bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recurrent nontraumatic aortic tears resulting in valvular avulsion and aortic insufficiency
Authors: Jaworsky C. , Smith D. W. , Shindler D. , Kostis J. 
Published: February 2009

AbstractA case of aortic insufficiency due to avulsion of two of three semilunar valves was remarkable because of the intimal and medial tears which caused it. The tears were in different stages of repair, suggesting repetitive injury. Antemortem steroid therapy and bouts of violent coughing may explain these unusual findings.
Echocardiographic findings in pompe's disease with left ventricular obstruction
Authors: Shapir Y. , Roguin N. 
Published: February 2009

AbstractTwo infants with Pompe's disease (type II glycogenosis) showing echocardiographic evidence of obstructive cardiomyopathy are described. On M‐mode and two‐dimensional (2‐D) echocardiography there was a severe hypertrophy of the interventricular septum, free, and posterior left ventricular wall with midsystolic closure of the aortic valve. The combined echocardiographic and electrocardiographic findings are helpful in the clinical diagnosis of this severe disease.
Pitfalls in the diagnosis of tricuspid atresia: Report of a new angiocardiographic sign
Authors: Hausdorf G. , Gravinghoff L. , Sieg K. , Keck E. W. 
Published: February 2009

AbstractTwo patients with the classical clinical, angiographic, and echocardiographic signs of tricuspid atresia are reported, where the correct diagnoses were made at operation; one child had cor triatriatum dexter, the other child total anomalous systemic venous drainage to the left atrium. The literature on cor triatriatum dexter and total anomalous systemic venous drainage is discussed and a new angiographic sign for the differentiation from tricuspid atresia is reported: nonopacification of the right atrial appendage with right atrial angiocardiography.
Potential prevention of myocardial rupture resulting from acute myocardial infarction
Authors: Nakano T. , Konishi T. , Takezawa H. 
Published: February 2009

AbstractThe clinical characteristics of 30 cases of myocardial rupture resulting from acute myocardial infarction were analyzed. Predisposing factors of myocardial rupture appeared to be the following (1) age 60 years or older, (2) female, (3) no previous history of angina or myocardial infarction, (4) hypertenstion on admission, (5) persistent or recurrent chest pain, (6) physical activity and/or emotional unrest, (7) less than 10 days since the onset of myocardial infarction. From 1979 to 1982, we tried to eliminate these risk factors in the acute stage of myocardial infarction, of which hypertension appeared to be the most important and main correlating factor. The incidence of myocardial rupture before elimination of risk factors was 31.2 % (26 of 84 patients) which was reduced to 8.8% after elimination. In the years 1981 and 1982, only two cases of myocardial rupture were found in each year, 4.3% and 5.6% of MI patients, respectively.
Improvement in exercise capacity and associated changes in hemodynamics and left ventricular function after the addition of metoprolol to nifedipine in patients with stable exertional angina
Authors: Choong C. Y. P. , Roubin G. S. , Shen W. F. , Tokuyasu Y. , Harris P. J. , Kelly D. T. 
Published: February 2009

AbstractIn 10 men with stable exertional angina, the changes in exercise capacity, hemodynamics, and left ventricular (LV) function were measured after 20 mg sublingual nifedipine (N) and again after adding 100 mg oral metoprolol (M). Nifedipine alone did not significantly improve exercise workloads (+18%) and duration (+21 %), but the addition of metoprolol increased both parameters by a further 37 and 32%, respectively (both p< 0.005 vs. N). After nifedipine the onset of angina was slightly delayed (5.14±2.41 min placebo (P), 6.00±2.31 min N, p<0.1) and occurred at higher workloads (36±17 W P, 43±8WN, p<0.1). After the addition of metoprolol, the onset of angina was delayed substantially more (9.57±2.22 min, p<0.001 vs. P and N) and occurred at much higher workloads (62±20 W, p < 0.001 vs. P and N). At rest (R) and during exercise (E), nifedipine decreased systemic vascular resistance (‐36% R, ‐27% E, both p<0.001) and mean arterial pressure (‐18% R, ‐21% E, both p<0.001), and increased heart rate (+15% R, +11% E, both p<0.001), Pulmonary artery wedge pressure on exercise increased less (22 ±7 mmHg P, 13±5 mmHg N, p<0.001). After adding metoprolol, the major change was a reduced heart rate (‐25% vs. N at R and E, both p <0.001), and arterial pressure was unaltered. Pulmonary artery wedge pressure on exercise increased to 18±5 mni Hg (p<0.05 vs. N). Exercise LV ejection fraction and volume did not change significantly after adding metoprolol despite marked improvement in angina. In this acute exercise study in patients with stable exertional angina, metoprolol added to nifedipine markedly improved exercise capacity by preventing the increase in heart rate seen with nifedipine. In our patients with relatively normal LV function at rest, the combination was safe and produced no deleterious effects on LV function.
Detection of different blood flow patterns in the true and false lumina with aortic root dissection by pulsed doppler echocardiography
Authors: Mohri M. , Nagata Y. , Hisano R. , Koyanagi S. , Hirata T. , Nakamura M. 
Published: February 2009

