Cardiology Morning Presentation 2 IM

Dr Ihab Suliman

31/5/2011

60 years old male with Multiple Co-Morbid issues.

• NSR,RBBB

60 years old male with Multiple COMORBID ISSUES, came 2 ER with CP

60 years old male with Multiple COMORBID ISSUES

• Tall Tent of hyperkalemiaed T-Waves

Referred 2 cardiology 2 r/o ACS

CT/Stress –Rest Rubidium (CT/PET)

• Stress 120 Sec Above Compared 2 Rest 120 sec showed inferolateral small infarct with Significant Peri-infarct ischemia

55 years old male with Previous cardiac history

• What 2 procedures done.

• Patent LIMA ,Stent in the CX , occluded graft ( see the nipple on the arch of the aorta), 4 stents in RCA with instent restenosis (see the dark dot inside the RCA stents)

44 years old male survived cardiac arrest & MVA 2005, family screened, he Got AICD

6 years later 2010 , eldest son 23 years old ,had arrest

2005 ECG

• Brugada syndrome is a heritable arrhythmia syndrome that is characterized by an electrocardiographic pattern consisting of coved-type ST-segment elevation (2 mm) followed by a negative T wave in the right precordial leads, V1 through V3 (often referred to as type 1 Brugada electrocardiographic pattern),

Genetic Basis of Brugada Syndrome

• BrS is inherited as an autosomal dominant trait; however, over 50% of BrS cases may be sporadic.