ISSN:0009-7322    

出版商:OVID    

年代:1963

数据来源: OVID

摘要:

Isoproterenol and epinephrine were given intravenously in dilute solutions to nine patients with Stokes-Adams attacks due to ventricular tachycardia and fibrillation. The drugs produced ventricular acceleration and thereby controlled the attacks. This technic proved useful for prompt, short-term prevention of seizures; for the long term, direct electric stimulation with internal pacemakers was required.

ISSN:0009-7322    

出版商:OVID    

年代:1963

数据来源: OVID

摘要:

Within the limits of the technic in this study, intercoronary anastomotic channels over 40 &mgr; in diameter were unrelated to age and the degree of coronary atherosclerosis.Intercoronary anastomotic channels over 40 &mgr; in diameter with one exception were found only in the presence of myocardial infarcts.Those persons who died suddenly and unexpectedly with advanced coronary atherosclerosis did not reveal any evidence of intercoronary anastomoses over 40 microns in diameter. This may be a possible factor in the inability of such individuals to survive a severe initial attack of myocardial ischemia.

ISSN:0009-7322    

出版商:OVID    

年代:1963

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1963

数据来源: OVID

摘要:

It has been generally thought that significant elevations of the left atrial and pulmonary vascular pressures occur in patients with mitral regurgitation of sufficient severity to produce serious disability and gross enlargement of the left atrium. Ten patients with severe mitral regurgitation have been encountered in whom gross left atrial enlargement was accompanied by normal left atrial and pulmonary artery pressures. These patients ranged in age from 8 to 49 years, all were in functional classes III or IV, and the average duration of symptoms was 7.3 years. Nine patients had rheumatic mitral regurgitation while one had a congenital lesion. Atrial fibrillation and the physical findings of pure mitral regurgitation were present in all patients, as was striking left atrial enlargement on their roentgenograms. Left atrial pressure, determined by left heart catheterization, averaged 9.1 mm. Hg and did not exceed 12 mm. Hg in any patient, and the V wave was not particularly prominent. The cardiac index was markedly depressed and averaged 2.0 L./min./M.2B.S.A.The observed discrepancy between left atrial size and pressure must reflect a disturbance in the compliance of the left atrial wall. It is suggested that long-standing mitral regurgitation may modify the mechanical characteristics of the atrial wall and that the presence of a normal left atrial pressure must not be assumed to exclude the presence of severe mitral regurgitation. The manner in which variations in left atrial compliance affect the clinical picture of mitral regurgitation and the selection of patients for operative intervention are discussed.

ISSN:0009-7322    

出版商:OVID    

年代:1963

数据来源: OVID

摘要:

Severe hypertension of at least 7 years' duration, due to coarctation of the right renal artery, was treated by reconstruction of the abnormal artery and restoration of blood flow to the coarcted kidney. Renal biopsies revealed normal microscopic architecture in the right kidney and advanced hypertensive pathology in the opposite kidney. After 8 months' observation of persistent, moderate hypertension, the left kidney was removed with prompt return of blood pressure to normal levels during the subsequent 2½ years.These observations demonstrate the precise correlation of hypertension due to renal artery stenosis in the human with the experimental model in rats.

ISSN:0009-7322    

出版商:OVID    

年代:1963

数据来源: OVID

摘要:

A metabolic balance study in a patient with cerebral salt wasting is reported. The results suggest that a normal aldosterone mechanism was present in association with inappropriate antidiuretic hormone secretion.

ISSN:0009-7322    

出版商:OVID    

年代:1963

数据来源: OVID

摘要:

Isoproterenol was infused intravenously at a rate of 0.03 to 0.07 &mgr;g. per Kg. per minute in 38 patients undergoing cardiac catheterization to evaluate the routine postoperative condition of 19 patients and to support or confirm the clinical diagnosis in 19 others.A steady response was obtained in 2 to 4 minutes, and no toxic effects were observed. During the infusion the heart rate increased an average of 55 per cent; the respiratory rate, 23 per cent. The right atrial pressure fell. In general the pulmonary and systemic arterial pressures also decreased. Limited observations on the cardiac output confirmed the previously reported increase. Ten patients developed a significant systolic gradient between the right ventricle and pulmonary artery (greater than 20 mm. Hg) during the infusion. Four of these were postoperative patients, three of whom were considered completely corrected prior to infusion of the isoproterenol. Four patients with aortic stenosis were studied, and the systolic gradient increased in three (80, 93, and 145 per cent).The results indicate that infusion of isoproterenol is a safe, practical, and effective means of simulating exercise in infants and children. Used in addition to the customary cardiac catheterization studies, it is of distinct value in appraising congenital cardiac defects.

ISSN:0009-7322    

出版商:OVID    

年代:1963

数据来源: OVID

摘要:

A systematic search was made for the effective axes from an orthogonal lead system that best duplicated the diagnostically significant features of precordial leads.Only one of 240 precordial leads was not matched with a rotated orthogonal lead having the same features judged to be clinically significant.The average rotated lead axes corresponding to precordial leads V1through V6were systematically located from an axis directed upward and to the right corresponding to V1to one directed downward and to the left corresponding to V6.The location of these average rotated axes has been presented and the per cent contribution of XYZ leads to each of these axes has been calculated.These results provide a guide to the orthogonal lead location of diagnostic information now obtained from precordial leads.

ISSN:0009-7322    

出版商:OVID    

年代:1963

数据来源: OVID

摘要:

A combination of physical findings, x-ray films and fluoroscopy, electrocardiography, vectorcardiography, cardiac catheterization including oxygen analysis, indicator-dilution curves, and selective angiocardiography was employed to evaluate 259 consecutive patients undergoing right heart catheterization. All patients were classified on the basis of existing shunts. The present report concerns 63 patients with no shunts and 70 patients with a left-to-right shunt through a ventricular septal defect alone.A method employing oxygen analysis of right heart blood was evaluated as an isolated diagnostic technic. Blood specimens were obtained in rapid sequence during withdrawal of the catheter from the pulmonary arteries. Spectrophotometric measurements of blood oxygen saturation were appropriately grouped. The difference in means between the right ventricular outflow tract and right atrium was standardized with the estimated standard deviation and the statistical significance determined from thet-distribution.Reliability was defined as the probability of correctly excluding a shunt when none exists. Sensitivity was defined as the probability of diagnosing an existing shunt. By use of the 1-per cent level of signfiicance as critical the method employed was 98.4 per cent reliable and 97.1 per cent sensitive.Sequential sampling is of vital importance. The value of larger numbers of specimens is illustrated, and the relationship of sensitivity and reliability to the size of the shunt and the number of blood specimens analyzed is illustrated.The reliability and sensitivity of our method and criteria appear superior to previous criteria currently in use.

ISSN:0009-7322    

出版商:OVID    

年代:1963

数据来源: OVID