Biomedical subjects
Publications and source records attributed to J Kajzr.
The authors describe the case of a haemodynamically unstable patient with dysfunction of a valvular prosthesis which was resolved by emergency surgery. In the discussion they deal with two basic causes of these dysfunctions and their possible solutions.
Sudden cardiac death is a sudden unexpected non-violent death for cardiac reasons which according to the majority of authors occurs within one hour after the development of symptoms of acute impairment of health. This syndrome is a major problem of contemporary medicine with a very adverse prognosis. The authors analyze the epidemiology, causes, influence of the external environment, basic arrhythmogenic mechanisms and prognosis of sudden death. Examination methods of this clinical condition are evaluated from the aspect of their application in the risk stratification of patients.
In addition to acute treatment of sudden cardiac death the authors focus attention in particular on an analysis of long-term diagnostic and therapeutic provisions to cope with this serious clinical condition. The basic therapeutic procedures include influencing of the arrythmogenic substrate and modulating factors associated with the development of tachyarrhythmias by revascularization of the myocardium and radiofrequency ablation; as to drugs in particular by administration of angiotensin converting enzyme inhibitors and in rare instances by the application of other surgical methods. Haemodynamically important ventricular arrhythmias are treated by antiarrhythmics (beta-blockers, amiodarone, sotalol) and an implantable cardioverter-defibrillator. In the conclusion the authors propose a diagnostic therapeutic algorithm after circulatory arrest with successful cardiopulmonary resuscitation.
A 26-year-old patient with an irrelevant personal and family-history was treated on account of attacks of relapsing ventricular tachycardia and cardiac failure, mostly dextrolateral. After ruling out other possible causes of the disease--such as embolism of the lungs, ischaemic heart disease, out other possible causes of the disease--such as embolism of the lungs, ischaemic heart disease, Ebstein's anomaly, the diagnosis of an arrhythmogenic right ventricle was established. This disease is suggested by negative T waves in the thoracic leads V1-V3 during sinus rhythm and by the shape of the QRS complex which was the type found in block of the Tawara branch with an axis of + 100 degrees during attacks of ventricular tachycardia. Moreover, ventricular tachycardia of the same type was produced during electrocardiographic examination. On angiographic examination ARVD is suggested by marked trabeculization and impaired kinetics of the outflow tract of the right ventricle. In the prevention of relapses of ventricular tachycardia beta-blockers and Cordarone were successful when used simultaneously with cardiac stimulation type AAI applied on account of a confirmed sinoatrial block.