bluuebunny/crossref_metadata_2025_split huggingface dataset:
Continuous electrocardiographic monitoring in patients with sickle‐cell anemia during pain crisis
Authors: Maisel A. , Friedman H. , Flint L. , Koshy M. , Prabhu R. 
Published: February 2009

AbstractElectrocardiographic studies in patients with sickle‐cell anemia have been performed during the normal resting state with routine twelve‐lead ECGs. We studied 30 patients with sickle‐cell disease in acute crisis with 24‐hour continuous electrocardiographic monitoring. The standard ECG demonstrated a high incidence of abnormalities, but only three patients had arrhythmias. These findings contrasted sharply with the results of continuous monitoring, during which arrhythmias were detected in 24 of 30 patients. They were fairly evenly split between atrial (60%) and ventricular (67%). Nine of the patients had “complex arrhythmias” including two with episodes of ventricular tachycardia. Seventeen patients subsequently underwent equilibrium gated‐blood pool scans. Eight patients had abnormal contractility and tended to have more arrhythmias on monitoring than those with normal contractility. Thus, continuous electrocardiographic monitoring of sickle‐cell patients during crisis revealed a higher incidence of arrhythmias than previously thought.
Effects of laser irradiation on human erythrocytes: Considerations concerning clinical laser angioplasty
Authors: Theis J. H. , Ikeda R. M. , Stobbe D. , Ogata C , Lui H. , Mason D. T. , Lee G. 
Published: February 2009

AbstractRecent studies demonstrate the potential use of laser to vaporize human coronary atherosclerotic plaques. The laser energy is transmitted through flexible quartz fiber and discharged intravascularly. Since red blood cells could be exposed to intense heat, we examined effects of laser irradiation on human erythrocytes. Blood was obtained and placed in 5 ethylene diaminetetracidic acid (EDTA) vials for each normal donor. A flexible 400 diameter core quartz fiber coupled to an argon‐ion laser source was positioned 1 cm above the surface of 1.5 ml blood. Four vials were exposed to 5 W laser beam for 5, 10, 15, or 20 s; the remaining vial was left untreated. Packed cell volume fell primarily during the first 5 s of laser exposure (p<0.01) and plateaued beyond 5 s. Plasma hemoglobin (Hgb) rose progressively with each increased duration of exposure (p<0.01). This study indicates that lysis of erythrocytes occurs in cells exposed directly to the laser beam. However, beyond the direct beam, damage to red cell membrane took place as evident by progressive Hgb leakage into plasma despite no further cell lysis. These observations require consideration during clinical laser angioplasty.
The time course in acute myocardial infarction evaluated with precordial mapping and standard ecg
Authors: Herlitz J. , Hjalmarsson Å , Waagstein F. , Waldenström A. , Swedberg K. 
Published: February 2009

AbstractFifty‐six patients with acute transmural anterior wall myocardial infarction (MI) were investigated with a 24‐electrode grid and 34 patients with an acute transmural inferior wall MI were investigated with standard ECG leads II, III, and a VF in order to study the length of time after the onset of pain during which the development of Q waves and reduction of R waves progress. These ECG changes continued for 18‐26 h after onset of pain but the majority appeared during the first 12 h.
Atrial septal defect in adult identical twins: A variation in theme
Authors: Macdonald I. L. , Mcmurtry T. J. , Dodek A. 
Published: February 2009

AbstractThe diagnosis of atrial septal defect was established in monozygotic twin females at age 63. Each patient mimicked a different acquired heart disease. One twin had congestive heart failure and atrial fibrillation and was diagnosed as having rheumatic mitral insufficiency. The other twin had atypical chest pain and systemic hypertension and was thought to have arteriosclerotic heart disease. In each case the correct diagnosis was made at cardiac catheterization. Although the same basic congenital heart lesion was present in both patients, the symptoms and findings differed. Symptomatic improvement was achieved by different therapeutic modalities. One patient had open heart surgery, while the other twin improved with medical therapy.
The modern diagnosis of cardiac myxoma: Role of two‐dimensional echocardiography
Authors: Mcgarry K. M. , Jugdutt B. I. , Rossall R. E. 
Published: February 2009

