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Ao: aorta; ICE: intracardiac echocardiography; LV: left ventricle; * pseudoaneurysm/closure device.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Luís Paiva, Marco Costa, Rogério Teixeira, Lino Gonçalves" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Luís" "apellidos" => "Paiva" ] 1 => array:2 [ "nombre" => "Marco" "apellidos" => "Costa" ] 2 => array:2 [ "nombre" => "Rogério" "apellidos" => "Teixeira" ] 3 => array:2 [ "nombre" => "Lino" "apellidos" => "Gonçalves" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204917303860?idApp=UINPBA00004E" "url" => "/21742049/0000003600000012/v1_201712220644/S2174204917303860/v1_201712220644/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2174204917303549" "issn" => "21742049" "doi" => "10.1016/j.repce.2016.12.025" "estado" => "S300" "fechaPublicacion" => "2017-12-01" "aid" => "1061" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "Rev Port Cardiol. 2017;36:959.e1-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2882 "formatos" => array:3 [ "EPUB" => 178 "HTML" => 2168 "PDF" => 536 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>" "titulo" => "Hypercalcemic crisis and primary hyperparathyroidism: Cause of an unusual electrical storm" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "959.e1" "paginaFinal" => "959.e5" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Crise hipercalcémica e hiperparatiroidismo primário: causa de tempestade arrítmica invulgar" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1475 "Ancho" => 2667 "Tamanyo" => 1098798 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Rhythm strip recording monomorphic ventricular tachycardia with pattern of left bundle branch block and rate of around 300 bpm.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Tatiana Guimarães, Miguel Nobre Menezes, Diogo Cruz, Sónia do Vale, Armando Bordalo, Arminda Veiga, Fausto J. Pinto, Dulce Brito" "autores" => array:8 [ 0 => array:2 [ "nombre" => "Tatiana" "apellidos" => "Guimarães" ] 1 => array:2 [ "nombre" => "Miguel" "apellidos" => "Nobre Menezes" ] 2 => array:2 [ "nombre" => "Diogo" "apellidos" => "Cruz" ] 3 => array:2 [ "nombre" => "Sónia" "apellidos" => "do Vale" ] 4 => array:2 [ "nombre" => "Armando" "apellidos" => "Bordalo" ] 5 => array:2 [ "nombre" => "Arminda" "apellidos" => "Veiga" ] 6 => array:2 [ "nombre" => "Fausto J." "apellidos" => "Pinto" ] 7 => array:2 [ "nombre" => "Dulce" "apellidos" => "Brito" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S0870255117306571" "doi" => "10.1016/j.repc.2016.12.015" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255117306571?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204917303549?idApp=UINPBA00004E" "url" => "/21742049/0000003600000012/v1_201712220644/S2174204917303549/v1_201712220644/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>" "titulo" => "Always look at the sinus rhythm electrocardiogram in patients with ventricular tachycardia" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "961" "paginaFinal" => "964" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Gustavo Lima da Silva, Nuno Cortez-Dias, Irina Neves, Ana G. Almeida, João de Sousa" "autores" => array:5 [ 0 => array:4 [ "nombre" => "Gustavo" "apellidos" => "Lima da Silva" "email" => array:1 [ 0 => "gustavolssilva@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Nuno" "apellidos" => "Cortez-Dias" ] 2 => array:2 [ "nombre" => "Irina" "apellidos" => "Neves" ] 3 => array:2 [ "nombre" => "Ana G." "apellidos" => "Almeida" ] 4 => array:2 [ "nombre" => "João" "apellidos" => "de Sousa" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Serviço de Cardiologia, Hospital de Santa Maria, Centro Académico Médico de Lisboa, CCUL, Lisboa, Portugal" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Olhar sempre para o ECG em ritmo sinusal nos doentes com taquicardia ventricular" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 679 "Ancho" => 1500 "Tamanyo" => 86137 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Cardiac magnetic resonance steady-state free precession cine imaging in 4-chamber view (A) and short-axis view (B) showing a severely dilated thin-walled right ventricle (arrow).