bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lithium causing a serious sinus‐node dysfunction at therapeutic doses
Authors: Montalescot G. , Levy Y. , Farge D. , Brochard L. , Fantin B. , Arnoux C. , Hatt P. Y. 
Published: February 2009

AbstractThe cardiovascular effects of lithium have been indexed in literature since 1900, most frequently in cases of intoxication. We recently studied the exceptional case of a patient showing a serious sinus node dysfunction during lithium treatment. The serum lithium levels were always within the therapeutic range. After two endocardial explorations and withdrawal of lithium, we found that the sinus node dysfunction was due to lithium and reversible after withdrawal of it. Some ignored dysfunctions could exist with a regularly controlled treatment.
Staphylococcal abscess complicating endocardial aneurysmectomy
Authors: Schneiderman H. , Bloom K. , Shima M. , Ezri M. , Goldin M. 
Published: February 2009

AbstractSubendocardial left ventricular aneurysmectomy relieved previously intractable ventricular tachycardia in a 68‐year‐old man with severe coronary artery disease. Staphylococcal septicemia developed postopera‐tively; an infected venoclysis site may have provided the portal of entry. Autopsy confirmed staphylococcal abscess at the epicardial aspect of the ventriculotomy, constituting the first reported case, to our knowledge, of this complication following endocardial surgery.
The efficacy and safety of high‐dose verapamil and diltiazem in the long‐term treatment of stable exertional angina
Authors: Weiner D. A. , Mccabe C. H. , Cutler S. S. , Ryan T. J. , Klein M. D. 
Published: February 2009

AbstractThe efficacy and safety of high‐dose verapamil (480 mg/day) and diltiazem therapy (360 mg/day) were compared in separate cohorts of 26 and 20 patients, respectively. All patients had stable exertional angina and underwent an initial 6‐week double‐blind, placebo‐controlled, randomized phase followed by a 12‐month open‐label period. Angina attacks were reduced by verapamil (6.3±7.5 to 2.5±4.1 attacks per week, p<0.001) and by diltiazem (9.2±7.5 to 3.0±3.1 attacks per week, p<0.001), while treadmill time increased with both verapamil (372±132 to 444±108 s, p<0.001) and diltiazem (412± 175 to 536± 164 s, p<0.001) during the short‐term study. Both agents continued to show similar salu‐tory effects at the end of one year. The beneficial effects of both drugs appeared to be related in part to a reduction of the rate‐pressure product during submaximal exercise (12% by verapamil, 7% by diltiazem, both p<0.05). Adverse effects were few and consisted primarily of mild constipation in six patients taking verapamil, and pedal edema and transient flushing in 2 patients each using diltiazem. Thus, high‐dose verapamil and diltiazem have similar beneficial effects and are safe for the long‐term treatment of effort‐related angina pectoris.
Impact of thallium‐201 imaging on clinical assessment and management of patients with chest pain
Authors: Schmoliner R. , Dudczak R. , Kronic G. , Mösslacher H. , Zangeneh M. , Pollak C. , Schurz B. , Schoberwalter A. 
Published: February 2009

AbstractThe histories, rest, and exercise ECG results of 60 patients without myocardial infarction complaining of chest pain were submitted to 6 physicians (3 cardiologists and 3 noncardiologists) who were unaware of the angiographic findings. The physicians were requested to estimate the probability of coronary artery disease present in percentages and to assess the need for coronary angiography on a five‐point scale (1 = definitely not indicated, 5 = definitely indicated). After obtaining the results of thallium‐201 imaging following dipyridamole (0.50 mg/kg intravenously) administration, the physicians were again requested to estimate probability and need for angiography. In the 43 patients with coronary artery disease the judgment of probability was increased significantly after 201T1 from 75.6±20.2% to 82.9±23.2% (p<0.001) and the need for angiography from 4.3±0.9% to 4.5 ±0.9% (p<0.001). In the subgroup of patients with atypical angina the relative change in probability was higher than in other subgroups of patients with coronary artery disease. In the 17 patients with normal coronary arteries the probability estimation fell after 201Tl from 36.7±22.0% to 24.8±21.0% (p<0.001), the need for angiography was decreased from 2.7 ±1.1 % to 2.2± 1.2% (p<0.001). With the 201T1 information, cardiologists performed a better diagnostic differentiation of patients with and without coronary artery disease than noncardiologists. The study demonstrates the improvement of clinical diagnosis in patients with chest pain by thallium‐201 imaging and confirms the favorable influence of the method on the management of the patients in terms of indications for coronary angiography.
Tuberculous pericarditis in transkei
Authors: Strang J. I. G. 
Published: February 2009

