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Öğe Aberrant origin of the right ventricular coronary artery: A case report(2003) Uyan, Cihangir; Akdemir, Ramazan; Uyan, Ayten P.; Erbilen, EnverThis case describes a 45-year-old man with an abnormal origin of the right ventricular branch of the right coronary artery originating from a separate ostium in the right coronary sinus. Coronary arteries with abnormal origin constitute roughly 0.64% to 1.2% of all the representations encountered during coronary angiography. We suggest that the presence of such a vessel must be shown in patients undergoing coronary angiography and/or cardiac surgery.Öğe Aberrant right ventricular branch of right coronary artery with mitral valve prolapse(2004) Arınç, Hüseyin; Gündüz, Hüseyin; Tamer Ali; Özhan, Hakan; Akdemir, Ramazan; Özkökeli, Mehmet; Uyan, CihangirA 37-year-old man presented with a three-week history of chest pain. Transthoracic echocardiography demonstrated a mitral valve prolapse and mild mitral insufficiency. Coronary angiography showed normal left main, circumflex, left anterior descending and right coronary arteries; however, the right ventricular branch of the right coronary artery had a separate ostium. Concomitant congenital heart abnormaliries have been observed with coronary artery anomalies. Primary congenital coronary and valvular anomalies may have genetic heredity. In the present case, mitral valve prolapse was accompanied by a right ventricular coronary artery origin anomaly which, to the best of our knowledge, is the first report in the literature in which both anomalies presented together. © 2004 Pulsus Group Inc. All rights reserved.Öğe Aberrant right ventricular coronary artery: Case report(2003) Akdemir, Ramazan; Yazıcı, Mehmet; Tataroğlu, Cenk; Uyan, Cihangir; Gündüz, Hüseyin; Erbilen, EnverThis case describes a 50-year-old woman with the abnormal origin of a right ventricular branch of the right coronary artery originating from the same ostium in the right coronary sinus. Coronary artery anomalies, constitute roughly 0.64% to 1.2% of all the representations encountered during coronary angiography. We suggest that the presence of such a vessel must be shown in patients undergoing coronary angiography and/or cardiac surgery.Öğe Acute myocardial infarction secondary thrombosis associated with ovarial hyperstimulation syndrome(Elsevier Ireland Ltd, 2002) Akdemir, Ramazan; Uyan, Cihangir; Emiroğlu, YunusOvarian hyperstimulation syndrome (OHSS) is one of the most serious complication of controlled ovarian stimulation. Cerebral infarction. myocardial infarction, death and vascular thrombotic events associated with OHSS had been reported. We report a case of a patient with myocardial infarction associated with OHSS.Öğe Akut miyokard infarktüsü sonrası erken dönemdeki solunum fonksiyon testlerindeki değişiklikler(2003) Yazıcı, Mehmet; Durmuş, Bedri; Görgülü, Şevket; Akdemir, Ramazan; Erbilen, EnverAmaç: Bu çalışmada Akut Miyokard İnfarktüsü (AMI) sonrası erken dönemde (3-12.gün) solunum fonksiyon testlerindeki değişiklikler araştırılmıştır. Gereç ve Yöntem: Çalışmaya AMI'li 84 hasta (E/K: 70/14, yaş: 58±13) ve 81 sağlıklı birey (E/K: 62/19, yaş: 57±12) alındı. Spirometri ile solunum fonksiyon testi (SFT) yapılarak ZVK (zorlu vital kapasite), ZEV 1 (1 .saniyedeki zorlu ekspirasyon volümü), ZEV1/ZVK oranı ve ZEAH%25-75 (zorlu ekspirasyon ortası akım hızı) elde edildi (yaş ve cinse göre beklenen değerlerin %'si olarak). Bulgular: AMI grubunda kontrollere göre ZVK ve ZEV1 anlamlı olarak azalmıştı (ZVK; 75$\pm$24 ve 91$\pm$21, p<0.001, ZEV1; 81±29 ve 98±27, p<0.001). Fakat ZEV1/ZVK ve ZEAH%25-75 değerleri iki grupta benzerdi (p>0.05). AMI hastalar fizik muayenede inspiratuar raileri olan ve olmayanlar olarak iki gruba ayrıldığında, rali olanlarda FEV1 and FEV%25-75 anlamlı olarak düşüktü (FVC: 68$\pm$26 ve 80±21, p<0.03, FEV1:70±29 ve 89±25, p<0.04, FEF%25-75:75±46 ve 112$\pm$49, p<0.01). AMI lokalizasyonuna göre SFT sonuçları non-Q>inferior>anteroseptal>anterior olarak gittikçe azalan şekilde sıralandı. Fakat aradaki fark anlamlı değildi (p>0.05). Sonuç: FEV1/FVC ve FEF%25-75de azalma olmayıp FVC ve FEV1 de azalma olması AMI'li hastalarda solunum fonksiyonlarında restriktif tipte değişiklikler olduğunu göstermektedir. Ayrıca, buna sol kalp yetmezliğinin belirginleşmesiyle (staz rali varlığına göre) küçük hava yollarında obstruktif bir bozukluğunda (ZEAH o/o25.75 daki azalma) eklendiği söylenebilir.