Ventricular fibrillation refractory to automatic internal cardiac defibrillator in Fabry's disease. Review of cardiovascular manifestations.
Fabry's disease is a disorder of glycosphingolipid metabolism leading to alpha-galactosidase deficiency with systemic sequelae. Clinical cardiac manifestations include dysrhythmias, structural abnormalities apparent on echocardiography, and histologic changes secondary to glycosphingolipid deposition. The introduction of automated internal cardiac defibrillators (AICD) has been shown to decrease the incidence of circulatory collapse in individuals with known terminal arrhythmias. We present a patient with Fabry's disease, who underwent coronary angiography without finding of obstructive disease. He returned after aborted sudden cardiac death necessitating the placement of an AICD. He again presented after an episode of ventricular fibrillation refractory to internal defibrillation necessitating advanced life support, and subsequently expired. We review the electrocardiographic, cardiovascular structural, and histologic manifestations of Fabry's disease.
Eckart
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Department of Cardiology and Pathology, Tripler Army Medical Center, Honolulu, HI 96859-5000, USA. robert_e.eckhart@tamc.chcs.amedd.army.mil
Kinney
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Belnap
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D017147:Defibrillators, Implantable; D004562:Electrocardiography / Q000379:methods*; D000795:Fabry Disease / Q000150:complications / Q000473:pathology / Q000628:therapy*; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008854:Microscopy, Electron / Q000379:methods; D008875:Middle Aged; D016610:Tissue Embedding / Q000379:methods; D014693:Ventricular Fibrillation / Q000150:complications / Q000628:therapy*