We report a 66-yr-old male patient who developed tricuspid regurgitation secondary to internal cardiac massage. After uneventful off-pump coronary artery bypass surgery, the subject experienced cardiac arrest in the intensive care unit. External cardiac massage was initiated and internal cardiac massage was performed eventually. A transesophageal echocardiography revealed avulsion of the anterior papillary muscle and chordae to the anterior leaflet after successful cardiopulmonary resuscitation. Emergency repair of the papillary muscle was performed under cardiopulmonary bypass.
Aged ; Heart Massage/*adverse effects ; Humans ; Male ; Tricuspid Valve Insufficiency/diagnosis/*etiology/physiopathology

PURPOSE: The objective of this study is to evaluate the effects of heat and massage application on autonomic nervous system. MATERIALS AND METHODS: One hundred thirty-nine subjects volunteered and completed this study. Heat and massage was daily applied for 40 minutes, 5 days a week for 2 weeks. Primary-dependent measures included heart rate variability, sympathetic skin response, and serum cortisol and norepinephrine levels. RESULTS: Serum cortisol levels were significantly decreased at 2 weeks compared to baseline (p=0.003). Plasma norepinephrine levels at 4 weeks were significantly decreased compared to baseline (p=0.010). Heart rate, using the power spectra, increased significantly after 2 weeks compared to baseline. Of autonomic nerve conduction measures, latency was significantly increased at 2 and 4 weeks compared to baseline (p=0.023, 0.012), and amplitude was significantly decreased at 4 weeks compared to baseline (p=0.008). There were no serious adverse events such as burns or other major complications. CONCLUSION: The results of this study suggest that heat and massage applications provide relaxation to the autonomic nervous system without serious adverse events.
Autonomic Nervous System/*physiopathology ; Female ; Heart Rate/*physiology ; Hot Temperature/adverse effects/*therapeutic use ; Humans ; Hydrocortisone/blood ; Male ; Massage/adverse effects/*methods ; Norepinephrine/blood