Öğe Angiotensin-converting enzyme, angiotensin II receptor, apolipoprotein E and endothelial constitutive nitric oxide synthase gene polymorphisms in dilated cardiomyopathy(2004) Özhan, Hakan; Zungur, Mustafa; Yazıcı, Mehmet; Akdemir, Ramazan; Gündüz, Hüseyin; Erbilen, Enver; Albayrak, Sinan; Uyan, CihangirAmaç: Dilate kardiyomiyopati (DCM) sol yada her iki ventrikülün sistolik fonksiyonlarının bozulması ve genişlemesi ile karakterize bir hastalıktır. Ailesel kökenli DCM'nin tanımlanmasından sonra ailesel olmayan DCM olguları için de genetik faktörlerin rol oynayabileceği düşünülmüş ve konuyla ilgili araştırmalar yapılmıştır. Makalemizde ülkemizde yaşayan DCM'li olgularda, hastalığın patofizyolojisinde rol oynaması muhtemel dört aday genin polimorfizmleri araştırılmıştır (Angiotensin dönüştürücü enzim (ACE) I/D polimorfizmi, angiotensin II reseptör (AGTR1) 1166 A/C polimorfizmi, apolipoprotein E (APOE) ve endotelyal konstitütif nitrik oksit sentaz (ecNOS) geni polimorfizmi). Ortalama yaşı 58±12 olan ardışık 76 hasta ve yaş ortalaması 59±12 olan 88 kontrol grubu çalışmaya alındı. Bütün hastalara ve kontrol grubuna ekokardiyografik çalışma yapıldı. DCM tanısı için ekokardiyografik olarak end-diastolik çapın >55mm ve ejeksiyon fraksiyonunun <%40 altında olması kriter alındı. Yine hasta grubuna koroner anjiografi yapılarak hastalar iskemik ve idyopatik DCM gruplarına ayrıldı. Spesifik kalp kası hastalığı, izole sağ ventrikül genişlemesi, kapak ve perikard hastalığı olanlar çalışma dışında tutuldu. Hasta ve kontrol grubunun kan hücrelerinden deoxiribonükleik asit (DNA) spesifik polimeraz zincir reaksiyonu (PCR) yöntemi ile genetik analiz yapıldı. Gen distribüsyonu ki kare testi ile değerlendirildi. Bağımsız risk için multivariate regresyon analizi uygulandı. 0,05 altındaki p değerleri istatistiksel olarak anlamlı kabul edildi. Sonuçlar: Hasta ve kontrol grubunun allel sıklıkları, ekokardiyografi, biyokimya analizi sonuçları ve demografik verileri karşılaştırıldı. APO E gen allel sıklığına ait dağılım her iki grupta farklılık gösterse de regresyon analizi sonuçlarına göre bu farklılığın bağımsız bir risk oluşturmadığı gözlendi.Öğe Aort darlığında plazma homosistein yüksekliği koroner arter hastalığı varlığını gösterebilir mi?(2003) Gündüz, Hüseyin; Akdemir, Ramazan; Tamer, Ali; Binak, Emrah; Ayarcan, YaseminAmaç: Kalsifik aort kapak hastalığı tespit edilen hastalardaki kardiyak risk faktörleri koroner arter hastalığı (KAH) ile benzer olup, koroner arter hastalığı prevalansı artmıştır. Son zamanlarda yapılan çalışmalarda; artmış plazma homosistein konsantrasyonunun koroner arter hastalığı için bağımsız bir risk faktörü olduğu, çeşitli mekanizmalarla ateroskleroza yol açarak aterosklerotik damar hastalıklarını ve venöz sistemde trombüs oluşumunu kolaylaştırıcı etki gösterdiği tespit edilmiştir. Fakat aort darlığı olan hastalarda plazma homosistein düzeyinin koroner arter hastalığı varlığı ile ilişkisi araştırılmamıştır. Bu çalışmanın amaçları; orta-ileri aort darlığı olan hastalarda plazma homosistein düzeyininin koroner arter hastalığı varlığını ne şekilde etkilediğini araştırmak ve aort darlığında homosistein düzeyi, koroner arter hastalığı varlığının noninvaziv bir belirleyicisi olabilir mi sorusuna cevap aramaktır. Gereç ve Yöntem: Çalışmaya transtorasik ekokardiyografi ile orta-ileri derecede aort darlığı tespit edilen ve sonrasında koroner anjiyografi yapılan toplam 58 hasta (koroner arter hastalığı olan 30, koroner arter hastalığı olmayan 28 