[Analysis of post-pacing beats in the diagnosis of sick sinus syndrome].
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Biomedical subjects
Publications and source records attributed to E Astorri.
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Three cases of aortic sinus aneurysm and three cases of prolapse and regurgitation of the aortic valve associated with ventricular septal defect are discussed from an angiographic point of view. It is pointed out that aortic regurgitation into the left ventricle might be helpful for a correct diagnosis. Aortic regurgitation, in fact, is the result of an anatomically unsupported aortic valve that becomes gradually distorted by haemodynamic influences. This pathogenetic mechanism is often found in subpulmonar and infracrestal ventricular septal defect.
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A case of isolated tricuspid insufficiency is reported. The lesion, that at surgery resulted to be an anterior valve leaflet detachment, was well tolerated for a long time. After 23 years from the trauma the patient was successfully treated by surgical correction. The clinical features, compared to the 33 cases reported in the literature, demonstrated that the clinical course was more dramatic in patients with papillary muscle rupture than in those where the lesion was located on the chordae tendineae and/or the valves. The physical findings are characteristic but not specific of the traumatic type of tricuspidal insufficiency. However, when these symptoms are found in a patient where a trauma has previously occurred, the correct diagnosis should consider this possibility. The ECG usually shows incomplete bundle branch block, and the chest roentgenogram reveals cardiomegaly. Furthermore, the blood pressure levels in the right chambers are nearly normal. Surgery is often indicated and seems to give very good results. Our patient markedly improved after surgical treatment. Electrocardiographic and vectorcardiographic evidence of right atrial and ventricular hypertrophy was reduced as well as the roentgenographic pattern.
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