Ventricular fibrillation following deodorant spray inhalation

We report one case of out-of-hospital cardiac arrest with ventricular fibrillation following butane poisoning after inhalation of antiperspiration aerosol. An early management using semi-automatic defibrillator explained the success of the resuscitation. The mechanism of butane toxicity could be an increased sensitivity of cardiac receptors to circulating catecholamines, responsible for cardiac arrest during exercise and for resuscitation difficulties. The indication of epinephrine is discussed.     

Right ventricular infarction caused by isolated right ventricular branch occlusion: a case report

It is rare to observe right ventricular infarction caused by isolated right ventricular branch occlusion. Isolated right ventricular infarction accounts for less than three percent of all cases of infarction. Generally, it is associated with occlusion of a non dominant right coronary artery or of a right ventricular branch. ECG can be misleading with ST segment elevation in anterior leads. We describe a patient admitted for chest pain with ST segment elevation in leads V1 to V3 associated with ST segment elevation in leads V3R and V4R. Coronary angiography demonstrated isolated total occlusion of the right ventricular branch. Thus, right precordial leads need to be done in every patient presenting with ST segment elevation in precordial leads V1 to V3 and not only in inferior myocardial infarction.     

Routine electrocardiographic criteria for the diagnosis of left ventricular hypertrophy: performance in Black Africans

OBJECTIVE: To determine, in Black Africans, the performance of routine electrocardiographic criteria in the diagnosis of left ventricular hypertrophy (LVH). METHODS: Thirty voluntary healthy subjects and 154 patients were explored at echocardiography (according to Pen convention) and 12-lead electrocardiography (ECG). The performance of Lewis, Sokolow and Cornell (Cornell S1 for a threshold of 28 mm in men, and Cornell S2, for a threshold of 24 mm) criteria were defined by their sensitivity, specificity, positive and negative predictive values. RESULTS: The prevalence of LVH in the 154 patients ranged from 15.6% to 35.7%, according to the ECG criteria. Sensitivities were of 0.19, 0.43, 0.30 and 0.76 for the Lewis, Sokolow, Cornell S1 respectively, and the specificities were of 0.89, 0.73, 0.91 and 0.54. Positive predictive value ranged from 0.16 (Cornell S2) to 0.91 (Cornell S2), and the negative predictive value, from 0.48 (Lewis) to 0.86 (Cornell S2). CONCLUSION: Routine ECG criteria for the diagnosis LVH have low performance in Black African. There is a need of new ECG criteria with better performance.