AbstractWe reviewed our experience with the diagnosis of cardiac myxoma in 10 patients seen between 1960 and 1981. At surgery, large myxomas (>5 cm) were found in the left atrium in 6 patients, right atrium in 3, and right ventricle in 1. The correct preoperative diagnosis was made in 9 patients: clinically in 3 and at catheterization and angiocardiography in 6. Diagnoses were falsely negative in 3/13 (23%) catheterizations and 2/10 (20%) angiocardiograms. Echocardiography (echo) was positive in 5/5 (100%). Gated blood‐pool scans confirmed a right atrial myxoma in 1 patient. The interval between onset of symptoms and surgery was 30.5 months, (range, 2‐120) and was not significantly different in the eras before and after echo. The age at diagnosis exceeded 40 years in 9 patients and was not significantly less in the echo era. The size and site of the tumor at surgery agreed with findings on M‐mode echo (n=5) or two‐dimensional (2‐D) echo (n=2), but the size (85 vs. 88 cm3) and mass (81 vs. 88 g) of the tumors were similar in the 2 eras. Although 2‐D echo facilitates the preoperative diagnosis of cardiac myxoma, earlier patient referral of suspicious cases for 2‐D echo is still necessary.
Correction of intraoperative diastolic myocardial dysfunction with nifedipine
Authors: Lee T. H. , Lilly L. S. , Antman E. M. , Disesa V. J. , Cohn L. H. 
Published: February 2009

AbstractWe report the case of a 62‐year‐old man with severe aortic stenosis and hypertrophic cardiomyopathy, who could not be weaned from cardiopulmonary bypass after aortic valve replacement until buccal administration of the calcium‐blocking agent nifedipine led to achievement of adequate hemodynamics. These observations demonstrate the importance of diastolic dysfunction in patients with hypertrophic cardiomyopathy, and suggest an important peri‐ and intraoperative role for calcium‐blocking agents in their management.
M‐mode and two‐dimensional contrast echocardiography in adult patients with atrial septal defects
Authors: Grenadier E. , Alpan G. , Keidar S. , Palant A. 
Published: February 2009

AbstractM‐mode and two‐dimensional echocardiographic studies, with and without contrast injection, were performed in 14 adult patients with clinical and radiological signs of atrial septal defects. Two‐dimensional contrast echocardiography was found to be the most sensitive technique, allowing a definitive diagnosis to be made noninvasively in 12 patients (86%) of those patients studied. M‐mode contrast echocardiography demonstrated an atrial shunt in 6 patients (43%). Regular two‐dimensional echocardiography produced a high proportion of false‐positive and false‐negative results, while the findings on M‐mode echocardiography are sensitive but nonspecific. All 14 patients described had the diagnosis confirmed on cardiac catheterization. Performance of the Valsalva maneuver during contrast echocardiography was found to be diagnostically unhelpful. The findings suggest that contrast echocardiography, particularly two‐dimensional, is an effective, noninvasive diagnostic technique to be applied on clinical suspicion of atrial septal defects.
Surgical treatment of ventricular septal rupture and mitral regurgitation complicating acute myocardial infarction: Report of a case and review of the literature
Authors: Gonzalez‐Lavin L. , Friedman J. P. 
Published: February 2009

AbstractCoexisting ventricular septal rupture (VSR) and severe mitral regurgitation following myocardial infarction is rare; only ten cases have been documented in the English literature. Present refinements in myocardial preservation and surgical techniques have markedly improved the results of surgery in this group of desperately ill patients. Early repair of both lesions is advocated and exemplified by a case report.
Q‐T prolongation and torsades de pointes in a patient with subarachnoid hemorrhage
Authors: Hust M. H. , Nitsche K. , Hohnloser S. , BöHM B. , Just H. 
Published: February 2009

AbstractAn extreme Q‐T prolongation in a patient with subarachnoid hemorrhage was observed. Multiple torsades de pointes occurred. Lidocaine, metoprolol, and atropine were not effective in controlling the arrhythmia, whereas shortening the Q‐T interval by intravenous administration of orciprenaline or overdrive ventricular pacing was successful. The occurrence of T wave alternations was a sign of increased sympathetic activity.
Unloading the right ventricle in the crest syndrome variant of progressive systemic sclerosis (scleroderma)
Authors: Morrison D. , Goldman S. , Alepa F. P. 
Published: February 2009

AbstractA patient with severe pulmonary hypertension secondary to the CREST syndrome variant of scleroderma is described. Acute reductions in both pulmonary artery pressure and total pulmonary resistance were seen with nifedipine and oxygen administration. Reductions in resistance were maintained for over one month with this combination. These results raise the possibility that some of the pulmonary hypertension seen in this condition is reversible.
Embolus to the right atrium simulating myxoma
Authors: Buckingham T. A. , Williams G. A. , Aker U. T. , Kennedy H. L. 
Published: February 2009

