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Biomedical subjects

D J Heaven

Publications and source records attributed to D J Heaven.

4 recordsLinked to original sources
PubMed2000

Sudden death in a child with an unusual accessory connection.

An 8-year-old boy with Wolff-Parkinson-White syndrome died suddenly whilst exercising. He had been well with no immediate preceding symptoms of an arrhythmia, and was receiving no drugs. As an infant he had suffered recurrent episodes of atrioventricular reciprocating tachycardia (AVRT) and had documented pre-excited atrial fibrillation. At electrophysiological (EP) study, the refractory periods of his two accessory pathways were less than 220 ms. Drugs were discontinued at 4 years of age when he remained asymptomatic. Autopsy confirmed a very unusual accessory pathway. It was a muscular connection between the base of the right atrial appendage and the right ventricle, distant from the annulus of the tricuspid valve.

Child↗
PubMed2000

Syncope.

Syncope is a common clinical presentation. Although most commonly benign, it may herald a pathology with a poor prognosis. The work-up of syncope includes a careful history, physical examination, electrocardiogram, risk stratification, and appropriately directed testing. The key factor in the investigation of syncope is the presence (or absence) of structural heart disease or an abnormal electrocardiogram. The most useful investigation in unexplained syncope with a normal heart is the tilt table test for evaluating predisposition to neurocardiogenic (vasovagal) syncope. In the setting of structural heart disease or an abnormal electrocardiogram, electrophysiologic studies play a more important role. The utility of noninvasive cardiac monitoring for symptom-rhythm correlation may be limited by infrequent symptoms. The availability of external and implantable loop recorders allows prolonged periods of monitoring to increase diagnostic yield. The management of patients with syncope may be complex. Early referral to a cardiac electrophysiologist is warranted in patients who are at high risk.

Electroencephalography↗
PubMed2000

Pacemaker lead related tricuspid stenosis: a report of two cases.

Only four cases of tricuspid stenosis related to endocardial pacemaker leads have been reported. Two further cases associated with perforation of a tricuspid valve leaflet by a pacemaker lead are presented: a 46 year old woman and a 60 year old man. It is possible that tricuspid valve disease related to endocardial pacemaker and non-thoracotomy defibrillator leads is underrecognized. Diagnosis requires clinical suspicion and the use of Doppler echocardiography. Recent evidence of fibrosis affecting the tricuspid valve in hearts from patients who have had non-thoracotomy defibrillator implants suggests that this problem could be more common in the future.

Echocardiography, Doppler↗