T-wave inversion after a severe head injury without ischemic heart disease.

Electrocardiographic changes mimicking an acute coronary event with T-wave inversion have been reported in the resting electrocardiogram in patients without ischemic heart disease but with acute ischemic stroke, or subarachnoid hemorrhage, or intracerebral hemorrhage, or a severe head injury. We present a case of T-wave inversion in a 73-year-old Italian woman admitted to the Emergency Department following a severe head injury. Pericarditis, pericardial effusion, and acute coronary event were excluded.

Treatment failure of low molecular weight heparin bridging therapy before a cardiac surgery intervention in a patient with atrial fibrillation.

From time to time, it may be necessary to interrupt oral anticoagulant therapy in preparation for surgical procedures. In high-risk patients or for longer periods, unfractionated or low-molecular-weight heparin bridging treatment has been reported safe. This case focuses attention on treatment failure of low molecular weight heparin bridging therapy in a patient with atrial fibrillation.

Atrial fibrillation associated with chocolate intake abuse and chronic salbutamol inhalation abuse.

The use of substances as the substrate for atrial fibrillation is not frequently recognized. Chocolate is derived from the roasted seeds of the plant theobroma cacao and its components are the methylxanthine alkaloids theobromine and caffeine. Caffeine is a methylxanthine whose primary biological effect is the competitive antagonism of the adenosine receptor.

Capsaicin and arterial hypertensive crisis.

Chili peppers are rich in capsaicin. The potent vasodilator calcitonin gene-related peptide (CGRP) is stored in a population of C-fiber afferents that are sensitive to capsaicin. CGRP and peptides released from cardiac C fibers have a beneficial effect in myocardial ischemia and reperfusion.

Revelation of Brugada electrocardiographic pattern during a febrile state.

The prevalence of the Brugada-type ECG and its natural history are still unclear. The Brugada syndrome is usually identified by a characteristic Brugada-type ECG that consists of ST elevation of a coved type in the precordial leads V1 to V3 and ventricular fibrillation that can lead to sudden cardiac death, although affected individuals may have a normal ECG. Mutations in the cardiac sodium channel gene SCN5A, which encodes the alpha-subunit of the human cardiac voltage-dependent Na+ channel (Na(v)1.

Abnormal troponin I levels in acute pulmonary embolism without abnormal concentrations of D-dimer at admission.

Serum troponin I is a sensitive indicator of myocardial damage but abnormal troponin I levels have been reported without acute coronary syndrome and without cardiac damage. It has been reported that right ventricular overload and hypoxia in acute pulmonary embolism may lead to right ventricular myocardium injury reflected by elevated cardiac troponin levels and that in patients with acute central sub-massive or non-massive pulmonary embolism, even mild increase in troponin I >0.03 mug/L may provide relevant short-term prognostic information independent to clinical, laboratory and echocardiographic data.