Internal Medicine

0521779407-14 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:16

Mucormycosis Multifocal Atrial Tachycardia (MAT) 1007

follow-up

■Assess response to therapy

■May need prolonged treatment with antifungal agents

complications and prognosis

Complications

■May be cosmetically disfiguring, and major reconstructive surgery

is usually needed

Prognosis

■Depends to a large part on the prognosis of the underlying disease

(neoplasm, etc.)

■Overall mortality rate 50%

■Pulmonary disease may have worse outcome because of later diag-

nosis.

Prevention

■No cost-effective method known

➣Use of rooms with high-efficiency particulate air filters (HEPA) in

severely neutropenic patients (such as bone marrow transplant)

may have efficacy.

MULTIFOCAL ATRIAL TACHYCARDIA (MAT)

EDMUND C. KEUNG, MD

history & physical

History

■Most common in elderly patients with significant COPD.

Signs & Symptoms

■Palpitation with irregular rapid pulses. Predominant symptom: exac-

erbation of COPD with hypoxia

tests

■Basic Tests

➣12-lead ECG:

➣Narrow QRS tachycardia unless pre-existing conduction defect or

rate-related aberrant ventricular conduction. At least 3 different

P wave morphologies. P-P and P-R intervals highly variable. Atrial

rate 100–130 bpm. AV nodal block usually not present.

■Specific Diagnostic Test

➣none