© 2004 by BMJ Publishing Group & British Cardiac Society
Images in cardiology
Crystals in the heart
kobando@hsp.ncvc.go.jp
Keywords: Images in cardiology
| The first 150 words of the full text of this article appear below. |
A 22 year old woman was treated with an implantable cardioverter-defibrillator for ventricular tachycardia (VT) associated with dilated cardiomyopathy. The multifocal slow VTs persisted and were resistant to several antiarrhythmic drugs. Finally, nifekalant, a pure IKr channel blocker, was administered continuously and was effective for 10 months. A round mass was incidentally detected in the right atrium by transoesophageal ultrasonography and was moving to and fro through the tricuspid valves (panels A and B). An emergency operation was performed to remove this mass using cardiopulmonary bypass. The resected mass was a white elastic ball sized 5 x 4x 3 cm and histopathology revealed a fibrin thrombus containing needle crystals without a foreign body reaction (lower panel, haematoxylin and eosin x 400). This mass contained an extremely high amount of nifekalant and was traced through the superior vena cava up to the right brachiocephalic vein, which coincided with the route
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