Justin Tan - Academia.edu (original) (raw)

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Ori Rogowski

Sackler School of Medicine/American Program of Tel Aviv University School of Medicine

Sami Viskin

Sackler School of Medicine/American Program of Tel Aviv University School of Medicine

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Papers by Justin Tan

Research paper thumbnail of Exercise-Induced Polymorphic Ventricular Tachycardia in Adults Without Structural Heart Disease

The American Journal of Cardiology, 2008

Patients with catecholaminergic polymorphic ventricular tachycardia present at a young age with e... more Patients with catecholaminergic polymorphic ventricular tachycardia present at a young age with exercise-induced ventricular arrhythmias (VAs) and may have a positive family history. We describe 8 patients who presented with exercise-induced symptoms as adults, have a negative family history, and responded to ␤-blocker therapy. The study evaluated exercise treadmill electrocardiographic data from patients referred for exercise-induced VA. Inclusion criteria consisted of development of bidirectional, pleomorphic, or polymorphic ventricular tachycardia with exercise, adult age at first onset, negative family history, and no evidence of structural heart disease. We correlated VA configurations with respect to heart rate before and after ␤-blocker therapy. Patients displayed a pattern of increasing ventricular complexity with increasing heart rate. The appropriate ␤ blocker (n ‫؍‬ 7) or calcium channel blocker (n ‫؍‬ 1) was defined as the dose that resulted in control of symptoms. Three patients showed suppression of VA with sinus tachycardia at peak heart rate. Six patients had decreased VA defined as absence of higher complexity arrhythmias. With drug therapy, average heart rate associated with premature ventricular complex couplets/triplets increased, whereas duration and complexity of premature ventricular complexes decreased. One patient had an automatic implantable cardiac defibrillator placed but has had no discharges from the device since starting the appropriate ␤ blocker. In conclusion, these patients appear to respond well to ␤-blocker or calcium channel blocker therapy with decreased ectopic complexity and an increased heart rate threshold for inducing VA.

Research paper thumbnail of Fluoroscopy in a Cross-sectional World: The Esophagram

PURPOSE/AIM The esophagram remains a useful imaging tool despite the increased use of cross-secti... more PURPOSE/AIM The esophagram remains a useful imaging tool despite the increased use of cross-sectional imaging and endoscopy. It is inexpensive, fast, non-invasive and allows dynamic imaging and mucosal evaluation. This exhibit will review the anatomy of the esophagus, followed by cases of important pathology well demonstrated by esophagram. CONTENT ORGANIZATION 1. Normal anatomy as seen on esophagram 2. Normal impressions on the esophagus from adjacent structures including normal variants 3. Case review in quiz format including: esophageal cancers, achalasia, infectious esophagitis (HIV, candida, HSV), inflammatory esophagitis (reflux, ingestion, eosinophilic), esophageal perforation, strictures and diverticula. SUMMARY Anatomy will be presented in a didactic format. Cases will follow showing images accompanied by questions about diagnosis and management, whether it be clinical or further imaging. Upon completing the exhibit, the reader should have a solid understanding of the norma...

Research paper thumbnail of Exercise-Induced Polymorphic Ventricular Tachycardia in Adults Without Structural Heart Disease

The American Journal of Cardiology, 2008

Patients with catecholaminergic polymorphic ventricular tachycardia present at a young age with e... more Patients with catecholaminergic polymorphic ventricular tachycardia present at a young age with exercise-induced ventricular arrhythmias (VAs) and may have a positive family history. We describe 8 patients who presented with exercise-induced symptoms as adults, have a negative family history, and responded to ␤-blocker therapy. The study evaluated exercise treadmill electrocardiographic data from patients referred for exercise-induced VA. Inclusion criteria consisted of development of bidirectional, pleomorphic, or polymorphic ventricular tachycardia with exercise, adult age at first onset, negative family history, and no evidence of structural heart disease. We correlated VA configurations with respect to heart rate before and after ␤-blocker therapy. Patients displayed a pattern of increasing ventricular complexity with increasing heart rate. The appropriate ␤ blocker (n ‫؍‬ 7) or calcium channel blocker (n ‫؍‬ 1) was defined as the dose that resulted in control of symptoms. Three patients showed suppression of VA with sinus tachycardia at peak heart rate. Six patients had decreased VA defined as absence of higher complexity arrhythmias. With drug therapy, average heart rate associated with premature ventricular complex couplets/triplets increased, whereas duration and complexity of premature ventricular complexes decreased. One patient had an automatic implantable cardiac defibrillator placed but has had no discharges from the device since starting the appropriate ␤ blocker. In conclusion, these patients appear to respond well to ␤-blocker or calcium channel blocker therapy with decreased ectopic complexity and an increased heart rate threshold for inducing VA.

Research paper thumbnail of Fluoroscopy in a Cross-sectional World: The Esophagram

PURPOSE/AIM The esophagram remains a useful imaging tool despite the increased use of cross-secti... more PURPOSE/AIM The esophagram remains a useful imaging tool despite the increased use of cross-sectional imaging and endoscopy. It is inexpensive, fast, non-invasive and allows dynamic imaging and mucosal evaluation. This exhibit will review the anatomy of the esophagus, followed by cases of important pathology well demonstrated by esophagram. CONTENT ORGANIZATION 1. Normal anatomy as seen on esophagram 2. Normal impressions on the esophagus from adjacent structures including normal variants 3. Case review in quiz format including: esophageal cancers, achalasia, infectious esophagitis (HIV, candida, HSV), inflammatory esophagitis (reflux, ingestion, eosinophilic), esophageal perforation, strictures and diverticula. SUMMARY Anatomy will be presented in a didactic format. Cases will follow showing images accompanied by questions about diagnosis and management, whether it be clinical or further imaging. Upon completing the exhibit, the reader should have a solid understanding of the norma...

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