All Journals from Neil Andrews
Case Report
A 52 year old woman presented to the Acute Medical Unit with her 4th episode of palpitations in the past four weeks. Each episode was similar in nature and described as being acute in onset, fast and regular, associated with pre-syncope but never syncope or chest pain. The episodes lasted for 30 – 45 minutes and would self terminate. Of particular note, the episodes were not associated with exertion and she had a normal exercise tolerance.
Discussion
Ventricular tachycardias represent an important cause of palpitations. The differentiation of “benign” or “idiopathic” ventricular tachycardias from those which require more aggressive pharmacological and device therapy is an important diagnostic step and requires careful history taking, clinical examination and ultrasound evaluation of both left and right ventricular function.
Abstract
Acute mitral regurgitation (acute MR) is a rare cause of acute respiratory distress, which can present diagnostic challenges. We present the case of a 57 year old man who developed acute shortness of breath subsequently associated with fever, raised white cells and elevated CRP. Chest x-ray revealed unilateral shadowing and he was treated for pneumonia, despite the finding of severe mitral regurgitation on echo. Failure to respond to antibiotic treatment following 3 weeks on ITU led to the consideration of acute MR as the cause of his symptoms and he responded well to diuretics. He subsequently underwent mitral valve repair. The causes and clinical presentations of this condition are discussed.
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