Di Lorenzo M, Schiavo B
G Ital Cardiol. 1978;8(8):886-91.
The Authors describe the case of a 61 year old man suffering from rheumatoid arthritis; the diagnosis of "rheumatoid heart" was made on the basis of the humoral findings and of the clinico-ecgraphic picture of endocardial (mitral incompetence) and myocardial injuries. The different complications impairing the heart rhythm (FA, tachycardia S.V., and episodes of tachycardia V., torsade de pointes type) and the A-V and the I.V. conduction (RBBB phase 3, LBBB phase 4, BAV 1st, 2nd and 3rd degree) which determined the recurrence of episodes of heart block and required adequate intensive cardiological treatment, are described. In conclusion, the significance of the persistance of the L.A.D. in the course of complete LBBB and the discovery of an unusual type of escape-capture bigeminy in the course of 2nd degree BAV is discussed.
作者描述了一名61岁患类风湿性关节炎男性的病例;“类风湿性心脏病”的诊断是基于体液检查结果以及心内膜(二尖瓣关闭不全)和心肌损伤的临床超声心动图表现做出的。文中描述了各种影响心律(房颤、室上性心动过速以及室性心动过速发作、尖端扭转型室速)和房室及室内传导(完全性右束支传导阻滞3相、完全性左束支传导阻滞4相、一度、二度和三度房室传导阻滞)的并发症,这些并发症导致了心脏传导阻滞发作的复发,需要进行充分的强化心脏治疗。最后,讨论了完全性左束支传导阻滞病程中左前分支持久性的意义以及二度房室传导阻滞病程中发现的一种不寻常的逸搏-夺获二联律类型。