NDLI: Coexisting normal sinus rhythm and atrial fibrillation 18 years after heart transplant.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Gupta, Raghav Latif, Faisal Dasari, Tarun W. Lozano, Pedro
Description	Country affiliation: United States Author Affiliation: Gupta R ( Department of Internal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA. raghav-gupta@ouhsc.edu)
Abstract	Atrial fibrillation is an important cardiogenic cause of embolic phenomenon to the brain leading to stroke and long-term disability. Recognition of atrial fibrillation is of cardinal importance in the workup of stroke and transient ischemic attack (to prevent future strokes) by the timely institution of anticoagulation therapy. We describe a patient with history of standard orthotopic heart transplant (st.OHT) who had no clinical or electrocardiographic signs of atrial fibrillation. He presented with a transient ischemic attack (TIA) and subsequently was found to have two distinct left atrial appendages (LAA) in two different rhythms based on transesophageal echocardiography (TEE) and pulse wave (PW) Doppler. The donor LAA was in normal sinus rhythm (NSR) and recipient LAA in atrial fibrillation (AF). This was an extremely rare but important diagnosis in our patient, which led to the institution of anticoagulation therapy rather than aspirin and dipyridamole as described in neurological literature. We discuss different types of heart transplant techniques and their causatum on postoperative atrial tachycardias. Significance of TEE in the scenario of TIA and follow-up in heart transplant patients is also canvassed.
File Format	HTM / HTML
ISSN	08860440
Issue Number	6
Volume Number	23
e-ISSN	15408191
Journal	Journal of Cardiac Surgery
Language	English
Publisher	Wiley
Publisher Date	2008-11-01
Publisher Place	United States
Access Restriction	Subscribed
Subject Keyword	Discipline Cardiology Discipline Surgery Anticoagulants Therapeutic Use Atrial Fibrillation Etiology Heart Transplantation Adverse Effects Ischemic Attack, Transient Aged Complications Drug Therapy Physiopathology Diagnosis, Differential Echocardiography, Doppler, Pulsed Echocardiography, Transesophageal Methods Humans Male Risk Factors Time Factors Case Reports Journal Article
Content Type	Text
Resource Type	Case study Article
Subject	Pulmonary and Respiratory Medicine Surgery Cardiology and Cardiovascular Medicine

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