AbstractWe report a 53‐year‐old man with aortic dissection, in whom pulsed Doppler echocardiography showed two different flow patterns within the dilated aorta. Although two‐dimensional echocardiography has been successful in making the diagnosis of aortic root dissection, several conditions producing false positives have also been noted. Simultaneous recording of pulsed Doppler echocardiography may be useful to provide additional diagnostic clues in selected cases.
Right‐to‐left interatrial shunt secondary to an extensive right ventricular myocardial infarction
Authors: Wendel C. H. , Dianzumba S. , Jyner C. R. 
Published: February 2009

AbstractThis case report describes a rare complication of right ventricular myocardial infarction. Hypoxemia in this setting has only been described in two previous cases with a right‐to‐left interatrial shunt. This is suprising, given the high incidence of probe patent foramen ovale in randomly selected necropsy cases. Two‐dimensional echocardiography with contrast is the method of choice for detecting this abnormality.
Elevated CK‐MB and CK‐BB in serum and tumor homogenate of a patient with lung cancer
Authors: Lee B. I. , Bach P. M. , Horton J. D. , Hickey T. M. , Davis W. A. 
Published: February 2009

AbstractElevated serum levels of creatine kinase (CK) were found in a patient with small‐(oat) cell carcinoma of the lung. Fractionation of the enzyme showed markedly elevated CK‐MB and CK‐BB isoenzymes. Clinical and subsequent pathological examination showed no evidence of infarction, inflammation, or tumor involvement of the heart; however, analysis of tumor tissue for CK showed predominance of CK‐MB and CK‐BB isoenzymes, thus implicating tumor as the source of the circulating levels of CK‐MB and CK‐BB. Our case is the first to document CK‐MB from neoplastic tissue homogenates, and illustrates that markedly elevated circulating levels of CK‐MB, or increased levels of CK‐MB in combination with CK‐BB may point away from a myocardial source, and toward the existence of a malignancy.
Psychosocial aspects of surviving sudden cardiac death
Authors: Vlay S. C. , Fricchione G. L. 
Published: February 2009

AbstractThe psychosocial problems faced by the survivor of “sudden cardiac death” are discussed from the point of view of the patient, the family, and the physician. The patient faces a battery of intensive diagnostic tests, as well as concern for future capability to resume function as “spouse, parent, and citizen.” Emotions such as depression, anger, anxiety, frustration, and fear must be dealt with in a constructive manner. Management includes education, support, encouragement of adaptive denial, anxiolytic medication if necessary, and relaxation techniques when helpful. Our approach begins with education of the patient and family in regard to the medical aspects of the illness. Next, we provide support for the patient and allow the patient to express his or her concerns at an individual pace. Adaptive denial is encouraged and maladaptive denial addressed. Appropriate medication is prescribed when necessary, and finally, relaxation techniques may have a role in some patients. A strong physician‐patient relationship is necessary for successful evaluation and therapy. The unique stresses of the cardiologist and the electrophysiology team are described.
Secondary prevention after myocardial infarction: Subgroup analysis of patients at risk in the norwegian timolol multicenter study
Authors: Gundersen T. 
Published: February 2009

