Four cases of right-sided bundle-branch block and one case of atrioventricular block in three generations of a family

Four cases of complete right bundle-branch block and one case of atrioventricular heart block, all occurring within three generations of the same family, are described. The 4 patients with bundle-branch block had no symptoms, whereas the patient with atrioventricular heart block suffered Adams-Stokes attacks from the age of 13 and died at 47 years of age. A 33-year-old man with bundle-branch block had a normal electrocardiogram at the age of 7, suggesting that inherited bundle-branch block does not necessarily manifest itself during the first years of life.     

Oesophageal hiatus hernia in three generations of one family

A family is described in which eight members in three successive generations had a sliding type of oesophageal hiatus hernia (or partial thoracic stomach) as a sole anomaly. The trait in this family behaved as a strict dominant, manifesting the segregation of a single abnormal autosomal gene. Other possible aetiologies are discussed but considered unlikely.     

电子结肠镜下见一家族性结肠息肉病3例并1例癌变报告

家族性结肠息肉病是一种遗传性疾病, 癌变率较高.本文通过对家族性息肉病的内镜特点分析和家族调查,总结其临床特征,探讨家族性腺瘤性息肉病的早期诊断和治疗.结肠镜检查可了解家族性结肠息肉病结肠受累的部位和程度,为治疗及预后评价提供依据.通过家系调查,对高危亲属的追踪管理,可以发现早期病例,内镜下治疗效果满意.     

Juvenile polyposis coli A report of three patients in three generations of one family

Conclusions and Summary Three case reports are presented of three generations in one family having colonic polyps of juvenile type. A familial tendency to develop juvenile polyposis is suggested. Although a carcinoma occurred concomitantly in this series, there is insufficient evidence to suggest a relationship between familial juvenile polyposis coli and carcinoma.     

A study of twenty-eight cases of bundle-branch block

Twenty-eight cases of bundle-branch block are reported. They include nineteen with right branch block, one with temporary right, three with characteristic left, four with left, with reduced voltage, and one with both temporary right and left branch defect. All showed some degree of cardiovascular sclerosis, many an advanced degree.Prolonged periods of rest averted for months or years the final breakdown. Restricted use of digitalis helped at times.The outlook is poor. The majority die in a few months. The degree of cardiac degeneration is more important than age in prognosis. In this series the left branch cases were among the shortest lived.     

Alternating and intermittent bilateral bundle-branch block in acute myocardial infarct with development of total atrioventricular block]

The development of bilateral bundle branch block of various degree in the course of an acute myocardial infarction was demonstrated in a 74-year-old man during continuous ecg-monitoring. Initially there was a tachycardia- and bradycardia-dependent left bundle branch block, followed by a right bundle branch block with second degree type II AV block (Mobitz), and finally complete bilateral bundle branch block with asystole. Different combinations of incomplete block were shown and the presence of type I and type II second degree block within the bundle branches could be demonstrated; Wenckebach periods became indirectly visualized through changes in the AV conduction. This case illustrates the prognostic importance of progressive intraventricular conduction disturbance and reveals the multiplicity and possible mechanisms of conduction defects within the bundle branches.     

起搏器AV搜索功能致完全性房室阻滞患者心悸1例

1 临床资料 患者男,56岁,因“被人拳击胸部,左侧7～9肋骨骨折后突发完全性房室阻滞,于临时起搏10d后仍无正常房室传导而植入双腔起搏器”。患者既往体健,无高血压病,糖尿病,心脏病史,心肌酶,电解质,心脏超声等均正常。植入起搏器型号为MedtronicEnpulseE2DR01,起搏模式为DDD,双极电极。心室起搏部位为右心室流出道间隔部。     

Shortening of ventriculoatrial intervals with left bundle branch block during orthodromic reciprocating tachycardia in three patients with a right-sided accessory atrioventricular pathway

Previous studies of the effects of bundle branch block on ventriculoatrial (VA) intervals during orthodromic reciprocating tachycardia have focused on the timing of the atrial electrograms. However, left bundle branch block importantly affects the timing of initial ventricular activation, and this effect would also be expected to affect VA intervals during orthodromic reciprocating tachycardia. Presented here are three patients with a single right-sided accessory atrioventricular pathway exhibiting left bundle branch block during orthodromic reciprocating tachycardia. Each had shortening of the VA interval by 10 to 30 ms during left bundle branch block beats. This shortening was accompanied by a nearly equal increase in the HV interval, with the His bundle to atrial interval remaining constant. It is concluded that the timing of ventricular as well as atrial electrograms impacts on the VA intervals with left bundle branch block beats during orthodromic reciprocating tachycardia. With left bundle branch block, delay in initial left septal activation results in later onset of the QRS complex and, with right ventricular activation occurring normally, shortening of the VA interval occurs in patients with a right-sided pathway.