[ARVD-FORUM] Growth hormone. Dr. Valdes Garcia

[ARVD Symposium]

English - Spanish

Hello and congratulations,
You are carrying out a magnificent event, living up to these times. I am an
internist, exiled from Cuba and living in Mexico, due to the great demand
for cardiologists and because of my own interest I have started working on
electrocardiology. I have been doing this at clinical level for two years
[ecg, holter, stress test].
The reason of my message is that I have a male patient with no toxic habits,
50 years old, family history of type 2 diabetes mellitus from his mother's
side, and pulmonary emphysema from the father's side. The remaining data are
uninteresting, but since 5 months ago he started performing physical
exercise in a gym with a teacher and using gh [growth hormone]. Since two
weeks ago, he started feeling atypical chest discomfort, exhaustion,
palpitations without dizziness or syncope. On Monday, I saw him in my
private office, and I performed ECG with the following findings:
Sinus rhythm, AQRS 60 degrees, QS in V1, V2 and V3 with rsr pattern in V1
and QRS in 80 ms. My diagnostic suspicion is posterior MI, so I indicated a
Tl201 stress/rest.
Do you agree or do you think that I should also be looking for
arrhythmogenic RV dysplasia secondary to use of synthetic GH, and have you
seen cases associated to use of GH, which nowadays is promoted in many
advertisements?
Regards, thank you, and I'll see you in Gdansk,

 Dr. Jose Angel Valdes Garcia
        Especialista en Medicina Interna
        Especialista en Cardiologia Nuclear
        Investigador de la viabilidad miocardica.

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Mis saludos y felicitaciones:
Estan realizando un evento magnifico a la altura  de estos tiempos.
Soy internista exiliado cubano que vive en Mexico, por la gran demanda de
cardiologos y por mi interes propio he comenzado  a trabajar la
electrocardiologia llevo dos años a nivel clinico [ecg, holter, prueba de
esfuerzo].
   El motivo de mi mensaje es que tengo un paciente sin habitos toxicos de
50 años,  historia familiar de diabetes mellitus tipo 2 rama materna y 
enfisema pulmonar rama paterna. Resto sin interes, desde hace 5 meses comenzo 
a realizar ejercicio fisico en un  gimnasio con profesor y a usar gh [hormona
de crecimiento], desde hace dos semanas comenzo a sentir molestias toracicas
atipicas, agotamiento, palpitaciones sin mareos o sincope. Lo vi el lunes en
mi consultorio particular y le tome ECG con los siguientes hallazgos: ritmo
sinusal, AQRS 60grados, QS en V1, V2 y V3 con patron  rsr en v1 y QRS en 80
ms. Mi sospecha diagnostica es un IM  posterior por lo que indique un Tl201
stress/reposo.
  Coninciden o creen que ademas deba buscar una displasia arritmogena del VD
secundaria al uso de gh sintetica y si han visto casos asociados al uso de GH, 
la cual hoy dia se promueve en muchos spots publicitarios?
Saludos, muchas gracias  y nos vemos en Gdansk

Dr. Jose Angel Valdes Garcia
        Especialista en Medicina Interna
        Especialista en Cardiologia Nuclear
        Investigador de la viabilidad miocardica.

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-- 
Dr. Sergio Dubner
Director

Dr. Edgardo Schapachnik
Director