients treated with EVAR (Zenith(®) stent grafts; Cook) between May 1998 and February 2006 were prospectively enrolled in a computerized database, together with retrospectively collected data on medication, and electrocardiographic and echocardiographic variables. Mortality was assessed on 1 December 2010...
December 2011: Vascular Medicine
Alberto Bouzas-Mosquera, Jesús Peteiro, Francisco J Broullón, Elizabet Méndez, Gonzalo Barge-Caballero, Manuel López-Pérez, Angela López-Sainz, Nemesio Alvarez-García, Alfonso Castro-Beiras
BACKGROUND: There is limited insight into the association of electrocardiographic interpretability with outcome in patients referred for stress testing. METHODS: Exercise echocardiography was performed in 8226 patients with known or suspected coronary artery disease. Electrocardiograms were considered uninterpretable in the presence of left bundle-branch block (LBBB), left ventricular hypertrophy (LVH) with strain, repolarization abnormalities because of digitalis therapy, ventricular paced rhythm, preexcitation or ST depression ≥ 0...
May 2012: European Journal of Clinical Investigation
Salvador Pita-Fernández, Mónica Lombardía-Cortiña, Domingo Orozco-Veltran, Vicente Gil-Guillén
This study aimed to determine the clinical characteristics of elderly patients diagnosed with digitalis intoxication, on the Emergency Department, University Hospital Complex, A Coruña, Spain. During the study period (January-September 2008) cases were included in which digitalis intoxication was confirmed by plasma digoxin levels. We collected data on age, gender, base-line diseases, therapeutic indications for digoxin, functional classification, ejection fraction, plasma digoxin levels, creatinine clearance, ions, gasometry, electrocardiogram, concomitant medication, symptomatology and treatment...
September 2011: Archives of Gerontology and Geriatrics
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