AbstractIn the Transkei it was so frequently found that it was referred to as the “Transkei Heart.” The prognosis in tuberculous pericarditis is invariably bad and death may take place within one or two years but more often within a few months.Michael GelfandThe Sick African, Third Edition, 1957
Hemoptysis following mustard repair: A late complication
Authors: Sapire D. W. , Casta A. , Hayden K. , Swischuk L. E. 
Published: February 2009

AbstractHemoptysis was the presenting symptom in a 4‐year, 11‐month‐old male who had had a Mustard operation for hemodynamic correction of transposition of the great vessels at the age of five months. Chest roent‐genography demonstrated hyperlucency of the left lung and tomography showed compression and narrowing of left main stem bronchus. Angiography documented the absence of antegrade flow in the left pulmonary artery and no pulmonary venous drainage on the left. The left lung was supplied by bronchial collateral arteries which drained by retrograde filling of the left pulmonary artery. It is surmised that pulmonary venous drainage on the left was compromised at surgery and that the dilated main pulmonary artery compressed the left main stem bronchus. This combination promoted bronchial collateral ingrowth. Hemoptysis is a complication of enlargement of bronchial collateral vessels.
Two‐dimensional and M‐mode echocardiographic evaluation of fetal arrhythmia
Authors: Crowley D. C. , Dick M. , Rosenthal A. , Rayburn W. F. 
Published: February 2009

AbstractCardiac anatomy and rhythm were evaluated in the fetuses of 18 pregnant women (between 20 and 42 weeks of gestation) referred because of abnormal fetal heart rate or rhythm. Utilizing a 3 MHz two‐dimensional scan head with M‐mode capability, M‐mode recordings were obtained at paper speeds of 50 and 100 mm/s from 16 fetuses. The arrhythmia of two fetuses was diagnosed using two‐dimensional echo alone. Semilunar and atrioventricular valve opening and closing points, A waves, plus ventricular wall motion were used for timing purposes; and heart rate and rhythm were determined. Diagnoses made were atrial premature beats n=3, ventricular premature beats n=3, congenital heart block n=4, supraventricular tachycardia n=3, sinus bradycardia n=1, and blocked atrial beats n=1. In three fetuses no arrhythmia was identified. Cardiac anatomy was normal in 16 fetuses, with two (congenital heart block) felt to have univentricular hearts. Fourteen pregnancies went to term, two were delivered prematurely, and two fetuses with congenital heart block were stillborn. In three fetuses arrhythmia was confirmed during labor by fetal scalp electrode. Anhythmia was absent after birth in 11 of 16 infants, with congenital heart block persistent in two infants, and supraventricular tachycardia, atrial premature beats, and blocked atrial premature beats remaining in one each. Intervention with medical management was attempted in four pregnancies, with successful termination of arrhythmia (supraventricular tachycardia) in two fetuses. We conclude that combined two‐dimensional M‐mode capability is useful in the diagnosis of fetal rhythm distrubances, and perhaps in the selection of timing, and mode of intervention.
The apical impulse in coronary heart disease
Authors: Ranganathan N. , Juma Z. , Sivaciyan V. 
Published: February 2009

AbstractForty patients (36 with coronary artery disease), who had angiographic assessment of left ventricular function were studied using apexcardiography with a new method of standardization, the objective being to define the parameters of the apical impulse which reflect changes in the left ventricular function and correlate them with clinical assessment of the apical impulse. Based on measurements from patients with normal left ventricular function, abnormalities in apexcardiograms were identified. An increase in amplitude of percent A wave alone (greater than 13.3%) (palpable as an atrial kick in approximately half of these patients) was not associated with significant left ventricular dysfunction. An isolated abnormality in isovolumic slopes, although associated with mild left ventricular dysfunction, could not be detected clinically. Moderate to severe left ventricular dysfunction was always associated with abnormal ejection phase slopes and all had sustained apical impulses. The additional presence of a palpable atrial kick or an increased percent A wave on the apexcardiogram was more indicative of moderate rather than severe dysfunction. Thus this study clearly establishes that left ventricular function does in fact affect the nature of the apical impulse in patients with coronary artery disease and these can be easily defined.
The lowering of daytime blood pressures with a single daily dose of acebutolol in ambulant hypertensives
Authors: Mehta S. K. , Goldberg A. D. , Walsh J. T. 
Published: February 2009