hasta) alındı. Hastaların 12 saatlik açlık sonrası venöz kan örnekleri alınarak serum total kolesterol, LDL ve HDL kolesterol, trigliserid ve ELİSA yöntemiyle homosistein düzeyleri ölçüldü. Bulgular: Koroner arter hastalığı olan hastalarda (17 erkek,13 kadın, ortalama yaş 66±10 yıl) total kolesterol 266±45 mg/dL, trigliserid 194±93 mg/dL, LDL mg/dL 174±44, HDL 45±5 mg/dL, Homosistein düzeyi 13.2±3.1 µmol/l bulundu. Koroner arter hastalığı olmayan hastalarda ise (18 erkek,10 kadın, ortalama yaş 61±12 yıl) total kolesterol 204±38 mg/dL trigliserid 122±73 mg/dL, LDL 132±33 mg/dL, HDL 48±5 mg/dL, homosistein düzeyi 8.3±2.2 µmol/l bulundu. Koroner arter hastalığı olan hastalarda total kolesterol (p<0.01), LDL (p<0.05) ve homosistein düzeyi (p<0.01) anlamlı olarak yüksek bulundu. Sonuç: Bu sonuçlar orta-ileri aort darlığı olan hastalarda plazma homosistein düzeyindeki yüksekliğin koroner arter hastalığı varlığı ile korele olduğunu göstermektedir. Ayrıca aort darlığında koroner arter hastalığı varlığını gösteren bir noninvaziv test olarak araştırılması gerektiğini düşündürtmektedir.Öğe Asymptomatic giant left atrial myxoma supplied from right coronary artery in a 65-year-old woman(Elsevier Ireland Ltd, 2005) Yazıcı, Mehmet; Norgaz, Tuğrul; Akdemir, Ramazan; Albayrak, SinanPrimary cardiac tumors are rare and approximately 50% of them are atrial myxomas [1,2]. Myxomas rarely remain asymptomatic, especially if they are large. On the other hand, visualization of a myxoma by contrast dye during coronary angiography is an infrequent sign, which clarifies the vascular supply of the tumor. The present study reports a case of an asymptomatic giant left atrial myxoma, which was opacified by contrast dye on right coronary angiography.Öğe Atrial fibrillation after electrical shock: a case report and review(B M J Publishing Group, 2004) Akdemir, Ramazan; Gündüz, Hüseyin; Erbilen, Enver; Özer, İlker; Albayrak, Sinan; Ünlü, Hakan; Uyan, CihangirA 52 year old man was admitted to an emergency department with a fast ventricular rate atrial fibrillation after an electrical shock. Electrical cardioversion was attempted after echocardiographic examination. This failed, but the heart rate slowed. Successful pharmacological cardioversion was achieved after 16 hours of amiodarone infusion. Preexcitation syndrome was detected on baseline echocardiograph. Serum cardiac specific markers were all within normal limits. No abnormal findings were detected by chest radiography, echocardiographic, or coronary angiographic investigations. Acute onset atrial fibrillation after electrical injury is discussed.Öğe Can serum lipid and CRP levels predict the "severity" of aortic valve stenosis?(Taylor & Francis Ltd, 2003) Gündüz, Hüseyin; Akdemir, Ramazan; Binak, Emrah; Tamer, Ali; Keser, Nurgül; Uyan, CihangirBackground - Results of the studies performed have suggested that hypercholesterolaemia and inflammation are important aetiologic factors in aortic valve stenosis (AVS). However up to now no such data has been obtained to evaluate whether these predictors may still serve as valuable tools to estimate the progression and severity of AVS. If factors contributing to the "progression" of degenerative process can be understood and preventive measures can be taken, both clinical and economical beneficial effects can be achieved. The objective of this study is to investigate the correlation of serum cholesterol, triglyceride and CRP levels with the severity of aortic stenosis echocardiographically evaluated in patients with aortic valve stenosis. Material and methods -Aortic valvular areas of 60 patients (pts) hospitalized in our clinic with suspected AVS were calculated with Doppler echocardiography. Patients were grouped into mild, moderate and advanced AVS, each category containing 20 pts, and then were subclassified regarding those with and without coronary artery disease(CAD). Results -Total cholesterol and CRP levels were found to be 215 +/- 42 mg/dl and 2.0 +/- 