AbstractA space‐occupying mass of the right atrium was found by two‐dimensional echocardiography and angiography in a 68‐year‐old woman whose clinical diagnosis indicated multiple pulmonary emboli. Since right heart myxomas frequently cause pulmonary thrombo‐embolism, the patient was initially diagnosed by noninvasive and invasive techniques as having a right atrial myxoma. Surgery, however, revealed the pathologic findings of large thrombi of the right atrium, femoral and iliac veins, and pulmonary arteries. This case vividly demonstrates that deep venous thrombosis may embolize and lodge in the right atrial cavity simulating a right atrial myxoma.
Hypertension and stress
Authors: Hudzinski L. G. , Frohlich E. D. , Holloway R. D. 
Published: February 2009

AbstractThis study explores the relationship of chronic stress to hypertension. The study included 127 hospitalized and 134 outpatients of a stress treatment program and 129 “normal” persons in the general population. All subjects were matched for age, sex, and race. After three days of hospitalization, there was a 17.3% incidence of hypertension in the hospitalized patients when hypertension was defined as blood pressure levels greater than 140/90 mmHg. These data compare with a 5% and 13% incidence of hypertension in the outpatient stress and “normal” groups, respectively. The National Health Survey of 1962 indicated that 18% of the population were hypertensive. Our data indicate that the incidence of hypertension was no greater in a diagnostically established group of hospitalized stress patients than in the less stressed outpatient or an otherwise “normal” group. The frequently expressed notion that tension and chronic stress predispose a population to essential hypertension is not confirmed by this analysis.
Increase in bicycloprostaglandin E2 metabolite in congestive heart failure in response to captopril
Authors: Stanek B. , Punzengruber C. , Silberbauer K. 
Published: February 2009

AbstractVasodilating prostaglandins may be increased in patients with chronic congestive heart failure (CHF) to balance out the effects of vasoconstricting forces. Significant increases in plasma levels of bicycloprostaglandin E2 metabolite (PGEm), a chemically stable degradation product of the vasodilating prostaglandin E2, were found in response to captopril (39.4±7.8 vs. 46.2±8.2 pg/ml; p<0.01). With chronic captopril treatment bicyclo‐PGEm remained elevated for 12 h after the last dose after 1 and 2 months (75.5±5.5; p<0.05 and 72.1±6.3 pg/ml; p < 0.05, respectively). Upon readministration of captopril during chronic captopril treatment the significant increase of bicyclo‐PGEm in response to captopril was sustained, as were changes in plasma renin activity, angiotensin II, and blood pressure. Plasma catecholamines were unchanged with captopril or decreased slightly, vasopressin remained moderately increased throughout. Taken together, the results suggest that vasodilating prostaglandin E2 production might play a part in captopril's beneficial action in chronic congestive heart failure.
Left ventricular tamponade: Echocardiographic and hemodynamic manifestations
Authors: Lee R. T. , Bhatia S. J. S. , Kirshenbaum J. M. , Friedman P. L. 
Published: February 2009

AbstractA patient with progressive systemic sclerosis was evaluated for dyspnea. Echocardiography revealed enlarged right heart chambers, a moderate pericardial effusion, and diastolic collapse of the left ventricle. Hemodynamic studies before and after removal of pericardial fluid were consistent with compromise of left, but not right, heart filling by the pericardial fluid.
Right ventricular pacing wire thrombus presenting as pyrexia of unknown origin
Authors: Grunewald R. A. , Nihoyannopoulos P. , Playford R. J. , Levi S. , Hodgson H. J. F. , Smith P. L. C. 
Published: February 2009

AbstractPacing wire thrombosis may be invisible echocardiographically while producing severe symptoms. We report a patient whose pacing wire thrombosis presented as a pyrexial illness 5 months after its insertion. Treatment with tissue plasminogen activator provoked cardiovascular collapse; therefore, we recommend that such thrombosis be treated surgically.
Predictors of left ventricular hypertrophy in patients with essential hypertension
Authors: Glasser S. P. , Koehn D. K. 
Published: February 2009