AbstractIntra‐arterial blood pressure recordings were studied in 10 ambulant subjects with essential hypertension to evaluate the effect of a single daily dose of acebutolol. Blood pressures and heart rates, measured on a beat‐to‐beat basis were averaged over every hour, for the daytime, night‐time, and for the total 24 hours. Acebutolol significantly lowered the average daytime systolic pressure (160 to 142 mmHg, p = <0.01), diastolic pressure (78 to 66 dg, p = <0.01), and the heart rate (92 to 77 beats/min, p = <0.001). Significantly lower pressures were demonstrated up to 11 hours after the last dose of acebutolol. The effect on heart rate lasted up to 13 hours. The observed lowering of pressures and heart rate during the remaining 11 hours did not reach statistical significance.
Significance of the Q wave in acute myocardial infarction
Authors: Goldberg R. K. , Fenster P. E. 
Published: February 2009

AbstractAcute myocardial infarction may be associated with the development of Q waves on the electrocardiogram (ECG), or with changes limited to the ST segment or T wave. The ECG changes do not accurately differentiate transmural from nontransmural infarction. However, the presence or absence of a Q wave does correlate with some aspects of the clinical course of patients after myocardial infarction, and is therefore of prognostic value. Q‐wave infarctions are more likely to be complicated by congestive heart failure during hospitalization. The in‐hospital mortality is also higher after a Q‐wave infarction than after a non‐Q infarction. Both of these findings are probably due to the association of a Q wave with a larger mass of infarcted myocardium. The long‐term mortality, however, is the same for Q‐wave and non‐Q‐wave infarctions. This is probably due to an increased late mortality after non‐Q infarctions, related in part to a higher rate of reinfarction. The differences between Q‐wave and non‐Q‐wave infarctions are not due to obvious differences in extent and location of coronary artery obstructions. However, there may be differences in the collateral circulation, with more extensive collaterals associated with non‐Q infarcts. Appreciation of the prognostic significance of the ECG changes in acute myocardial infarction may help direct the evaluation and management of the patient after myocardial infarction.
Exacerbation of ventricular tachycardia by tocainide
Authors: Cheesman M. , Ward D. E. 
Published: February 2009

AbstractExacerbation of ventricular arrhythmias by antiarrhythmic drugs the lignocaine‐type has not been reported previously. In this paper we describe three patients with a variety of ventricular arrhythmias who were treated with tocainide and developed worsening of the ventricular arrhythmias. In one patient, frequent ventricular ectopic beats were converted to sustained ventricular tachycardia (VT) in another, nonsustained VT was converted to sustained VT, and in a third, monomorphic VT was converted to multimorphic VT. These patients illustrate the need for careful supervision of antiarrhythmic therapy for VT, even when lignocaine‐like drugs are being used.
Idiopathic coronary artery dissection: A rare in vivo diagnosis
Authors: Ramamurti S. , Mahrer P. R. , Magnusson P. , Bowyer J. V. , Sasse L. , Shaperman M. 
Published: February 2009

AbstractA 42‐year‐old white female, who had an acute myocardial infarction, developed post‐infarction angina and underwent coronary angiography seven weeks after the event. Coronary angiogram demonstrated a primary dissection of the left anterior descending artery. To our knowledge this is the sixth such report of a patient with primary dissection of a coronary artery demonstrated by angiogrdphy and the fourth such patient reported to achieve and maintain asymptomatic status without operative intervention.
Coronary artery atherosclerosis observed in men over 14 consecutive years
Authors: Murphy M. L. , De SOYZA N. , Doherty J. E. , Baker B. J. , Bissett J. K. , Watson J. W. 
Published: February 2009