1.4 mg/dl; 224 +/- 43 mg/dl and 2.4 +/- 2.1 mg/dl; 225 +/- 55 mg/dl and 2.7 +/- 2.1 mg/dl in pts with mild, moderate and advanced AVS, respectively. A statistically significant difference was not detected among the three groups (p>0.05). When subclasses were classified the levels were found to be much more increased in those patients having additional CAD. Conclusion - We have demonstrated that severity of AVS does not correlate significantly with hypercholesterolaemia and CRP and their levels do not rise in accordance with increasing severity of AVS. Elevations of lipid levels in AVS were found to correlate with the presence of CAD rather than the severity of AVS. So, not in patients with simply AVS but in patients under higher cardiovascular risks, investigation of CRP plus lipid levels might provide benefit with respect to preventive treatment and benefit from cholesterol-lowering drugs can be expected in such kind of patients.Öğe Cardiac emergencies caused by honey ingestion: a single centre experience(B M J Publishing Group, 2004) Özhan, Hakan; Akdemir, Ramazan; Yazıcı, Mehmet; Gündüz, Hüseyin; Duran, Sadık; Uyan, CihangirAn unusual type of food poisoning is commonly seen in the Black Sea coast of Turkey attributable to andromedotoxin containing toxic honey ingestion. This study is a retrospective case series of 19 patients admitted to an emergency department in 2002, poisoned by "mad'' honey. All of the patients had the complaints of nausea, vomiting, sweating, dizziness, and weakness, several hours after ingesting "mad'' honey. Physical examination showed hypotension in 15 patients, sinus bradycardia in 15, and complete atrioventricular block (AVB) in four patients on admission. Two patients with bradycardia and two with AVB fell and injured their heads. Three of them presented with local haematoma. One patient had a 6 cm cut on his head without any neurological deficit and his cranial computed tomography imaging was normal. Hypotension and conduction disorders resolved with atropine treatment, resulting in complete recovery within 24 hours.Öğe A case of coronary artery fistula with mitral stenosis(Kluwer Academic Publ, 2003) Gündüz, Hüseyin; Akdemir, Ramazan; Binak, Emrah; Ayarcan, Yasemin; Kurtoğlu, Nuri; Uyan, CihangirCoronary artery fistulae, being a rare form of congenital anomalies of the coronary arteries, are usually discovered by chance during coronary arteriography. However, these fistulae can cause an important coronary morbidity and mortality leading to angina, syncope, congestive heart failure, myocardial infarction and sudden death. The coincidence of mitral stenosis and congenital artery fistula is rare in the literature. In our case report, a patient with a coronary artery fistula originating from the circumflex, draining to the main pulmonary artery, discovered at cardiac catheterization and coronary angiography done with a prediagnosis of mitral stenosis is presented in the light of the literature.Öğe A case of hypothyroidism mimicking acute coronary syndrome(2006) Gündüz, Hüseyin; Arınç, Hüseyin; Yolcu, Mustafa; Akdemir, Ramazan; Kanat, Mustafa; Uyan, CihangirHypothyroid patients have increased concentrations of creatinine kinase that is mostly due to increased CK-MM. However, CK-MB has also been reported to increase above reference values in hypothyroid patients without apparent myocardial damage. This may create confusion during the evaluation of myocardial injury in a hypothyroid patient presenting with chest pain. Troponin I is considered as a superior marker for the diagnosis of myocardial infarction in hypothyroid patients. However, there are some reports showing an increase in the level of troponin I without any myocardial damage in hypothyroid patients as in our case. In this report, we present a 47 years old male hypothyroid patient who had chest pain, abnormal electrocardiographic findings and increased cardiac enzymes suggesting acute coronary syndrome although he had normal coronary arteriogram. © Springer 2005.