AbstractTimolol treatment after myocardial infarction is generally related to a significant reduction in both morality and reinfarction compared with placebo. Retrospective analyses of the timolol study are performed on subgroups of patients with a high placebo mortality. The present study shows that these patients are target groups for secondary prevention, as they benefit most from timolol treatment after myocardial infarction. In patients 65‐75 years of age, the number of cardiac deaths and reinfarctions prevented by timolol treatment is twice as high as that of patients below 65 years of age. Timolol treatment is well tolerated in the older age group and the contraindications for timolol treatment are independent of age up to 75 years. The reduction in mortality and reinfarction is independent of heart size at baseline. However, in patients with cardiomegaly and compensated heart failure on treatment with digitalis and diuretics, timolol treatment may be of special importance because of the very high incidence of cardiac death in this group of patients. In patients with compensated heart failure on treatment with digitalis and diuretics, timolol treatment does not precipitate heart failure. Patients with stable diabetes mellitus basically behave like nondiabetic patients regarding inclusion rate, side effects, and timolol‐related reduction in mortality and reinfarction. Decisions concerning secondary prevention with timolol should be independent of preinfarction and postinfarction angina. In conclusion, 70‐80% of all the patients below 75 years of age surviving myocardial infarction, without contraindication to betablocker treatment, can be treated with timolol 10 mg twice daily to reduce mortality and reinfarction. In contrast to previous routines, secondary prevention with beta blockers should be especially directed to high‐risk patients.
Values of electrocardiography and two‐dimensional echocardiography to identify myocardial infarction due to left circumflex and right coronary artery disease
Authors: Ogawa S. , Fujii I. , Yoshino H. , Tani M. , Ohnishi S. , Nagata M. , Chino M. , Handa S. , Nakamura Y. 
Published: February 2009

AbstractTo investigate the value of the 12‐lead ECG and two‐dimensional echocardiography (2DE) in the distinction of left circumflex (LCX) from right coronary artery (RCA) disease, we analyzed the location of Q waves, infarct lesions, and coronary artery narrowings in 26 patients with angiographically documented single‐vessel disease. Q waves in leads II, III, and aVF were associated with the posterior wall (PW) lesions at the papillary muscle level. Extensive lesions from the PW to the posterior septum (PS) identified RCA disease, while extension to the lateral wall (LW) identified LCX disease. Eleven of 12 patients with high posterior infarction (tall R wave in V1) were found to have extensive LW lesions and 10 of these had coronary narrowings in or proximal to the obtuse marginal branch of LCX. All 6 patients with high posterior infarction and high lateral infarction (Q in I or aVL) had infarct lesions extending from the LW to the anterior wall (AW) and were associated with LCX disease with a large obtuse marginal branch. Of 10 patients with Q waves in V6, the apical LW and PW were involved in 7 and either segment in 3. Nine of these 10 patients had LCX disease. It is concluded that the location of Q waves in inferior infarction could aid in recognizing infarct extension and underlying coronary artery disease.
Therapeutic effect of taurine in congestive heart failure: A double‐blind crossover trial
Authors: Azuma J. , Sawamura A. , Awata N. , Ohta H. , Hamaouchi T. , Harada H. , Takihara K. , Hasegawa H. , Yamagami T. , Ishiyama T. , Iwata H. , Kishimoto S. 
Published: February 2009

AbstractIn a double‐blind, randomized, crossover, placebo‐controlled study, we investigated the effects of adding taurine to the conventional treatment in 14 patients with congestive heart failure for a 4‐week period. Compared with placebo, taurine significantly improved the New York Heart Association functional class (p>0.02), pulmonary crackles (p>0.02), and chest film abnormalities (p>0.01). A benefit of taurine over placebo was demonstrated when an overall treatment response for each patient was evaluated on the basis of clinical examination (p>0.05). No patient worsened during taurine administration, but four patients did during placebo. Preejection period (corrected for heart rate) decreased from 148 ± 14 ms before taurine treatment to 137 ± 12 ms after taurine (p>0.001), and the quotient pre‐ejection period/left ventricular ejection time decreased from 47 ± 9 to 42 ± 8 % (p > 0.001). Side effects did not occur in the patients during taurine. The results indicate that addition of taurine to conventional therapy is safe and effective for the treatment of patients with congestive heart failure.
Apical left ventricular asynergy in chronic aortic regurgitation
Authors: Di DONATO M. , Barletta G. A. , Mori F. , Dabizzi R. P. , Fantini F. 
Published: February 2009