AbstractThe incidence of cardiovascular death and myocardial infarction associated with ischemic heart disease has declined over the past 15 years. Whether this is associated with a decrease in the severity of coronary atherosclerosis is unknown. The extent of coronary atherosclerosis in men was determined by postmortem coronary angiography in 505 patients over an observation period of 14 years. Patients were divided into those with ischemic heart disease (42%) and those without (58%). Mean coronary scores showed no significant trends over the 14‐year period in those without ischemic heart disease and for the last 10 years in those with ischemic heart disease. In those few patients evaluated early in the study with ischemic heart disease, a significantly lower coronary score was found compared to subsequent years. This study was performed during an era of declining cardiovas cular death rates and a declining incidence of myocardial infarction, and suggests that this decline may relate to favorable changes in pathogenesis rather than to a decrease in extent of coronary atherosclerosis.
Treatment of perinfarction recurrent ventricular fibrillation by percutaneous pharmacological block of left stellate ganglion
Authors: Biagini A. , Severi S. , Contini C. , L'abbate A. , Sabino F. , Marraccini P. , Paladini G. 
Published: February 2009

AbstractA patient suffering from an acute myocardial infarction presented on the seventh and eighth days of hospitalization recurrent episodes of ventricular fibrillation refractory to antiarrhythmic treatment. The life‐threatening ventricular fibrillation was suppressed by percutaneous pharmacological block of the left stellate ganglion.
Iatrogenic left main coronary artery stenosis following PTCA or valve replacement
Authors: Bashour T. T. , Hanna E. S. , Edgett J. , Geiger J. 
Published: February 2009

AbstractWe report three patients who developed iatrogenic severe left main coronary artery stenosis. In two, it was secondary to coronary cannulation during aortic valve replacement and in one it followed distention of the artery during balloon dilatation of a proximal lesion in the left anterior descending artery. In all three, the stenosis was clinically manifest a few months after the intervention. All were successfully treated by aortosaphenous coronary bypass. A common mechanism for the three cases may be mechanical distention of the left main coronary artery resulting in intimal damage with secondary fibro‐sis and stenosis. The percutaneous transluminal coronary angioplasty‐related stenosis is, to our knowledge, the first reported case of this nature, and represents a previously unrecognized complication of this procedure.
Clinical experience with two‐dimensional echocardiography to guide endomyocardial biopsy
Authors: Williams G. A. , Kaintz R. P. , Habermehl K. K. , Nelson J. G. , Kennedy H. L. 
Published: February 2009

AbstractTwo‐dimensional echocardiography was used to aid right ventricular endomyocardial biopsy during 163 procedures in 83 patients being evaluated for myocarditis, cardiac transplant rejection, or drug toxicity. Thirty procedures were performed using combined echocardiography and fluoroscopy and 133 using echocardiography alone. For 80 of the 83 patients (96%) the forceps could be adequately visualized entering the right atrium, crossing the tricuspid valve, and advancing to the right ventricular apex and free wall. The catheter could be guided to biopsy the septum and sample multiple, separate sites along the right ventricular walls. By opening the forceps prior to contact with the myocardium, the right ventricular free wall could be biopsied without perforation. We found two‐dimensional echocardiography to be a useful and safe technique for forceps visualization and manipulation in the right ventricle.
The relationship between the electrocardiographically estimated infarct size and 1 ‐ and 2‐year survival in acute myocardial infarction
Authors: Herlitz J. , Hjalmarson Å. 
Published: February 2009

AbstractIn 587 patients with acute myocardial infarction (AMI) and no previous MI, electrocardiographically estimated infarct size was related to 1 ‐ and 2‐year mortality. The overall mortality was higher in patients with transmural MI (Q‐ or R‐wave changes in standard ECG) than in patients with subendocardial infarction (ST‐T‐wave changes in standard ECG) after 1 year (18.8% compared to 6.5% p<0.001) and after 2 years (22.2% compared to 13.8%, p=0.049). When patients who were alive during primary hospitalization were analyzed separately, slightly higher mortality was found in patients with transmural MI than in subendocardial MI after 1 year (9.6% compared to 4.2%, p =0.076) while no difference was found after 2 years (13.4% as compared to 11.7%, p>0.2). In a subgroup of patients with anterior MI, precordial mapping with 24 chest leads was analyzed 4 days after arrival in hospital (n=197). Patients were divided into quartiles according to the sum of R waves, the sum of Q waves, and the number of Q waves. There was a similar overall mortality in each quartile after 1 year and after 2 years regardless of ECG parameters studied. Neither did we find any correlation between the sum of R waves in leads II, III, and a VF on the fourth day in patients with inferior MI and overall 1 ‐ or 2‐year mortality rate, although there was a trend towards higher mortality with more ECG changes.
Myocardial infarction and the weather: A significant positive correlation between the onset of heart infarct and 28 KHz atmospherics—A pilot study
Authors: Baumer H. , Ruhenstroth‐Bauer G. , Burkel E. M. , Sönning W. , Filipiak B. 
Published: February 2009

