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Biomedical subjects

E Wyss

Publications and source records attributed to E Wyss.

12 recordsLinked to original sources
PubMed1998

[Cor triatriatum dexter of an adult].

Cor triatriatum dexter is a rare congenital malformation in which a membrane divides the right atrium into two chambers. The membrane represents a persistence of the right sinus venosus valve (RSV). Normally the RSV regresses between the 9th and 15th week of gestation, as the cephalic portion forms the crista terminalis and the caudal portion develops into the Eustachian and Thebesian valve. Any failure in the regression process may result in remnants of RSV as a simple muscle bar, a Chiari-network or a fenestrated or unfenestrated membrane (cor triatriatum dexter). We describe a patient with cor triatriatum dexter in whom diagnosis was made several years after successful valvulotomy procedure for severe congenital valvular pulmonary stenosis.

Adult↗
PubMed1997

[Bradycardia-induced syncope].

Bradyarrhythmias are the cause of syncope in 3 to 10% of cases. Marked bradycardia or asystole can be due to impaired function of the sinus node (sick sinus syndrome), high degree AV block or neurocardiogenic disorders (carotid sinus syndrome, vasovagal syncope). A precise history, ECG and 24-h. Holter recordings are the most helpful tools in diagnosis of bradyarrhythmia-induced syncope. An association between symptoms and documented ECG is essential for proper diagnosis. Sometimes an event-recorder may be helpful for this purpose. If a patient has normal physical examination, ECG, Holter, stress test, tilt-table test and echocardiography, no further electrophysiological investigation is needed. If the noninvasive tests show pathologic results that do not clearly explain the cause of syncope (sinus bradycardia, first-degree AV block, fascicular block, structural heart disease), then electrophysiological studies are recommended, which will also rule out ventricular tachyarrythmias in the differential diagnosis. If all diagnostic tests in a patient with syncope are normal, the prognosis is fairly good despite 30% recurrence rate. Treatment for symptomatic bradyarrhythmias is implantation of a pacemaker. The selection of an appropriate pacemaker system is very important. Dual-chamber systems (DDD) provide physiological stimulation by maintaining AV synchrony; thus, they should be preferred whenever possible.

Bradycardia↗
PubMed1997

[Cardiac arrhythmias--ECG and electrophysiologic assessment].

The 12-lead resting surface ECG plays a major role in the diagnosis of cardiac arrhythmias. As a screening method, it provides important information about the cardiac rhythm and possible underlying heart diseases. It enables interpretation of possible arrhythmia mechanisms, especially if the recording is obtained at the time of the rhythm disorder. Since rhythm disorders exhibit spontaneous variability, event recorders and Holter monitoring are very helpful complementary noninvasive tools in the diagnosis of cardiac arrhythmias. In addition, Holter ECG can be used in monitoring the response to antiarrhythmic agents and in risk stratification of arrhythmias in certain cardiac disease states. Physical exercise, by inducing physiological and pathophysiological changes, may provoke arrhythmias, which forms the basis of exercise-stress testing. Stress testing may also be indicated when antiarrhythmic agents are initiated or therapy altered. Electrophysiological Study (EPS) is a time-consuming and costly investigation, which in general is reserved for further evaluation of tachyarrhythmias, conduction disturbances and syncope of unknown origin and routinely performed prior to radiofrequency ablation. EPS should only be performed in tertiary-care centers by well-trained and experienced cardiac electrophysiologists.

Arrhythmias, Cardiac↗
PubMed1996

[Hypertension refractory to therapy].

A 41-year-old musician developed severe refractory hypertension 13 years after radiotherapy of the retroperitoneum because of a teratocarcinoma of the right testis. An angiography revealed severe stenoses of both renal arteries. After percutaneous transluminal angioplasty of both renal arteries, blood pressure valves returned to the normal range. Radiation-induced injury of arteries may provoke premature atherosclerosis, which cannot be differentiated morphologically from common atherosclerosis. Patients who develop severe hypertension some years after radiotherapy of the retroperitoneum should therefore be screened for the presence of renovascular hypertension.

Adult↗
PubMed1994

[Fatal outcome of pneumocystis-carinii pneumonia under low-dose methotrexate and prednisone therapy for chronic rheumatoid arthritis. Case report and literature review].

New therapeutic schemes have been proposed recently for treatment of rheumatoid arthritis. Among these, methotrexate at low doses is recommended as basic therapy, already shortly after the diagnosis is established. We report on a 68-year-old female with rheumatoid arthritis who developed bilateral pneumocystis-carinii pneumonia with a lethal course and bilateral sinusitis maxillaris with candida lusitaniae. Various opportunistic infections have been described in the literature after low-dose methotrexate. It is our view that the use of methotrexate in rheumatoid arthritis should still be considered cautiously until further data on the risk-benefit ratio of long-term use become available.

Aged↗
PubMed1991

[Retroperitoneal rhabdomyosarcoma revealed by acute kidney failure in children. Report of a case].

Retroperitoneal sarcomas are rare tumors representing 0.1% to 0.2% of all malignant tumors. They are usually revealed by an abdominal mass (33%), possibly associated with pain (41%). Edema of the lower limbs is reported in 10% of cases. Acute renal failure with anuria by bilateral ureteral compression, associated with invasion of the inferior vena cava has not been previously reported.

Acute Kidney Injury↗