Predictive factors of ventricular fibrillation triggered by pause-dependent torsades de pointes associated with acquired long QT interval: role of QT dispersion and left ventricular function.

Introduction: Death due to acquired torsades de pointes usually is caused by ventricular fibrillation (VF), but the contributing factors to VF triggered by pause-dependent torsades de pointes are not understood.

Methods And Results: We evaluated 91 patients who fulfilled four criteria: (1) pause-dependent torsades de pointes; (2) prolonged QT interval and/or corrected QT (QTc) (>0.44 sec); (3) long-short initiation sequence; and (4) conditions known to induce pause-dependent torsades de pointes.

Double postinfarction cardiac rupture of left ventricular free wall and papillary muscle documented by transthoracic echocardiography.

A 70-year-old man presented with a posteroinferolateral acute myocardial infarction complicated by rupture of the left ventricular inferior wall and partial rupture of the posteromedial papillary muscle. Transthoracic echocardiography documented both of these complications and led to prompt and successful surgical repair.

Comparison of short-term efficacy of diltiazem and propranolol in unstable angina at rest--a randomized trial in 70 patients.

The short-term efficacy of diltiazem (D) has been compared to that of propranolol (P), in a group of 70 patients hospitalized in the Coronary Care Unit for unstable angina, defined as recent (less than one month) appearance or aggravation of spontaneous chest pains. Among the 70 patients, 24 had angina only at rest. The patients have been divided into two groups according to ST-T changes during chest pain: 29 with ST elevation (group A) and 41 with other repolarization abnormalities (group B).

[Acute cardiac liver. Diagnostic problems in 4 cases (author's transl)].

Four personal cases with histological examination of the liver and a review of 70 cases collected from the literature have enabled the authors to develop the diagnostic problems involved in acute cardiac liver. An accurate diagnosis of this condition, which consists of acute hepatic cytolysis on a background of heart failure, can only be based on its course and/or on the presence of histological changes in the liver.