Mitral valve prolapse

Kowalski, Stephen

doi:10.1007/bf03010036

Cited by 6 publications

(1 citation statement)

References 15 publications

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“…The dysrhythmias caused by the prolapsed leaflets may be enhanced further by increased catecholamine level, because an increased sensitivity to catecholamines is seen in patients with mitral valve prolapse. 4 Halothane itself is well known to sensitize the heart to catecholamines.…”

Section: Discussionmentioning

confidence: 99%

Ventricular fibrillation during general anaesthesia in a seven-year-old patient with mitral valve prolapse

et al. 1986

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Intraoperative arrhythmias occurs frequently during paediatric anaesthesia. Common causes include surgical stimulation under light anaesthesia, hypoxia and hypercarbia. We report an unusual case of ventricular fibrillation in a child during general anaesthesia, following tracheal intubation. Case reportThe patient was a seven-year-old white male scheduled for hypospadias revision. The initial hypospadia repair, two years previously under general anaesthesia had been without anaesthetic complications. The patient had no significant past medical history, no history of allergies, and currently was receiving no medications. Physical examination revealed a well developed boy with a blood pressure of 110/70 mmHg and heart rate of 85 (regular), who was afebrile and weighed 26 kg. The patient had normal first and second heart sounds with no murmurs, gallops, or rubs. The remainder of the physical examination was normal. Laboratory studies were within normal limits.Since the patient was admitted on the day of surgery no premedication had been given. The patient was monitored with an EKG, a doppler for blood pressure measurement, and a precordial stethoscope. Mask induction with 02, N20, and halothane was performed. A 20 gauge 1V was then started and a rectal temperature probe inserted. The patient at this time was given 0.5 mg.kg -~ atracurium to facilitate tracheal intubation. The EKG showed a normal sinus rhythm and there was minimal decrease of blood pressure. Just prior to laryngoscopy, however, the patient' s EKG changed to a nodal rhythm with a rate of 74, and occasional CAN ANAESTH SOC J 1986 / 33:6 / pp795-8

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Section: Discussionmentioning

confidence: 99%

Ventricular fibrillation during general anaesthesia in a seven-year-old patient with mitral valve prolapse

et al. 1986

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Anaesthesia and Marfan’s syndrome: case report

Wells

Podolakin

1987

Can J Anaesth

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The incidence of Marfan's syndrome in the general population is thought to be between 1:10,000 and 1:50,000. t Hence it is possible that at some stage during their practising life many anaesthetists will be called upon to treat such a patient. We recently anaesthetized a patient for a cardiac procedure who demonstrated most of the features of this generalised disorder of connective tissue.Case report An 18-year-old male presented to hospital four days after the acute onset of left sided chest and neck pain. The pain was associated with severe dyspnoea, nausea and faintness and lasted about 15 seconds. It was followed by constant, heavy retrosternal chest pain. Similar episodes of diffuse, heavy chest pain were described on several occasions over the previous two years.The patient gave a history of multiple recurrent dislocations of both shoulders and also of a dislocation of his left ankle. He had undergone surgery at the age of 12 for the correction of a severe pectus excavatum deformity, at 15 years of age for osteo-chondritis dissecans of the left knee and at 17 years, for torsion of the fight testis.Examination of this tall (185 cm), thin (62 kg) patient revealed the typical features of Marfan's syndrome; an arm span that was greater than his height, a cathedral palate, winging of the scapulae, ulnar deviation of fire mctacarpophalangeal joints and residual pectus excavatum. He had also an abberant left radial artery, situated on the dorsum of the forearm.There were significant abnormalities on examination of the cardiovascular system. The blood pressure in the left arm was 110160 mmHg and in the right arm 120f70 mmHg. His apex beat was widely displaced to the 7th left intercostal space, mid axillary line. There was an ejection systolic murmur heard to the right of the sternum with a mid-systolic click at the left sternal edge.A chest x-ray showed a prominent and slightly tortu ous aorta with cardiomegaly and a marked thoracic scoliosis. There were no interstitial pulmonary changes. His ECG showed right atrial hypertrophy and large left ventricular complexes. The following day an aortogram was performed, outlining a large false aortic sac with a possible entry site proximal to the innominate artery. The aortic root was not outlined. He was treated with oral CAN J ANAESTH 1987 ! 34:3 / pp311-4

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