Öğe A case of myocardial infarction with sumatriptan use(Springer, 2005) Erbilen, Enver; Özhan, Hakan; Akdemir, Ramazan; Yazıcı, MehmetSumatriptan is widely used in the treatment of acute attacks of cluster headache. It is a serotonin-1 (5HT-1) agonist. Several studies have reported an association between sumatriptan use and myocardial infarction, possibly due to the generalized vasoconstrictive nature of this agent. We report a 16-year-old male patient presenting with acute inferior myocardial infarction after sumatriptan use without any known risk factors of coronary artery disease.Öğe A closed interatrial septal aneurysm mimicking a tumor in the left atrium(Texas Heart Inst, 2006) Akdemir, Ramazan; Duran, Sadık; Bulur, Serkan; Kaya, Ahmet; Sözen, Serhat Bahadır; Bilir, Cemil; Arınç, HüseyinA56-year-old woman presented with a congenital atrial septal aneurysm (ASA) that was found incidentally on routine echocardiographic evaluation. The echocardiographic images mimicked a left atrial tumor. She had hypertension, and she had been taking amlodipine for 5 years. There was no audible murmur. The chest radiograph and electrocardiogram were normal. Two-dimensional echocardiography showed rheumatic valvular disease and a mobile mass in the left atrium that resembled a cyst or cor triatriatum sinister. Further evaluation by other echocardiographic views confirmed the ASA.Öğe Color M-mode regurgitant flow propagation velocity: A new echocardiographic method for grading of mitral regurgitation(2004) Akdemir, Ramazan; Özhan, Hakan; Gündüz, Hüseyin; Yazıcı, Mehmet; Erbilen, Enver; Albayrak, Sinan; Ünlü, Hakan; Bulur, Serkan; Uyan, Cihangir; Arınç, HüseyinThe aim of this study was to evaluate the reliability of mitral regurgitation color M-mode regurgitant flow propagation velocity (RFPV) in grading mitral regurgitation (MR). This new transthoracic Doppler echocardiographic technique is easier and equally or more practical than qualitative and quantitative methods used to grade MR in patients both with normal and low left ventricular ejection fraction (LVEF). Color M-mode echocardiography allows resolution of regurgitant flow propagation along the echocardiography beam inside the left atrium. The characteristics of the velocity of this jet have not been studied in detail before. The present study compares the different qualitative and quantitative methods of MR grading with the RFPV. We prospectively examined 52 consecutive patients with grades of MR mild in 10 patients, moderate in 19 patients and severe in 23 patients with quantitative pulse Doppler echocardiography. MR was evaluated by vena contracta diameter (VCD), regurgitant jet area (RJA) and RFPV. These qualitative and quantitative methods were compared with the pulsed Doppler quantitative flow measurements and concordance of these 3 methods was determined. The mean RFPV for mild, moderate and severe MR were 26.4±7 cm/s, 43.3±7 cm/s and 60.3±7.3, respectively (p<0.001). RFPV is highly sensitive and moderately specific in differentiating mild and severe MR from other subgroups. Sensitivity and specificity were 92.1-64.3% for mild and 100-68.5% for severe MR, respectively. Significant correlation was observed between pulse Doppler quantitative grades, RFPV, VC and RJA (p<0.0001, r=.87; p<0.0001, r=-.84; p<0.0001, r=.76, respectively). This results show that RFPV is a reliable and simple semi-quantitative new method that can be used for determining severity of MR.