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A previously healthy 44-year-old male with unremarkable family history presented to the emergency department with fast palpitations. The electrocardiogram (ECG) revealed a wide QRS tachycardia, 190 bpm, with a left bundle branch block pattern and inferior axis, QS morphology in V1 and RS transition at V6, suggestive of ventricular tachycardia (VT) originating in the right ventricle (RV) (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>A). After synchronized electric cardioversion, the ECG (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>B) showed deep inverted T waves from V1 to V5 and small post-QRS positive inflections suggestive of epsilon waves in the right precordial leads, which raised suspicion of arrhythmogenic right ventricular cardiomyopathy (ARVC). Signal-averaged ECG demonstrated the presence of late potentials (<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>). Cardiac magnetic resonance revealed a severely dilated thin-walled right ventricle, with 7% ejection fraction and akinesia of the free wall (<a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a>; Supplementary Videos 1 and 2), confirming the diagnosis of ARVC. The patient underwent electrophysiology study with induction of several VTs of different morphology originating in the RV and hemodynamic collapse, requiring defibrillation (<a class="elsevierStyleCrossRef" href="#fig0020">Figure 4</a>). An implantable cardioverter-defibrillator was implanted and the patient was discharged on sotalol. At one year of follow-up he remains asymptomatic and has had no further arrhythmic events.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">The classic ECG is a critical diagnostic tool in cardiology. This case demonstrates the importance of the sinus rhythm ECG in the etiological diagnosis of VT.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0015" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-09-26" "fechaAceptado" => "2016-11-27" "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0035" class="elsevierStylePara elsevierViewall">The following are the supplementary material to this article:<elsevierMultimedia ident="upi0005"></elsevierMultimedia><elsevierMultimedia ident="upi0010"></elsevierMultimedia></p>" "etiqueta" => "Appendix A" "titulo" => "Supplementary material" "identificador" => "sec0015" ] ] ] ] "multimedia" => array:6 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1632 "Ancho" => 2500 "Tamanyo" => 316600 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) 12-lead electrocardiogram (ECG) showing a wide QRS tachycardia, 190 bpm, left bundle branch block pattern with inferior axis, QS morphology in V1 and RS transition at V6; (B) 12-lead ECG after synchronized electric cardioversion revealing epsilon waves (arrows) in the right precordial leads and inverted T waves from V1 to V5.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1194 "Ancho" => 1583 "Tamanyo" => 149886 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Signal-averaged electrocardiogram revealing the presence of late potentials (arrow), namely RMS40=9 μV and LAD40=56 ms. Normal values are presented in brackets. fQRS: filtered QRS duration; RMS<span class="elsevierStyleInf">40</span>: root-mean-square voltage of the terminal 40 ms of the QRS; LAD<span class="elsevierStyleInf">40</span>: low-amplitude (below 40 μV) signal duration.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 679 "Ancho" => 1500 "Tamanyo" => 86137 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Cardiac magnetic resonance steady-state free precession cine imaging in 4-chamber view (A) and short-axis view (B) showing a severely dilated thin-walled right ventricle (arrow).</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1295 "Ancho" => 2500 "Tamanyo" => 346192 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Electrophysiological study: (A) induction of ventricular tachycardia (VT) originating in the right ventricle and hemodynamic collapse; (B) defibrillation of the VT with 150-J biphasic shock (arrow) and post-shock sinus pause (arrowhead).</p>" ] ] 4 => array:7 [ "identificador" => "upi0005" "etiqueta" => "Video 1" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc1.mp4" "ficheroTamanyo" => 292791 "Video" => array:2 [ "flv" => array:5 [ "fichero" => "mmc1.flv" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] "mp4" => array:5 [ "fichero" => "mmc1.m4v" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Cardiac magnetic resonance steady-state free precession cine imaging in 4-chamber view showing a severely dilated thin-walled right ventricle.</p>" ] ] 5 => array:7 [ "identificador" => "upi0010" "etiqueta" => "Video 2" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc2.mp4" "ficheroTamanyo" => 301213 "Video" => array:2 [ "flv" => array:5 [ "fichero" => "mmc2.flv" "poster" => "mmc2.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] "mp4" => array:5 [ "fichero" => "mmc2.m4v" "poster" => "mmc2.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Cardiac magnetic resonance steady-state free precession cine imaging in short-axis view showing a severely dilated thin-walled right ventricle.</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/21742049/0000003600000012/v1_201712220644/S2174204917303859/v1_201712220644/en/main.assets" "Apartado" => array:4 [ "identificador" => "9915" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in cardiology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003600000012/v1_201712220644/S2174204917303859/v1_201712220644/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204917303859?idApp=UINPBA00004E" ]
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