AbstractThe purpose of this study was to assess clinical variables which might be predictive of echocardiographic left ventricular hypertrophy in mildly hypertensive patients. Eighteen patients (mean age 51) were studied following four weeks of hydrochlorothiazide monotherapy. Variables assessed included age, duration of hypertension, body surface area, serum cholesterol, alcohol consumption, smoking, maximum systolic and mean blood pressures, and variability of blood pressure determined from hourly measurements taken 12 hours after hydrochlorothiazide dosing. Using stepwise multiple linear regression (with left ventricular mass index analyzed as a continuous variable), the variability of blood pressure was predictive of an eleveated left ventricular mass index (p < 0.0003, r2=0.61). The duration of hypertension added significantly to the variability in predicting an elevated left ventricular mass index (p < 0.004, multiple r=0.74). In conclusion, echocardiographic left ventricular hypertrophy was significantly related to the variability of blood pressure recorded hourly for 12 h after subjects received 50 mg of hydrochlorothiazide.
Optimal management of patients with complete atrioventricular septal defect
Authors: Fox L. S. 
Published: February 2009

AbstractControversy still persists as to whether patients with complete atrioventricular septal defect should be treated by primary total correction or a two‐stage approach utilizing initial pulmonary artery banding. We believe a selected management program dictated by each individual patient's anatomy, presentation (size and preoperative functional class), and associated anomalies should be practiced, but with a strong preference toward initial total repair incorporating modern techniques to construct left and right atrioventricular valves, correct valvular incompetence, and close ventricular and atrial defects. Utilizing this management program, 23 consecutive patients (age 5 days to 51 months) with complete forms of atrioventricular septal defect were surgically corrected from July 1, 1984 through June 30, 1988. Fourteen patients were 12 months of age or less at the time of complete repair. Five patients (22%) had initial pulmonary artery banding, but only 2 were performed by us. Both had very extenuating circumstances making complete repair inappropriate. Only 2 of these 23 patients having complete repair died (hospital mortality 9%) and one had pulmonary artery banding 3 years previously. Of the 5 patients with initial pulmonary artery banding, 3 (60%) required right ventricular outflow tract reconstruction and/or repair of pulmonary artery bifurcation stenosis. We believe these good results support our continued practice of selective management of patients with complete forms of atrioventricular septal defect, but we maintain a strong preference toward initial complete repair.
Diastolic atrioventricular valve closure and regurgitation following atrial contraction: Their relation to timing of atrial contraction
Authors: Okamoto M. , Tsubokura T. , Kajiyama G. , Miyatake K. , Kinoshita N. , Sakakibara H. , Nimura Y. 
Published: February 2009

AbstractSome authors have proposed that atrial contraction per se is able to close the atrioventricular (AV) valves. To determine whether tight closure of the AV valves can be accomplished solely by atrial contraction, the existence of diastolic regurgitation following atrial contraction and its relation to the PQ interval were examined in 13 patients with AV block (2 of the first degree, 4 of the second degree, and 7 of the third degree), using pulsed Doppler echocardiography, which allowed noninvasive estimation of valvular regurgitation in the physiological state. Diastolic mitral and tricuspid regurgitations were detected in the left and right atria near the respective AV valves in all 13 patients despite different degrees of AV block, while these valves were observed to be in an apparently closed position during regurgitation on the two‐dimensional and M‐mode echocardiograms. The duration of regurgitant signals was prolonged with an increase in the PQ interval in the electrocardiogram, but it became short again as the P wave approached the preceding rapid filling wave. These results suggest that atrial contraction may initiate the closure of the AV valves but is not capable of closing the valves tightly, and atrial contraction with long PQ interval may contribute little to augmentation of cardiac output in patients with AV block.
Temporary pacing catheter placement in patients requiring continuous external pacing
Authors: Tilkemeier P. , Hakim KHAN A. 
Published: February 2009

AbstractElectrocardiographic features of temporary transvenous pacemaker have been discussed and have been used to guide insertion of pacemaker without fluoroscopic aid. The following is a description of the electrocardiographic features of temporary endocardial pacemaker insertion in a patient who is chronically dependent on external temporary transthoracic pacing.
The application of radionuclide ventriculography to cardiac screening
Authors: Lindsay J. , Milner M. R. , Goldstein S. A. , Chandeysson P. L. , Rodman D. J. , Okin P. M. 
Published: February 2009

