Angina after a heart transplant with evidence of late sympathetic reinnervation. Report of one caseWe report a 56 years-old man presenting with chest pain with exercise, seven years after an orthotopic heart transplant. A coronary angiography showed an atherosclerotic lesion in the common left main coronary artery with more than 90% obstruction. The lesion was successfully treated with a transluminal angioplasty with stenting. A 131-I metaiodobenylguanidine (MIBG) scan demonstrated sympathetic reinnervation. Sixteen months later, due to progression of allograft vasculopathy, coronary artery bypass was required (Rev

IGT-I levels (Rev Méd Chile 2004; 132: 857-9Correspondencia a: Dr. Iván Quevedo L. Avenida Andalué N° 1825, San Pedro de la Paz, Concepción -Chile. E-mail: equevedo@udec.cl E l struma ovarii es un tumor quístico de los ovarios, que corresponde aproximadamente al 0,4% de los tumores ováricos 1 . El tejido tiroideo del struma ovarii es funcional y estructuralmente similar al tejido tiroideo cervical normal. Generalmente se presenta como un tumor ovárico asintomático 2 . Una forma inhabitual de struma ovarii es el carcinoide del estroma, en que existe la presencia de tejido tiroideo con tumor carcinoide en un tumor ovárico monodermal 3 . Clínicamente la asociación con ascitis es relativamente común y puede ocurrir en más del 10% de los casos 4,5 .Al revisar la literatura, sólo existe un caso documentado de asociación de struma ovarii y adenoma hipofisiario, que correspondía a un microprolactinoma 1 . Hasta donde sabemos, no se ha reportado ningún caso de struma ovarii en pacientes con adenoma hipofisiario productor de somatotrofina.Presentamos el caso de una mujer que en el seguimiento de una struma ovarii (carcinoide del estroma) se detectó un adenoma hipofisiario secretor de somatotrofina. CASO CLÍNICOMujer de 49 años, previamente asintomática, sin antecedentes mórbidos de importancia, con dos

We report a 59 year-old woman who had recurrent episodes of paroxystic supraventricular tachycardia despite pharmacologic therapy. A previous electrophysiological study (EPS) was done two years earlier without induction of any sustained arrhythmia. A new EPS was performed, during which atrial and ventricular programmed stimulation failed to induce tachycardia, and only by fast ventricular stimulation during intravenous isoproterenol infusion, a typical atrio ventricular nodal reentrant tachycardia (AVNRT) was induced. We successfully ablated the slow nodal pathway. After ablation the tachycardia was not inducible. We comment the occasional difficulties to induce AVNRT and the importance of a complete induction protocol to avoid false negative studies during the EPS.