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Biomedical subjects

B Strasberg

Publications and source records attributed to B Strasberg.

189 records · Page 11Linked to original sources

Unusual electrocardiographic presentation of idiopathic hypertrophic subaortic stenosis.

A patient with idiopathic hypertrophic subaortic stenosis and normal coronary arteries, with dynamic electrocardiographic changes resembling acute myocardial ischemia, is presented. A definite association between the electrocardiographic changes and the idiopathic hypertrophic subaortic stenosis cannot be absolutely confirmed; however, the findings demonstrate the broad spectrum of electrocardiographic presentation in this disease.

Cardiomyopathy, Hypertrophic↗

Coexistent Wenckebach phenomenon in the distal branches of the specialized conduction system.

A patient in whom Wenckebach phenomenon was observed to coexist in the three distal branches of the specialized ventricular conduction system, with an intermittent trifascicular block producing a second degree A-V block, is described. Surface electrocardiogram demonstrated the presence of this phenomenon in the right bundle branch (RBB) and the anterior division of the left bundle branch (LBB). Evidence of the presence of Wenckebach phenomenon in the remaining fascicle was provided by His bundle recording.

Aged↗

Dissociation of the atrioventricular node in acute inferior wall myocardial infarction. 1. Transverse dissociation (alternate Wenckebach periods).

Two cases of alternate Wenckebach periods developing during the acute phase of inferior wall myocardial infarction are presented. In both cases, syncope occurred and severe bradyarrhythmia was recorded on the day of admission. Electrophysiologic study performed in one patient and a narrow QRS complex in the other patient during the alternate Wenckebach periods confirmed the atrioventricular node as the level of block. Transverse dissociation of the atrioventricular node with two (or more) levels of block is the most acceptable explanation for this phenomenon. We suggest that alternate Wenckebach periods occurring during the acute phase of inferior wall myocardial infarction is a severe bradyarrhythmia, and prophylactic temporary pacing is recommended.

Acute Disease↗

Dissociation of the atrioventricular node in acute inferior wall myocardial infarction. 2. Longitudinal dissociation (dual atrioventricular nodal pathways).

Four cases of longitudinal dissociation of the atrioventricular node, with dual pathways developing during the acute phase of an inferior wall myocardial infarction (three cases) or during acute ischemia (one case), are presented. In all four cases, two grossly different P-R intervals were recorded, and in two cases, studies of the His bundle confirmed the location of the dissociation within the atrioventrcular node. In one case, premature atrial depolarization caused a bidirectional shifting of P-R intervals, while in the remaining three cases, premature ventricular depolarization (spontaneous or pacemaker-induced) was responsible for this phenomenon. In all cases, evidence of longitudinal dissociation of the atrioventricular node appeared during the acute phase of the infarction or ischemia, and in all of them the phenomenon was transient. This favors the assumption that this phenomenon is of a functional nature, most probably related to the ischemic lesion of the atrioventricular node.

Acute Disease↗

Inducible polymorphous ventricular tachycardia following Mustard operation for transposition of the great arteries.

A 22-year-old woman with chronic atrial tachycardia following Mustard's operation for transposition of the great arteries presented with dizziness and ventricular tachycardia documented with dynamic 24-h electrocardiogram. During intracardiac electrophysiology study, programmed ventricular extrastimulation induced polymorphous ventricular tachycardia (torsades de pointes). This was prevented by intravenous administration of procainamide. We postulate that polymorphous ventricular tachycardia is a possible cause of death in patients with Mustard's operation. Postoperative electrophysiologic study may define those patients at risk to develop this potentially fatal arrhythmia.

Adult↗