AbstractScreening asymptomatic individuals for latent coronary disease often requires sequential testing because exercise electrocardiography typically produces more false positive than true positive results in a population with a low prevalence of coronary disease. Cardiac scintigraphy is a technique that may be employed as a confirmatory test in lieu of coronary arteriography to further evaluate the significance of a positive exercise electrocardiogram.Radionuclide ventriculography was employed in 98 asymptomatic individuals who were considered to be at moderate risk of heart disease after risk factor analysis and exercise electrocardiography. Seventeen (17%) patients had an abnormal study and underwent cardiac catheterization. Seven had coronary artery disease, two had cardiomyopathy, and eight were normal. Eighty‐one (83%) patients had a normal study. Because the sensitivity of radionuclide ventriculography is 63–80%, it was postulated that 2 to 5 individuals with disease were missed. Thus, from a population with an H‐14% prevalence of disease, two subsets were identified. A large subset in which a prevalence of 2–6% could be estimated was separated from a much smaller one in which a prevalence of approximately 50% was demonstrated.
Percutaneous (nonsurgical) supported angioplasty in unprotected left main disease and severe left ventricular dysfunction
Authors: Vogel J. H. K. , Ruiz C. E. , Jahnke E. J. , Mc FADDEN R. B. , Setty R. , West C. , Fink S. B. , Avolio R. , Stafford J. , Klein J. L. 
Published: February 2009

AbstractA 69‐year‐old patient with the equivalent of severe, unprotected left main coronary artery disease associated with marked left ventricular dysfunction with ventricular aneurysm who had Class IV angina, underwent suppported angioplasty utilizing a total percutaneous approach. The patient tolerated occlusion of his main left coronary artery for a total of 7 minutes without difficulty, during dilatation of left anterior descending and two circumflex lesions. He was discharged the following day, symptom free.
Familial homozygous hypercholesterolemia: Clinical and cardiovascular features in 18 patients
Authors: Brook G. J. , Keidar S. , Boulos M. , Grenadier E. , Wiener A. , Shehada N. , Markiewicz W. , Benderli A. , Aviram M. 
Published: February 2009

AbstractHomozygous familial hypercholesterolemia (HFH) is a very rare autosomal dominant disease characterized by accelerated severe atherosclerosis. We examined 18 patients from 9 families with HFH. The age range was 6–30 years (mean == 16 years). Male to female ratio was equal. All patients had huge, multiple tuberous xanthomas on the skin and tendons. Mean ± standard deviation of plasma cholesterol, triglycerides, low‐density lipoproteins (LDL), and high‐density lipoproteins (HDL) cholesterol levels were 608±89, 122±39, 550±88, and 26±8 mg/dl, respectively. Five patients (28%) had angina pectoris, two sustained a myocardial infarction, and one died at the age of 15 years. Two‐dimensional echocardiography demonstrated supravalvular aortic stenosis in 3 of the 13 patients (23%). Coronary arteriography performed in 11 patients demonstrated significant obstruction in 6 patients, 2 each with single‐, double‐, and triple‐vessel disease. Left main stenosis was present in 3 patients (27%). Supravalvular aortic narrowing was demonstrated in 6 patients (54%) and was associated with a gradient in 2 (25 and 35 mmHg, respectively). Segmental contraction abnormalities were detected in 2 of the 11 patients (18%). It is concluded that coronary artery disease is prevalent in patients with HFH and, based on the data presented, we recommend the performance of noninvasive technique, coronary arteriography and supravalvular aortography at an early age to detect and to follow the progression of the disease.
Delay time in suspected acute myocardial infarction and the importance of its modification
Authors: Herlitz J. , Blohm M. , Hartford M. , Hjalmarsson Å. , Holmberg S. , Karlson B. W. 
Published: February 2009

AbstractThis paper summarizes the present knowledge of delay time in suspected acute myocardial infarction. More than 50% of deaths in acute myocardial infarction occur outside of the hospital setting. Recent experiences indicate that early and even late mortality can be dramatically reduced by intervention in the early phase. This points up the importance of bringing patients with suspected acute myocardial infarction to the hospital as early in the course of MI as possible. The predominating cause of delay is the time it takes for the patient to decide to go to hospital regardless of a previous history of cardiovascular disease. Patients arriving in hospital in later stages of MI are at a very high risk of mortality. Therefore one of the most important problems to be resolved is how to reduce delay time in suspected acute myocardial infarction. Such efforts have been surprisingly few. Limited experiences indicate that public education can reduce delay time dramatically.