Nutritional alterations and the effect of fish oil supplementation in dogs with heart failure.

Alterations in body composition and nutritional status are common in humans with heart failure and are related, in part, to increases in cytokine concentrations. Cytokines have not been studied previously in dogs with naturally occurring cardiac disease nor has fish oil administration been used in this population to decrease cytokine production. The purposes of this study were to characterize nutritional and cytokine alterations in dogs with heart failure and to test the ability of fish oil to reduce cytokines and improve clinical outcome.

Unusual manifestations of severe sick sinus syndrome.

An extremely athletic 56-year-old male physician was found to have profound sinus bradycardia. His only symptom was markedly increased alertness while actively exercising. During pacemaker insertion he had an episode of prolonged sinus arrest terminated by a precordial thump.