Value of baseline left lateral wall postsystolic displacement assessed by M-mode to predict reverse remodeling by cardiac resynchronization therapy.

Although left ventricular (LV) dyssynchrony assessed by ultrasound is emerging as superior to QRS duration in predicting response to cardiac resynchronization therapy (CRT), the role of conventional echocardiographic parameters of dyssynchrony is still debated. Forty-eight patients with heart failure in New York Heart Association classes III to IV, LV ejection fraction < or =35%, and QRS duration > or =120 ms were studied. LV dyssynchrony was evaluated by M-mode as septal-to-posterior wall motion delay and left lateral wall postsystolic displacement (LWPSD).

Silent acute myocardial infarction following a wasp sting.

Hymenoptera sting can lead to an acute myocardial infarction by different pathogenetic mechanisms depending on the presence of preexistent coronary atherosclerosis, the development of shock or the therapeutic use of epinephrine. The case of a 67-year-old man with acute myocardial infarction with ST-segment elevation after a wasp sting treated with fibrinolysis and without significant coronary atherosclerosis is reported. Of particular interest in the present case report is the silent presentation and the absence of any pharmacological interference.