Our study would confirm that percutaneous PFO closure is a safe procedure, pointing out that early complications AZD6244 and those during follow-up are not uncommon and are mostly related to cardiac arrhythmias. We thank Dr. Andrea Smith for help with English version. “
“Chronic hyperventilation syndrome (CHVS, tetania and spasmophilia) represents a relatively common but poorly understood clinical entity. Approximately 10% of patients in a general internal medicine practice are reported to have CHVS. Chronic hyperventilation syndrome typically present with recurrent and different respiratory, neurological, cardiac or

dysphoric symptoms, however, the underlying pathophysiology has not been clearly elucidated so far [1]. Patients with CHVS usually undergo extensive and expensive investigations but in majority of them no organic causes are discovered. Chronic hyperventilation syndrome is thought to result from hypocapnia, hypocalcemia or alcalosis due to psychogenic hyperventilation but although CHVS and psychiatric disorders may overlap, only quarter of patients with hyperventilation syndrome manifest panic disorder. Different stressors such as emotional distress but also sodium lactate, caffeine, isoproterenol can provoke an exaggerated respiratory response. We hypothesized that various

endogenic trigger substances might enter the systemic circulation through cardiac or pulmonary right-to-left shunt (RLS) instead of being trapped in the pulmonary capillaries

and contribute with development selleck chemicals llc of CHVS. The aim of this single center study was to evaluate the incidence of RLS in patients with CHVS. Twenty-eight patients with previously diagnosed CHVS and 25 healthy subjects (control group, CG) were prospectively recruited to the study and admitted to Clinic of Neurology, Military Medical Institute, Warsaw, Poland. Chronic hyperventilation Adenosine syndrome was diagnosed basing on typical recurrent clinical symptoms (dizziness, numbness, paresthesias or near syncope), which could be reproduced by voluntary hyperventilation. The diagnosis was confirmed with presence of spontaneous electromyographic (EMG) activity with 2 or more multiplets during provocative ischemia and hyperventilation [2]. All patients with CHVS had undergone brain neuroimaging (MRI), EEG, carotid duplex ultrasonography and transcranial Doppler (TCD) ultrasonography to exclude organic causes of the symptoms before entering the study. Total and ionized calcium was within the normal reference range levels in all examined subjects. Patients were consulted with neuropsychologist and endocrinologist. Three patients in whom diagnosis of panic disorder (n = 1), agoraphobia (n = 1) or endocrine disturbance (n = 1) had been established were not included into the trial.