摘要:

A new technic is described for the detection of left-to-right shunts. A miniature Geiger-Müller tube is placed in the esophagus behind the left atrium and positioned by the electrocardiogram. In this position the G-M tube measures radioactivity from the left atrium. Curves are then recorded simultaneously from the precordium, lung, and left atrium. Methods of injection, monitoring, and recording are presented that provide greater diagnostic accuracy over those external detector technics currently in use.Of 23 patients studied, 11 presented left-to-right shunts. Eight of these 11 patients were submitted to surgery; all were studied preoperatively and seven were studied postoperatively. Seven of the 11 shunts were detected by both precordial and esophageal technics. Four of the 11 shunts were missed by conventional precordial technics but were correctly diagnosed preoperatively by the esophageal detector. In addition, one shunt, which remained open postoperatively, was demonstrated clearly by the esophageal technic but was not indicated by the precordial curves. In no instance was the precordial curve positive for left-to-right shunt when the esophageal curve was negative.Although the accuracy of any radioisotope detection technic with external counting may not approach that of direct cardiac catheterization, this method, because of its relative simplicity and accuracy, is useful in the demonstration of left-to-right shunts both preoperatively and postoperatively.

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

摘要:

The clinical and postmortem findings in a case of sickle cell-hemaglobin C disease complicated by acute rheumatic fever with accompanying carditis, and rheumatic pneumonitis are presented and discussed. This is believed to be the first such case reported.The recent literature pertaining to the cardiac manifestations of SS and SC hemoglobinopathies is briefly reviewed.A possible explanation for the failure of the rheumatic process to respond to conventional therapy in our patient is given.

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

摘要:

A case of constrictive pericarditis complicating disseminated lupus erythematosus is reported in a 58-year-old man. Hemodynamic studies documented the diagnosis and also confirmed the clinical suspicion of coexistent atrial septal defect. Measurement of left ventricular volume by a thermodilution technic augmented information available from routine studies. Pericardiectomy and closure of the atrial septal defect relieved the mechanical lesion.The case is also unique in its documentation of the coexistence of three different forms of heart disease—congenital atrial septal defect, pericardial constriction from lupus erythematosus, and rheumatic valvular disease.

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

摘要:

A case of congenital aortic stenosis with an associated discrete saccular aortic aneurysm is presented. The few previously reported cases of this combination of lesions are reviewed and the nature and mechanisms of the aneurysmal changes are discussed. The apparent etiologic importance of the systolic jet striking a localized area of vessel wall is emphasized.

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

摘要:

Hemodynamic observations in 15 cases of the Hunter-Hurler syndrome are reported. Required premedication was two to three times that usually needed. No major complications or deaths occurred. As a group, these individuals tend to have slight elevations of pulmonary artery pressures and more definite elevations of systemic arterial pressures. They generally have normal cardiac outputs and, thus, elevations of total systemic, total pulmonary, and pulmonary arteriolar resistances. In only one case was there clinical and angiocardiographic evidence of valvular involvement, that case having aortic insufficiency. In another case there was only angiocardiographic evidence of mitral insufficiency. Only one child was in congestive heart failure at the time of the study. There was no evidence of coronary artery disease. The ascending limb right ventricular pressure curve was frequently notched and the pressure rise time of the left ventricle (dp/dt) was low. Nocase had a congenital malformation of the heart.Those individuals who have normal vascular bed resistances appear to live longer than those who have elevated resistances early in life. The prognosis is also better for the male Hurler of the sex-linked variety than for those cases due to autosomal recessive inheritance.

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID