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Biomedical subjects

J Schildberger

Publications and source records attributed to J Schildberger.

11 recordsLinked to original sources

[Restrictive cardiomyopathy as a manifestation of primary amyloidosis].

Primary amyloidosis is a rare disease, cardiac involvement occurs in up to 40% of patients. Diffuse amyloid deposits cause an impairment of myocardial systolic and diastolic function. In this paper we are presenting a case of a 54-year-old woman. The woman was admitted because of progressive fatigue, dyspnoea, chest pain, later she experienced hypotension, dyspepsia, and enterorrhagia. ECG showed decrease in QRS amplitude. We have found an echocardiographic evidence of wall hypertrophy. Right cardiac catheterization showed a restrictive situation. Immunobinding of serum and urine revealed monoclonal kappa light chains. The diagnosis was determined by rectal biopsy. Unfortunately, amyloid deposits caused progressive heart failure, hemorrhage, and death just before the diagnosis of primary amyloidosis could be determined on the basis of results of the immunofixations of serum and urine proteins (detection of the monoclonal light chains kappa) and from biopsy specimens taken from rectum (amyloid deposits).

Amyloidosis↗

[What does the ECG reveal in infectious endocarditis?].

The electrocardiogram should be recorded at the very beginning of infectious endocarditis. It provides information on the origin and complications of possible organic disease (aortal stenosis--left ventricular hypertrophy). Moreover regular follow up of ECG tracings can reveal changes signalizing spread of the infection beyond the endocardium. Thus the conduction system may be affected--bundle branch block, atrioventricular blocks grade I to III, ectopic functional tachycardia, extrasystoles, myocardium--by development of typical ECG changes during myocardial infarction after embolization of the vegetation into the coronary artery, or last not least, the pericardium, after spread of the infection into the pericardial cavity with the serious finding of purulent pericarditis with diffuse ST-T elevations on the ECG tracing.

Arrhythmias, Cardiac↗

A mutation in the X-linked Emery-Dreifuss muscular dystrophy gene in a patient affected with conduction cardiomyopathy.

A screening for mutation in the X-linked Emery-Dreifuss muscular dystrophy (X-EMD) gene was performed among patients affected with severe heart rhythm defects and/or dilated cardiomyopathy. Patients were selected from the database of the Department of Cardiology of the University Hospital Brno. One patient presented a mutation in the X-EMD gene and no emerin in his skeletal muscle. The patient had a severe cardiac disease but a very mild muscle disorder that had not been diagnosed until the mutations was found. This case shows that mutations in X-EMD gene, as it was shown for autosomal-dominant EMD, can cause a predominant cardiac phenotype.

Adult↗

[Pitfalls in the diagnosis of infectious endocarditis].

A group of 63 patients with infectious endocarditis (IE) (1991-1998) was subjected to a detailed retrospective analysis. The authors investigated the age of the patients, site of IE, type of infectious agent, incidence of coinciding diseases or interventions in the close premorbid period of IE, size of vegetation, incidence of embilizations, heart failure, indications for vital early cardiosurgery, number of deaths. From the clinical analysis it may be concluded: 1. There is a new group of patients with IE, who before development of the disease have no manifest cardiac disease who however frequently suffer from another coinciding disease; 2. There is a significant increase of dextrolateral IE (frequently "pacemaker" IE); 3. The ratio of staphylococcal strains in the etiopathogenesis of IE is rising; 4. The mean age of the affected patients is rising (as well as the age scatter); 5. IE is unfortunately frequently diagnosed only after embolization of the vegetation (mostly cerebrovascular attacks) in obscure febrile conditions.

Adult↗

[Solitary cardiac metastasis from carcinoma of the cervix].

Authors report the case of 37 years old women after radiotherapy for spinocelular cervical carcinoma which was presented by a solitary metastasis in the right ventricle causing right ventricle output tract obstruction. Cardiosurgical intervention as well as chemotherapy were not indicated for the great extension of cardiac involvement. The patient died from a massive pulmonary embolism. Echocardiography, although limited by the discrimination ability, seems to be the best method for the cardiac metastasis detection.

Adult↗