Search

Pheochromocytoma are known to have various common and uncommon cardiac complications including arrhythmias, heart failure, myocardial infarction and cardiomyopathy. We report the case of a middle aged lady presenting with recurrent pre-syncope due Polymorphic ventricular tachycardia. Further evaluation revealed that she had a labile hypertension with abdominal mass, which turned out to be pheochromocytoma on further investigation. After surgical removal of the tumor her symptoms subsided with normalization of the QT interval.

Current guidelines recommend implantation of permanent pacemakers for advanced atrioventricular block complicating acute myocardial infarction (MI) when the block is present beyond the usual hospital course. In patients with inferior MI, such blocks are usually transient, but they can also be persistent. However, they are not considered as primary indications for early reperfusion by percutaneous coronary intervention (PCI) in the absence of ongoing ischemia. We describe a patient with inferior MI in whom a successful PCI was effective in reversing persistent complete heart block, thus avoiding implantation of a permanent pacemaker. In selected patients with inferior MI and advanced atrioventricular block, PCI should be considered as a treatment option before recommending permanent pacemaker implantation.

Background: Pulmonary arterial hypertension is managed with vasodilators, and till date no specific drug has been identified with sufficient degree of success. Potassium channels have been implicated in the pathogenesis of primary pulmonary arterial hypertension. We undertook this study to assess the acute effect of oral nicorandil in patients of pulmonary arterial hypertension., Methods and Results: We studied acute hemodymanic response of 40 mg oral nicorandil in 10 patients with primary pulmonary arterial hypertension aged between 15 and 39 years (mean age 27.2 +/- 6.7 years). Responders (Group I) were defined as those with > or =20% reduction of pulmonary vascular resistance index and no change or increase in cardiac index; and non-responders (Group II) were those with < 20% reduction of pulmonary vascular resistance index. There were 7 responders (pulmonary vascular resistance index decreased from 22.8 +/- 9.3 to 17.9 +/- 6.5 Wood units) and 2 non-responders (pulmonary vascular resistance index decreased from 26 +/- 3.5 to 25 +/- 1.0 Wood units). The maximum reduction in pulmonary vascular resistance index from baseline was 29.77 +/- 6.53% (23.7-40.5%) in responders and 7.3 +/- 4.2% (4.3-10.3%) in non-responders. The study was halted prematurely in one patient who developed hypotension, requiring intravenous inotropes., Conclusions: Our results suggest that nicorandil significantly decreases pulmonary artery pressure in primary pulmonary arterial hypertension acutely and can be cautiously tried for the therapeutic use in primary pulmonary arterial hypertension. Further studies are warranted.

Infective endocarditis is a rare but serious complication following device closure of atrial septal defect. Surgical removal of the device is mandatory in such cases. We report a rare case of polymicrobial endocarditis following implantation of Amplatzer septal occluder in an eight-year-old child.