A tick in the ear is a very painful condition and removal is difficult because it grips firmly to the external auditory canal or tympanic membrane. Facial paralysis is a rarely reported localised neurological complication of an intra-aural tick infestation. The pathophysiology of localised paralysis is discussed, together with the safe way of handling patients with an intra-aural tick infestation.
Ticks ; Isolated ; physiopathological ; Paralysis ; Membranes

OBJECTIVETo observe field potentials (FPs) and activation sequence at Langendorff perfused guinea pigs heart, SD rat cardiac tissue strips perfused by Tyrode's solution and cultured ventricular cardiomyocytes of suckling mice by microeletrode arrays (MEA) technique.

METHODFPs and activation sequence were recorded from perfused heart, cardiac tissue strips (5 mm x 5 mm) and cultured ventricular cardiomyocytes by MEA.

RESULTS(1) FPs could be recorded in hearts perfused for 30 to 90 min with a heart rate 90 - 120 beats/min. FP durations of both ventricular and atrial tissue were (210 +/- 78) ms and (164 +/- 58) ms, respectively and atrial ventricular conduction time was (320 +/- 150) ms. (2) The excitability of Tyrode's solution perfused tissue strips was visible for more than 2 h, and FP durations of ventricular and atrial tissue strips were (115.80 +/- 11.61) ms and (83.71 +/- 6.48) ms, respectively. (3) Spontaneous beating frequency (150 +/- 100) beats/min and FPs could be readily recorded in cardiomyocytes cultured between 2 to 72 hours.

CONCLUSIONMEAs is a sensitive, low noise and stable technique for observing local tissue action potential and activation sequence of whole heart, cardiac tissue strips and cultured cardiomyocytes.

Action Potentials ; Animals ; Heart ; Isolated Heart Preparation ; Microelectrodes ; Myocytes, Cardiac ; Rats, Sprague-Dawley

Noncompaction of the ventricular myocardium is a rare congenital cardiomyopathy that is thought to be caused by arrest of normal endomyocardial embryogenesis. It is usually diagnosed via echocardiography. The three major clinical manifestations of noncompaction are heart failure, arrhythmia and embolic events. We report here on a case of isolated noncompaction of the ventricular myocardium, and the patient was admitted due to palpitation and dyspnea. Sadly, he died of intractable heart failure despite that we administered intensive medical treatment.
Aged* ; Arrhythmias, Cardiac ; Cardiomyopathies ; Dyspnea ; Echocardiography ; Embryonic Development ; Female ; Heart Failure ; Humans ; Isolated Noncompaction of the Ventricular Myocardium* ; Myocardium ; Pregnancy

Noncompaction ventricular myocardium is an unusual cause of cardiomyopathy. It is association with congenital heart defects, most often with outflow obstructive lesions or coronary anomalies. However, no factor could explain the arrest of development of myocardial structure (isolated form). The pathogenesis of isolated noncompaction is thought to be an arrest in endomyocardial morphogenesis. It has been reported that myocardial noncompaction could present as acquired disease. The most common site of involvement is the left ventricle, with right ventricular involvement being reported in a few cases. In this report, we present a case with noncompaction of the right ventricle (RV). Cardiac computed tomography angiography and magnetic resonance imaging demonstrated morphological abnormalities of the RV.
Angiography ; Cardiomyopathies ; Heart Defects, Congenital ; Heart Ventricles* ; Isolated Noncompaction of the Ventricular Myocardium ; Magnetic Resonance Imaging ; Morphogenesis ; Multidetector Computed Tomography ; Myocardium*

OBJECTIVE: To retrospectively summarize the cardiac magnetic resonance imaging (CMRI) findings of isolated noncompaction of ventricular myocardium (INVM). MATERIALS AND METHODS: Eleven patients (M:F = 9:2; mean age, 35 years) were evaluated. Steady-state free precession (SSFP), fast spin echo (SE) sequence, SSFP cine imaging, and delayed enhanced inversion recovery spoiled gradient echo (IR-SPGR) sequence were used for showing abnormal myocardium, measuring ratio of noncompacted/compacted myocardium layers (NC/C ratio), and detecting myocardial viability. The left ventricle was divided into nine segments and a NC/C ratio > 2.3 in diastole was used as cutoff value in diagnosing left INVM. The right ventricle was assessed qualitatively. RESULTS: Cardiac MRI indicated left INVM in seven patients, right INVM in one patient and biventricle INVM in three patients. Characteristic CMRI changes included prominent trabeculations, deep intertrabecular recesses and an increase in the NC/C ratio. The most frequently involved segments was left ventricular apex. Three patients had abnormal high signals within the trabecular structures on SE T2 weighted image. One ventricular aneurysm and one apical thrombus were also observed. Delayed enhancement was seen in six of nine patients with subendocardial and transmural patterns. CONCLUSION: There are CMRI features that might be characteristic for INVM.
Adolescent ; Adult ; Female ; Heart Aneurysm/complications/diagnosis ; Heart Ventricles/pathology ; Humans ; Isolated Noncompaction of the Ventricular Myocardium/complications/*diagnosis ; *Magnetic Resonance Imaging ; Male ; Middle Aged ; Myocardium/pathology ; Young Adult