AbstractThe date of occurrence of a heart infarct was tabulated for 162 patients admitted to four Munich clinics with cardiology departments from January 1 to July 31, 1981. This occurrence calendar was correlated with the daily average density of 28 KHz and 10 KHz atmospheric (atm) impulses and several classic weather parameters. The occurrence of heart infarcts has a certain positive correlation with the increased appearance of “pure” 28 KHz impulses, the correlation with 10 KHz impulses is very slight. Among the classic weather parameters, the average daily humidity has the highest negative correlation coefficient.
Combined administration of propranolol and quinidine in the conversion of paroxysmal atrial fibrillation
Authors: Antonelli D. , Bloch L. , Barzilay J. 
Published: February 2009

AbstractQuinidine was combined with propranolol to restore sinus rhythm in cases of paroxysmal artrial fibrillation (PAF) in 42 patients. The treatment was started with propranolol and quinidine at a test oral dose of 10 mg and 0.2 g, respectively, thereafter a dose of 0.4 g of quinidine and 10 mg of propranolol every two hours was added. The procedure was stopped when sinus rhythm was achieved, or when the administered quinidine reached the total dose of 1.6 g. Sinus rhythm was restored in 37 patients. The side effects were gastrointestinal disorders in 16 patients, atypical ventricular tachycardia in one case, and embolism of the left femoral artery in another patient.
Pentoxifylline treatment of moderate to severe chronic occlusive arterial disease
Authors: Lee B. Y. , Berkowitz P. , Savitsky J. P. , May G. S. , Brobst J. , Mccann W. J. 
Published: February 2009

AbstractA pilot study of the effects of pentoxifylline in 19 patients with moderate to severe chronic occlusive arterial disease (COAD) is described. The severity of disease was assessed by the degree of limitation in the walking distance on the flat surface (< 100 m), the absence of peripheral pulses on palpation, the diminished Doppler tibial/brachial pressure (the ischemic index) at rest, and by contrast arteriography, when available. After a 2‐week washout phase, all subjects received pentoxifylline (1200 mg/day) in an open‐label manner for a total of 12 weeks. Twelve of the nineteen patients showed a definite increase in exercise tolerance by the end of the study, with a concomitant reduction in ischemic symptoms. All except 3 patients felt they had derived benefit from the medication. In contrast to the clear improvements in walking distance and symptoms, only small effects on noninvasive vascular laboratory measurements were noted. Platelet aggregation, induced by ADP, epinephrine, and collagen, gradually decreased over the study period. Pentoxifylline appears to be useful in the medical management of patients with moderate to severe chronic occlusive arterial disease; future controlled trials in such patients are now justified.
Combining left ventricular systolic time intervals and M‐mode echocardiography in the evaluation of primary pulmonary hypertension in women
Authors: Leier C. V. , Sahar D. , Hermiller J. B. , Unverferth D. V. 
Published: February 2009

AbstractEight patients with primary pulmonary hypertension underwent systolic time intervals, M‐mode echocardiography, and direct hemodynamic studies in order to determine the correlation between noninvasive parameters and hemodynamic variables and to evaluate the utility of these noninvasive studies in primary pulmonary hypertension. The ratio of the pre‐ejection period to left ventricular ejection time (PEP/LVET) of the systolic time intervals was abnormally increased (>0.42) for each subject; the increase in the PEP/LVET was secondary to a shortening of the left ventricular ejection time in four patients, prolongation of the pre‐ejection period in one, or a combination of such, noted in three patients. In contrast, echocardiographic parameters of left ventricular function, specifically percent change in the minor axis of the left ventricle with systole, velocity of circumferential fiber shortening, and ejection fraction, were normal. In addition, a very good correlation was noted between PEP/LVET and total pulmonary resistance (r value = −0.89, p<0.05), while the echocardiographic parameters correlated well with stroke volume and cardiac output (r values ranged from 0.68 to 0.72, p<0.05). These results indicate that in primary pulmonary hypertension, the performance of both systolic time intervals and M‐mode echocardiography noninvasively provides useful information concerning the hemodynamic status of these patients. Systolic time intervals provide an estimation of overall cardiac‐cardiovascular performance, rather than left ventricular function alone, which in turn, is validly examined by M‐mode echocardiography.