Öğe Color m-mode regurgitant flow propagation velocity: a new echocardiographic method for grading of mitral regurgitation(Blackwell Publishing, 2005) Akdemir, Ramazan; Özhan, Hakan; Bulur, Serkan; Ünlü, Hakan; Gündüz, Hüseyin; Arınç, Hüseyin; Uyan, CihangirPurpose: The aim of this study was to evaluate the reliability of mitral regurgitation color M-mode regurgitant flow propagation velocity (RFPV) in grading mitral regurgitation (MR). Methods: We prospectively examined 52 consecutive patients with grades of MR mild in 10 patients, moderate in 19 patients, and severe in 23 patients with quantitative pulse Doppler echocardiography. MR was evaluated by vena contracta diameter (VCD), regurgitant jet area (RJA), and RFPV. These qualitative and quantitative methods were compared with the pulsed Doppler quantitative flow measurements and concordance of these three methods was determined. Results: The mean RFPV for mild, moderate, and severe MR were 26.4 +/- 7 cm/sec, 43.3 +/- 7 cm/sec, and 60.3 +/- 7.3 respectively (P < 0.001). RFPV is highly sensitive and moderately specific in differentiating mild and severe MR from other subgroups. Sensitivity and specificity were 92.1%-64.3% for mild and 100%-68.5% for severe MR, respectively. Significant correlation was observed between pulse Doppler quantitative grades, RFPV, VC, and RJA (P < 0.0001, r = 0.87; P < 0.0001, r = -0.84, P < 0.0001, r = 0.76, respectively). Conclusion: This results show that RFPV is a reliable and simple semiquantitative new method that can be used for determining severity of MR.Öğe Color M-mode regurgitant flow propagation velocity: A new echocardiographic method for grading of mitral regurgitation(2004) Akdemir, Ramazan; Özhan, Hakan; Gündüz, Hüseyin; Yazici, Mehmet; Erbilen, Enver; Albayrak, Sinan; Ünlü, HakanThe aim of this study was to evaluate the reliability of mitral regurgitation color M-mode regurgitant flow propagation velocity (RFPV) in grading mitral regurgitation (MR). This new transthoracic Doppler echocardiographic technique is easier and equally or more practical than qualitative and quantitative methods used to grade MR in patients both with normal and low left ventricular ejection fraction (LVEF). Color M-mode echocardiography allows resolution of regurgitant flow propagation along the echocardiography beam inside the left atrium. The characteristics of the velocity of this jet have not been studied in detail before. The present study compares the different qualitative and quantitative methods of MR grading with the RFPV. We prospectively examined 52 consecutive patients with grades of MR mild in 10 patients, moderate in 19 patients and severe in 23 patients with quantitative pulse Doppler echocardiography. MR was evaluated by vena contracta diameter (VCD), regurgitant jet area (RJA) and RFPV. These qualitative and quantitative methods were compared with the pulsed Doppler quantitative flow measurements and concordance of these 3 methods was determined. The mean RFPV for mild, moderate and severe MR were 26.4±7 cm/s, 43.3±7 cm/s and 60.3±7.3, respectively (p<0.001). RFPV is highly sensitive and moderately specific in differentiating mild and severe MR from other subgroups. Sensitivity and specificity were 92.1-64.3% for mild and 100-68.5% for severe MR, respectively. Significant correlation was observed between pulse Doppler quantitative grades, RFPV, VC and RJA (p<0.0001, r=.87; p<0.0001, r=-.84; p<0.0001, r=.76, respectively). This results show that RFPV is a reliable and simple semi-quantitative new method that can be used for determining severity of MR.Öğe Complete atrioventricular block in Becker muscular dystrophy(2004) Akdemir, Ramazan; Özhan, Hakan; Gündüz, Hüseyin; Yazıcı, Mehmet; Erbilen, , Enver; Uyan, Cihangir; İmirzalıoğlu, NecatÖğe Complete atrioventricular block in becker muscular dystrophy: A case report(2003) Akdemir, Ramazan; Uyan, Cihangir; İmirzalıoğlu, Necat; Yazıcı, MehmetBecker Musküler Distrofi'de; dilate kardiyomiyopati, hafif-orta derecede mitral yetersizliği, kardiyak ritim ve ileti bozukluklarını içeren kardiyak tutulum, hastalığın seyri sırasında en önde gelen problemlerdendir (1,2). Ancak, Becker Musküler Distrofi ile ilişkili, kalıcı kalp pili takılmasını gerektiren atrioventriküler tam blok oldukça nadir bir komplikasyondur. Bu yanda, daha önceden Becker Musküler Distrofi tanısıyla izlenmekte olan bir hastada saptanan dilate kardiyomiyopati ve atrioventrikiiler tam blok olgusu tartışılmaktadır.
