WCIM 2014 SEOUL KOREA 61
Poster Session
The Korean Journal of Internal Medicine Vol. 29, No. 5 (Suppl. 1)
PS 0057 Cardiology
The Exercise Test Data in Interrelation with the Heart Rate Variability in Cardiovascular Heart Disease and Arterial Hypertension
Igor TSOI1, Gulnora NAGAEVA2
Republican Cardiologic Center, Uzbekistan1, Republican Cardiologic Center, Uzbekistan2
Background: To give a comparative evaluation of the parameters of exercise test (ET) in conjunction with the heart rate variability (HRV) in patients with CAD, with CHD and AH and only AH.
Methods: 80 pts were included in the study, which was 51,76 ± 9,65 years (range 25 to 73 years), of which 49 (61.25%) - males. All patients were examined: the calcula- tion of body mass index (BMI), the HRV parameters.
Results: The pts of 2gr. characterized by relatively high values of body weight = 82,45
± 10,15 kg, 3.07% and 7.57% more than 1gr. and 3gr. (BMI in 1gr. = 28,80 ± 3,95 kg/m2; in 2gr. = 29,83 ± 3,25 kg/m2; in 3gr. = 27,51 ± 3,89 kg/m2). HRV parameters confi rmed the results, SDNN, rMSSD, pNN50 and TI had the lowest values in patients 3gr. Spectral indices point to the prevalence of low-frequency spectrum of HRV (LF / HF = 4,47 ± 2,97, which is 1.4 and 1.7 times higher than in groups 1 and 2, p <0.05.
However, analysis of exercise capacity revealed that patients of 3gr. had high exercise capacity at 37.5%, against 33.3% and 15%, respectively, 1 and 2 groups, with an av- erage exercise capacity - 50% vs. 58% and 80%, respectively, in groups 1 and 2, and low exercise capacity - in 12.5% versus 8.3% and 5%, respectively, in groups 1 and 2 (all p> 0.05).
Conclusions: Patients with AH during the exercise test, despite of a relatively high tolerance to physical activity and relatively low weights, characterized by autonomic imbalance with a predominance of sympathetic activity of the autonomic nervous system.
PS 0058 Cardiology
A Case of Sinus of Valsalva Rupture Presented as Right Ventricular Outfl ow Tract Ventricular Tachycardia
Kwon TAEHUN1
Yeungnam University Mecical Center, Korea1
Introduction: Ruptured sinus of valsalva aneurysm(RSVA) is a rare disease that fi rst described in 1840 by John Thurman. Symptoms vary depending on the rapidity of the rupture, the size of the ruptured origice and the chamber into which rupture occurs.
Case report: A 54-year-old woman was admitted to our emergency department presenting with sudden-onset palpitation and chest discomfort while singing a song.
ECG in the ambulance was compatible with wide QRS tachycardia but initial ECG in the emergency room was changed atrial fi brillation. A physical examination demon- strated grade 6 continuous murmur was auscultated on the left lower sternal border.
Transthoracic echocardiogram was performed and revealed mild TR with increased RV systolic pressure of 67mmHg and a shunting fl ow over 4m/s from right coronary cusp to right ventricle. Also the 8mm-sized defect was detected on dilated aneurysm of right coronary sinus. There was no significant stenosis in coronary arteries and the ratio of the volume of pulmonary fl ow (Qp) and systemic fl ow (Qs) was 2.63 and oxygen saturation of RV(89.8%) was slightly higher than one of RA by 8%. She was still suffering from palpitation, and the 12-lead ECG showed RVOT VT same as before in ambulance with hemodynamic instability. A total of 8 times electrical cardioversion were immediately performed. Next, she underwent an emergency operation and was discharged without any complications including recurrent VT.
Discussion: It would be the fi rst case that ruptured sinus of Valsalva aneurysm pre- senting with RVOT VT. We thought the mechanism triggering RVOT VT in this case is abrupt volume stretch caused by signifi cant amount of left to right shunt followed by rupture of the aneurysm.
PS 0059 Cardiology
Lymphoma with Constrictive Pericarditis
Zhen-Yu LIAO1, Jer-Young LIOU1, Kou-Gi SHYU1,3, Huey-Ming LO1,2, Jun-Jack CHENG1, Chiung-Zuan CHIU1,2
Division of Cardiology, Shin Kong Wu Ho-Su Memorial Hospital, Taiwan R.O.C1, School of Medicine, College of Medicine, Fu-Jen Catholic University, Taiwan R.O.C2, Graduate Institute of Clinical Medicine, Taipei Medical University, Taiwan R.O.C3
Patients with pericardial diseases usually present with nonspecifi c symptoms, these diseases may not be detected until they have reached an advanced stage. It is there- fore important to distinguish between normal pericardial structure and disease. Per- icardial constriction is typically chronic, but variants include subacute, transient, and occult constriction. Pathologically, this results in chronic infl ammation and, frequently, calcifi cation. Constrictive pericarditis has multiple etiologies and can lead to disabling symptoms and severe heart failure with poor quality of life. We described a patient who presented with symptoms of heart failure and was found to have diastolic heart failure. Several investigations pointed to the diagnosis of constrictive pericarditis which was later confi rmed by cardiac catheterisation. The etiology turns out to be primary cardiac lymphoma which is extremely rare in immunocompetent patients.