AbstractApical left ventricular (LV) wall motion abnormalities have been described in chronic volume oveload. To evaluate if these abnormalities are due to an acual hypokinesia we analyzed the percent shortening of apical LV radiants (PS%) by an angiographic computerized method and the endocardial systolic movement (ESM) and thickening (%Th) of the same region using M‐mode echocardiographic technique in 11 patients affected by pure aortic regurgitation (AR). In these patients mean apical radii shortening was reduced with respect to normal values. Both %Th and ESM were significantly reduced in AR when compared to normal subjects (24.5 ±31.7% vs. 63.8 ±35.8%, p<0.01 and 4 ±7 vs. 10 ± 3 mm, p<0.01, respectively). In addition, %Th and ESM directly correlated with PS% (r=0.79, p<0.01 and r=0.77, p<0.01, respectively). PS% correlated positively with systolic eccentricity and inversely with end‐systolic volume index (r=0.64, p<0.05 and r=0.57, p<0.05, respectively). Finally, in AR %Th was related to a normalized peak rate of systolic wall thickening (r=0.85, p<0.01) and to a normalized peak rate of diastolic wall thinning (r=0.68, p<0.05). These results showed that in AR a reduced apical radii percent shortening was associated with a reduced apical wall thickening and with a reduced normalized peak rate of systolic wall thickening and of diastolic wall thinning, thus indicating an actual hypokinesis and an impaired contractility. Moreover, the observed abnormalities correlated with an altered LV dynamic geometry linked to chronic volume overload.
The “straight back” syndrome: Current perspective more often associated with valvular heart disease than pseudoheart disease: A prospective clinical, electrocardiographic, roentgenographic, and echocardiographic study of 50 patients.
Authors: Ansari A. 
Published: February 2009

AbstractFifty consecutive patients (36 male, 14 female, mean age 28 years) who had heart murmurs and clinical and radiographic evidence of straight upper dorsal spine (straight back syndrome, SBS) underwent detailed clinical, electrocardiographic, roentgenographic, and echocardiographic evaluation. Palpable systolic thrill noted in one (2%) and widened S2 with persistent splitting in 2 (4%) patients were uncommon. Murmurs were invariably systolic in nature. Those located at the base of the heart in 19 (38%) patients were ejection in type and best heard during expiration. Those located at the apex in 26 (52%) patients were either mid‐, late‐, or pansystolic, and often associated with midsystolic click. Five (10%) patients had both types of murmurs. Diastolic murmurs were not heard in any patient. EKGs were normal in the majority. Cardiomegaly (C:T>55%) was present in only 5 (10%) and dilatation of the main pulmonary artery in 2 (4%) patients. Thus the incidence of pseudoheart disease (PsHD) was small (14%). Echocardiograms were normal in 18 (36%) and abnormal in 32 (64%) patients. There was evidence of mitral valve prolapse (MVP) in 29 (58%) patients and 3 (6%) had evidence of bicuspid aortic valve (BAV). In a control group of 40 age‐ and sex‐matched patients (26 male, 14 female, mean age 29.5 years), who also had heart murmurs but lacked straight upper dorsal spine, only 7 (17.5%) had MVP and none had BAV. The difference is both clinically and statistically significant (p<0.001). It is concluded that SBS is more often associated with valvular heart disease (MVP and BAV) than PsHD. Therefore, the diagnosis of SBS should remain presumptive until echocardiography has been performed to exclude MVP and BAV. SBS patients who have valvular heart disease should receive infective endocarditis prophylaxis.
Catheter‐induced spasm during spontaneous attack of variant angina
Authors: Matsuda Y. , Takashiba K. , Hamada Y. , Hyakuna E. , Ebihara H. 
Published: February 2009

AbstractThe simultaneous occurrences of spontaneous spasm and catheter‐induced spasm during coronary angiography were obtained in 3 patients. Catheter‐induced spasm was seen in the right coronary artery in 3 patients: 1 patient had spontaneous spasm in the distal right coronary artery and 2 patients had spontaneous spasm in the proximal left anterior descending coronary artery. These findings suggest that patients with variant angina may be susceptible to mechanical induction of spasm.
Evaluation of flecainide acetate in rapid atrial fibrillation complicating wolff‐parkinson‐white syndrome
Authors: Kappenberger L. J. , Fromer M. A. , Shenasa M. , Gloor H. O. 
Published: February 2009

