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ECG Challenge A 72-year-old woman with essential hypertension, peripheral vascular disease, and previously undiagnosed type 2 diabetes mellitus presented to the emergency department with a 1-hour history of dyspnea, central chest discomfort, and diaphoresis. Clinical observations were normal apart from a sinus tachycardia. Chest auscultation revealed normal breath sounds and normal heart sounds with no murmurs.
We read with interest the Lancet Clinical Picture by Mariam Chekhchar and colleagues. The authors describe a history of recurrent tonsillitis, suggestive of possible rheumatic heart disease—the most common cause of acquired mitral stenosis. 2 Iung B Baron G Butchart EG et al. A prospective survey of patients with valvular heart disease in Europe: the Euro Heart Survey on Valvular Heart Disease. Eur Heart J.
Róisín Trainor, MB BCh, BAO; Eamon P. McCarron, MBChB (Hons), MPhil; Shiva Sreenivasan, MBBS(UWI); Monica Monaghan, PhD Róisín Trainor, MB BCh, BAO South West Acute Hospital, Western Health and Social Care Trust, Enniskillen, United Kingdom (R.T., E.P.M., S.S., M.M.) Eamon P.
We read with interest the case report by Bennett and Iqbal describing a patient thought to have takotsubo cardiomyopathy (TC) induced by varicella zoster viral encephalitis.1 Unfortunately, cardiac magnetic resonance imaging (CMR) had not been available to the authors in the acute setting. Have the authors considered utilising CMR for patient follow up? CMR represents the ‘gold standard’ imaging modality for the assessment of ventricular size and function.
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