[SCD-FORUM] 97S Valvular Dilated Cardiomyopathy. Dr. Fernandez

[SCD Symposium]

Before anything, I would like to congratulate you for such an  
achievement.

Case: 64-year-old male, with dyslipaemia, HBP, smoker, sedentary,  
obese, carrier of Valvular Dilated Cardiomyopathy with history of  
Bentall surgery of Bono N27 plus Venous Bridge to Posterior Diagonal  
(severe LV), September, 2004.
In November, 2004, he presents episode of sudden death, he is  
implanted an ICD. In January 2005 syncope episode, a SPECT is carried  
out reporting: medial/apical ischemia, EF 32%, CAG and PTCA are  
carried out with a STENT to RCA.
In June 2005: infection of ICD wires: Exchange of wires and generator  
and corresponding treatment.
In October 2005 he is admitted due to multiple VT episodes and one  
spurious shock due to AF, in relation to amiodarone decrease from 400  
to 200 mg according to the patient; non-dialytic CRF, hyperthyroidism  
with TSH 0.06 that is why three months ago amiodarone is interrupted  
and danantizol deltisone is started.
In September 2006 he presents electrical storm, treatment is  
optimized with danantizol 20 mg/12 hs elevating TSH to 0.159,  
flecainide is interrupted, propafenone and lidocaine are started. He  
evolves with multiple episodes of NSVT. He presents sustained VT that  
required shocks. Presently he is on carvedilol 25 mg/12 hs, EV  
lidocaine.
A new CAG is carried out to assess progression of coronary artery  
disease, which does not account for the triggering of arrhythmia. He  
is evaluated by the Electrophysiology service staff, who say that  
there are access difficulties for mapping of ectopic focus and  
possible ablation. The patient is referred to us to evaluate cardiac  
transplantation.

Dr Carlos Fernandez

--
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee




-------------- next part --------------
An HTML attachment was scrubbed...
URL: http://www.grupoakros.com.ar/pipermail/scd-forum/attachments/20061025/6992fe7c/attachment.html