AbstractFlecainide is reported to be effective in patients with paroxysmal tachycardias, but its effect on rapid ventricular response over accessory atrioventricular pathway during atrial fibrillation is not known. The influence of flecainide on various electrophysiological properties of the accessory pathway with special emphasis on ventricular rate during atrial fibrillation was investigated in 9 patients with severe symptomatic Wolff‐Parkinson‐White syndrome. The shortest ventricular response during atrial fibrillation increased from 218 (190‐270) to 320 (240‐block) ms. In 4 patients sustained rapid atrial fibrillation converted to sinus rhythm. The rate of circus movement tachycardia decreased from 166/min to 130/min after flecainide, due to a lengthening of retrograde ventriculoatrial conduction time over the accessory pathway. Flecainide caused a significant prolongation of the effective refractory period of the accessory pathway in our subgroup with extremely fast AV conduction during atrial fibrillation and induced a depressant effect on retrograde accessory pathway conduction. This makes the drug very promising for the emergency treatment of dangerous rapid tachyarrhythias complicating this syndrome.
Systolic murmurs in pregnancy: Value of echocardiographic assessment
Authors: Northcote R. J. , Knight P. V. , Ballantyne D. 
Published: February 2009

AbstractA systolic murmur discovered in antenatal care is the most common reason for cardiological assessment during pregnancy. We have assessed the value of clinical and echocardiographic assessment in 50 consecutive patients who were referred to our cardiac clinic following the discovery of a cardiac murmur at an antenatal clinic. Most of the murmurs occurred at 10‐12 weeks gestation; 46 subjects had cardiac murmurs confirmed at the cardiac clinic, of whom 16 gave a history suggestive of a previous cardiovascular disorder. Of the 16 patients, 13 had been found to have a murmur earlier in life which was thought to be of no clinical significance. Complications during pregnancy were infrequent. The most frequent murmur discovered was a soft midsystolic murmur heard with greatest intensity at the left sternal edge. The results of electrocardiography and echocardiography were not helpful in assisting with the diagnosis or substantially altering antenatal management in these patients. We do not feel that echocardiography has an important role in the assessment of systolic murmurs in pregnancy in the absence of other clinical or ECG abnormalities.
No adverse effects from high doses of felodipine to patients with coronary heart disease
Authors: Emanuelsson H. , Holmberg S. 
Published: February 2009

AbstractAlthough vasodilators may be of value in treating hypertension and heart failure, excessive vasodilation may worsen poststenotic myocardial perfusion in patients with coronary artery disease. In this study, 11 patients with ischemic heart disease were given 0.010, 0.015, and 0.025 mg/min of felodipine, a potent arteriolar dilator, and hemodynamics and myocardial lactate extraction were measured. Plasma concentrations at the three dose levels (Dl, D2, and D3) were 11± 4, 22±5, and 40±8 nmol/1, respectively. Mean heart rate rose from 61 + 13 to 79±10 beats/min at D3 (p/0.01) and mean arterial pressure was reduced from 113±25 to 86+13 mmHg (p/0.01). There was a marked increase in cardiac index at all three dose levels (p/0.05 to p/0.01). The systemic vascular resistance was reduced by 47 % at D3 and coronary vascular resistance by 44% (both p/0.01). Myocardial oxygen consumption was not changed by felodipine. There were three patients with myocardial lactate production both before and after drug administration, but there were no ST‐segment shifts or chest pain in any patient. In conclusion, felodipine seems to be a potent vasodilator and deerioration of myocardial metabolic function occurs infrequently. OUr results suggest that felodipine can be safely administered even in high doses to patients with severe cononary artery diseases.
Nuclear medical determination of left ventricular diastolic function in coronary heart disease
Authors: Brugger P. , Lasser W. , Kullich W. , Stoiberer I. , Klein G. 
Published: February 2009

AbstractIn 64 patients with coronary heart disease, the left ventricular diastolic function was determined by means of a new nuclear medical method (nuclear stethoscope). The investigations revealed an abnormal diastolic filling in 85.9% of the cases on the basis of the parameters peak filling rate and time to peak filling rate as manifestation of a disturbed ventricular function.
Combination therapy with diltiazem and propranolol: Precipitation of congestive heart failure
Authors: Strauss W. E. , Mcintyre K. M. , Parisi A. F. , Egan T. 
Published: February 2009

AbstractAlthough congestive heart failure has been reported with the combination of a beta blocker and either verapamil or nifedipine, it has not previously been reported for combination therapy that includes diltiazem. The following case documents the occurrence of clinical congestive failure in a patient with baseline left ventricular dysfunction and severe angina pectoris. Although the patients had tolerated propranolol therapy for years without difficulty, and high‐dose diltiazem monotherapy with an excellent clinical response, the combination of diltiazem and propranolol resulted in the development of congestive heart failure. Thus, although generally well tolerated, given the suitable scenario of reduced left ventricular function, the combination of diltiazem and a beta blocker may adversely affect left ventricular performance.