Isolated noncompaction of ventricular myocardium, sometimes referred to as spongy myocardium, is a rare congenital cardiomyopathy. Spongy myocardium results from an arrest in normal endomyocardial embryogenesis. The clinical symptoms and electrocardiographic findings of this disorder can be showed variously. The diagnosis is usually made by echocardiography. We report a case of isolated noncompaction of the ventricular myocardium in a 20-year-old male patient initially presented with syncope caused by ventricular tachycardia, who was diagnosed with echocardiography, cardiac MRI and endomyocardial biopsy.
Adult* ; Biopsy ; Cardiomyopathies ; Diagnosis ; Echocardiography ; Electrocardiography ; Embryonic Development ; Female ; Humans ; Isolated Noncompaction of the Ventricular Myocardium ; Magnetic Resonance Imaging ; Male ; Myocardium* ; Pregnancy ; Syncope ; Tachycardia, Ventricular* ; Young Adult

Isolated noncompaction of ventricular myocardium, sometimes referred to as spongy myocardium, is a rare congenital cardiomyopathy. Spongy myocardium results from an arrest in normal endomyocardial embryogenesis. The clinical symptoms and electrocardiographic findings of this disorder can be showed variously. The diagnosis is usually made by echocardiography. We report a case of isolated noncompaction of the ventricular myocardium in a 20-year-old male patient initially presented with syncope caused by ventricular tachycardia, who was diagnosed with echocardiography, cardiac MRI and endomyocardial biopsy.
Adult* ; Biopsy ; Cardiomyopathies ; Diagnosis ; Echocardiography ; Electrocardiography ; Embryonic Development ; Female ; Humans ; Isolated Noncompaction of the Ventricular Myocardium ; Magnetic Resonance Imaging ; Male ; Myocardium* ; Pregnancy ; Syncope ; Tachycardia, Ventricular* ; Young Adult

Isolated left ventricular noncompaction (LVNC) is a rare cardiomyopathy with morphologic characteristics of two distinct myocardial layers i.e., thin compacted epicardial and thick noncompacted endocardial layers. The noncompacted myocardium consists of prominent ventricular trabeculae and deep intertrabecular recesses. It can lead to arrhythmias, heart failure or systemic embolisms. Electrocardiographic patterns of patients with LVNC are various and non-specific; however, the most common findings are intraventricular conduction delay, left ventricular hypertrophy, and repolarization abnormalities. We reported the first case, to the best of our knowledge, of a 29-year-old man who had recent cerebral infarction and incidental LVNC with spontaneous left atrial standstill.
Adult ; Arrhythmias, Cardiac ; Cardiomyopathies ; Cerebral Infarction ; Electrocardiography ; Embolism ; Heart Atria* ; Heart Failure ; Humans ; Hypertrophy, Left Ventricular ; Isolated Noncompaction of the Ventricular Myocardium ; Myocardium ; Stroke*

OBJECTIVETo analyze the incidence of coronary artery disease (CAD) and outcome of patients with left ventricular noncompaction (LVNC).

METHODSFifty-one patients with LVNC evaluated by echocardiography and/or cardiac magnetic resonance (CMR) from January 2006 to August 2010 were retrospectively reviewed. Coronary angiography or MDCT was performed for detecting coronary artery disease. Predictors of the cardiac events were analyzed by Cox regression analysis.

RESULTSThere were 31 LVNC patients without CAD and 20 LVNC patients with CAD including single vessel coronary disease in 9 cases, double vessel coronary disease in 3 cases, three vessel coronary disease in 5 cases and left main coronary disease in 3 cases. Coronary artery bypass graft and percutaneous coronary intervention (PCI) were performed in 4 patients. Compared to LVNC patients without CAD, mean age (P = 0.008), incidence of hypertension (65.0% vs. 19.4%, P = 0.001), diabetes mellitus (40.0% vs. 12.9%, P = 0.026) and hyperlipidemia (55.0% vs. 25.8%, P = 0.035) were significantly higher while NT-proBNP level was significantly lower (P = 0.049) in LVNC patients with CAD. Incidence of major cardiac events was similar in LVNC patients with or without CAD. LogNT-proBNP is the independent prognostic factor for adverse cardiac events in patients with LVNC (HR 3.993, 95%CI 1.140 - 13.988, P = 0.030).

CONCLUSIONSCoronary artery disease is common in patients with LVNC and associated with traditional risk factors for CAD. Poor prognosis is associated with increased NT-proBNP but not with CAD in this patient cohort.

Adolescent ; Adult ; Aged ; Cardiomyopathies ; complications ; diagnosis ; pathology ; Female ; Heart Ventricles ; pathology ; Humans ; Incidence ; Isolated Noncompaction of the Ventricular Myocardium ; complications ; diagnosis ; pathology ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Young Adult

Left ventricular hypertrabeculation/noncompaction (LVHT) is an uncommon type of genetic cardiomyopathy characterized by trabeculations and recesses within the ventricular myocardium. LVHT is associated with diastolic or systolic dysfunction, thromboembolic complications, and arrhythmias, including atrial fibrillation, ventricular arrhythmias, atrioventricular block and Wolff-Parkinson-White syndrome. Herein, we describe a patient who presented with heart failure and wide-complex tachycardia. Echocardiography showed LVHT accompanied with severe mitral regurgitation. The electrophysiologic study revealed a fasciculo-ventricular accessory pathway and atrial flutter (AFL). The AFL was successfully treated with catheter ablation.
Arrhythmias, Cardiac ; Atrial Fibrillation ; Atrial Flutter ; Atrioventricular Block ; Cardiomyopathies ; Catheter Ablation ; Echocardiography ; Heart Failure ; Humans ; Isolated Noncompaction of the Ventricular Myocardium ; Mitral Valve Insufficiency ; Myocardium ; Pre-Excitation, Mahaim-Type ; Tachycardia ; Wolff-Parkinson-White Syndrome