Electrocardiographic changes in patients with type A acute aortic dissection. Incidence, patterns and underlying mechanisms in 159 cases.

Background: Not only symptoms but electrocardiographic (ECG) changes mimicking acute coronary syndrome as well have been known to develop in acute aortic dissection (AAD). However, detailed information is lacking.

Objective: We sought to evaluate incidence, patterns, and underlying mechanisms for acute ECG changes in type A AAD.

Sudden death of a case of hypertrophic obstructive cardiomyopathy 19 months after successful percutaneous transluminal septal myocardial ablation.

A 56-year-old male with hypertrophic obstructive cardiomyopathy complicated with medically refractory paroxysmal atrial fibrillation and congestive heart failure was treated with percutaneous transluminal septal myocardial ablation. The resting left ventricular outflow tract gradient decreased from 70 mmHg to 0 mmHg after the procedure, and clinical symptoms improved dramatically. However, the patient died suddenly 19 months later and autopsy revealed nontransmural myocardial fibrosis with an irregular border in the interventricular septum.