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Biomedical subjects

J Ortega Carnicer

Publications and source records attributed to J Ortega Carnicer.

At least 19 recordsLinked to original sources
PubMed2006

[Early onset of torsades de Pointes and elevated levels of serum troponin I due to acute arsenic poisoning].

Most cases of acute arsenic poisoning occur through accidental or voluntary ingestion of pesticides or insecticides, and all body systems are affected. Arsenic can prolong the QT interval and lead to torsades of Pointes, a crucial type of arrhythmia characteristic of such QT interval prolongation. In our revision of the literature, there have been found only 5 cases of torsades of Pointes due to acute arsenic poisoning. Recently, there have been published four additional cases in patients with refractory or recurrent acute promyelocytic leukemia being treated with arsenic trioxide. In all nine cases, torsades of pointes appeared slowly after poisoning. Herein is described a case of acute arsenic poisoning which led to an early onset of torsades of Pointes, hypopotasemia and high levels of serum troponin I.

Acute Disease↗
PubMed2006

[Acute coronary syndromes with simultaneous elevation of the ST segment in inferior and precordial leads].

OBJECTIVE: To describe the patients with ischemic chest pain and simultaneous ST-segment elevation in the inferior and right precordial leads. MATERIAL AND METHODS. DESIGN: Series of cases. CONTEXT: an adult, Intensive Care Service with 16 beds, with no hemodynamic service, for the management of coronary and polyvalent patients. PATIENTS: we studied 10 patients with acute coronary syndrome who had: a) a ST-segment elevation > or = 1 mm in two or more contiguous leads in the inferior and right precordial leads, b) a resolution of the ST-segment elevation and/or the appearance of Q waves or decrease of the R wave amplitude after the disappearance of the angina and c) a coronary angiographic study. RESULTS: There were 9 men and 1 woman, with an average age of 62.6 years. Two patients had a background of inferior myocardial infarction. Nine patients received thrombolytic treatment after 122.2 +/- 93.9 minutes of the pain onset. Leads III and V3 showed the greatest elevations of ST segment. Serum levels of creatine kinase were normal in 3 cases and significantly elevated (> 1700 U/L) in six. The ECG evolved to normality in 2 cases and it showed inferior Q waves in 5 patients, and negative T waves in 3 patients. Three patients had no complications, three cases had cardiac blocks and three patients had ventricular tachycardias. The coronary arteriography was normal in 2 patients; three patients showed a proximal stenosis in the right coronary artery and five patients had two or more stenotic coronary arteries. Three patients were diagnosed of unstable angina, one patient was diagnosed of transient apical cardiomyopathy, 4 patients had an acute inferior myocardial infarction with right ventricular extension and 2 patients had a myocardial infarction without anterior Q wave. All the patients survived. CONCLUSIONS: Most of the patients with acute coronary syndrome associated with simultaneous SST elevation in inferior and right precordial leads had multivessel coronary disease and all patients with only one coronary vessel involved had right ventricular infarction secondary to severe proximal lesion of the right coronary artery.

Acute Disease↗
PubMed1993

[Heart arrest in outpatients resuscitated without neurologic sequelae].

BACKGROUND: Around 65% of the deaths by acute myocardial infarction are presented in the first hour of the attack when most patients are outside a hospital and it is almost always caused by ventricular fibrillation. Home defibrillation permits these patients to be saved if an integral emergency system is available. METHODS: The cases of ambulatory cardiac arrest resuscitated with no residual neurologic lesions in the province of Ciudad Real were reviewed. The hospital possesses an integral emergency department with an area of communication with one sole emergency telephone (006) and 7 mobile intensive care medical units. RESULTS: Five male patients with a mean age of 54 years were ambulatory defibrillated (4 at home and 1 at work) following cardiac arrest by ventricular fibrillation of acute myocardial infarction (4 inferior localization and 1 anterior). All the patients called for angina, except one for cardiorespiratory arrest. The mean time of delay between the call for help and the arrival of the doctor was 8.4 +/- 6.3 minutes; ventricular fibrillation was witnessed by a doctor in all the cases except for one. Ventricular fibrillation was recurrent in three patients and all required more than one defibrillation. Two patients required mechanical ventilation and vasoactive drugs due to cardiac failure. The complications secondary to resuscitation manoevers are commented upon but the absence of neurologic sequelae is of note. All the patients were discharged and returned to work with the exception of one patient who died due to rupture of the posteromedian muscle of the mitral valve. CONCLUSIONS: Cardiac arrest by ventricular fibrillation in the acute myocardial infarction may be successfully treated out of the hospital with an integral emergency system.

Ambulatory Care↗