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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
PubMed2001

Lung cancer presenting as cardiac tamponade associated with transmural myocardial ischaemia.

Cardiac tamponade due to carcinomatous pericarditis is a life-threatening complication of malignancy and is uncommon as its initial manifestation [Chest 88 (1985) 70; Cancer 45 (1980) 1697; J Am Med Assoc 257 (1987) 1088]. A case of lung cancer presenting with cardiac tamponade associated with transient ST-segment elevation and life-threatening arrhythmias is presented. To our knowledge, this is the first reported case of transmural myocardial ischaemia related to malignancy.

Cardiac Tamponade↗
PubMed2001

Aborted sudden death, transient Brugada pattern, and wide QRS dysrrhythmias after massive cocaine ingestion.

Although cocaine is one of the leading causes of drug-related deaths, there is little clinical information describing the precise sequence of events leading to death in the cocaine intoxication. Usually, cocaine-related sudden deaths are unwitnessed, its electrocardiographic features are not attainable, and the majority of these patients have a rapidly fatal course and die before arriving at the hospital. We report a patient with massive cocaine ingestion who developed psychomotor agitation and generalized seizures followed by asystolic cardiac arrest. Ventilation with supplemental oxygen by endotracheal intubation immediately restored spontaneous heart beat. After resuscitation, a severe metabolic acidosis (pH 6.65) and cardiac dysrrhythmias consistent with sodium channel poisoning were detected. The electrocardiogram showed accelerated junctional rhythm at 85 beats/min with right bundle branch block and left anterior hemiblock configuration, prolongation of QRS (0.16 sec) and QTc (0.52 sec) intervals, and terminal J wave associated with coved ST-segment elevation in leads V(1) and V(2) resembling the Brugada syndrome. Sodium bicarbonate administration was quickly followed by normalization of the cardiac conduction disturbances. This article discusses the clinical and electrophysiologic implications of these findings.

Acidosis↗
PubMed2001

Acute myocardial injury caused presumably by coronary spasm after magnesium fluoro-silicate ingestion.

A patient who developed magnesium fluoro-silicate poisoning is described. This condition was manifest by the findings of acute chest pain, dysphagia, diarrhea, metabolic acidosis, hypocalcemia and hypomagnesemia and was complicated by acute myocardial injury-a phenomenon not previously described. Coronary cineangiography showed normal coronary arteries. The physiopathologic mechanisms of this electrocardiographic finding are discussed.

Coronary Circulation↗
PubMed2000

Right bundle branch block-induced Q waves simulating anterior myocardial infarction extension.

A concept generally accepted in clinical electrocardiography is the assumption that a right bundle branch block (RBBB) does not alter significantly the initial portion of the QRS complex and because the left bundle branch is intact, the septum is activated normally in a left-to-right direction. We report a woman with an acute anterior myocardial infarction (MI) in which a small R wave was present in leads V1 and V4, but with the development of RBBB associated with PR-interval prolongation, these R waves were replaced by Q waves. Subsequently, the electrocardiographic features of anterior MI disappeared concomitantly with the loss of RBBB. The clinical and electrophysiologic implications of these findings are discussed.

Aged↗
PubMed1999

Impending acute myocardial infarction during severe exercise associated with a myocardial bridge.

A young man had an impending acute myocardial infarction while playing soccer. Chest pain and anterior ST-segment elevation lasted 3 hours despite anti-ischemic medication, including streptokinase thrombolysis. An electrocardiogram recorded after the symptoms had passed was normal. There was a minimal increase in cardiac enzyme levels, and a pyrophosphate scan and echocardiogram were normal. Coronary cineangiography showed normal coronary arteries except for systolic compression of the left anterior descending coronary artery. An exercise stress test, while the patient was on atenolol, showed absence of myocardial ischemia. This impending acute myocardial infarction could have been caused by an acute thrombus with lysis prior to catheterization or by a deep muscle bridge that kinked or twisted the coronary artery due to myocardial forceful muscular contraction during the sympathetic stimulation of exercise. In conclusion, an impending acute myocardial infarction may occur in young patients having myocardial bridges, and a beta-blocker must be administered, especially when this condition appears during severe exercise.

Adult↗
PubMed1998

Obstructive shock due to labor-related diaphragmatic hernia.

OBJECTIVE: To report diaphragmatic hernia as a cause of obstructive shock in the peripartum period. DESIGN: Case report. SETTING: An adult, 12-bed medical/surgical intensive care unit of a general hospital. PATIENTS: One patient who developed an obstructive shock following vaginal labor and was transferred under mechanical ventilation from a local hospital. INTERVENTIONS: Central venous pressure, blood pressure, blood gas analysis, electrocardiogram, and chest radiograph during and after obstructive shock. MEASUREMENTS AND MAIN RESULTS: During shock, systolic blood pressure was 60 mm Hg, central venous pressure was +12 mm Hg, and the electrocardiogram showed a supraventricular tachycardia and an acute cor pulmonale pattern. Chest radiograph showed signs of left diaphragmatic hernia and right mediastinal shift. Chest ultrasound examination demonstrated loops of bowel in the left pleural space. After surgical resolution of the left diaphragmatic hernia, the patient's blood pressure increased to 120/80 mm Hg, the central venous pressure decreased to +1 mm Hg, and the PaO2 increased to 154 torr (20.5 kPa) while receiving mechanical ventilation with an FiO2 of 50%. The electrocardiogram showed disappearance of the acute cor pulmonale pattern. The chest radiograph showed a central venous catheter located in a persistent left superior vena cava without abnormalities of the diaphragm, the mediastinum, or the lung. CONCLUSION: Diaphragmatic hernia must be included in the differential diagnosis of obstructive shock in pregnant patients.

Adult↗
PubMed1997

Pentavalent antimonial-induced torsade de pointes.

Unexplained sudden deaths following use of pentavalent antimonial drugs have been described, presumably owing to ventricular arrhythmias. A patient is reported with QT interval prolongation and syncopal episodes related to torsade de pointes following treatment of visceral leishmaniasis with meglumine antimoniate. This is the first reported case of documented torsade de pointes following treatment with pentavalent antimonial drugs.

Aged↗
PubMed1986

Left anterior hemiblock masking the diagnosis of right bundle branch block.

A case is presented in which left anterior hemiblock obscured totally the diagnosis of right bundle branch block by abolishing the S wave in leads 1 and aVL, and terminal R wave in leads V1 and V2. The presence of right bundle branch block was confirmed by recording high V1 and V2 leads. Subsequently, the ECG revealed how a greater degree of conduction delay in the right bundle branch may uncover the previously concealed right bundle branch block. The electrocardiographic features of these findings are discussed.

Aged↗
PubMed1983

Transient right bundle branch block and left anterior hemiblock during Prinzmetal's angina.

A case of transient right bundle branch block with left anterior hemiblock during Prinzmetal's angina is reported. Selective coronary arteriography revealed 90% narrowing on the proximal left anterior descending coronary artery; the left ventriculogram was normal. Transient ischemia of the proximal His-Purkinje system is the probable mechanism of this pattern.

Adult↗