ISSN:0009-7322    

出版商:OVID    

年代:1962

数据来源: OVID

摘要:

The electrocardiographic changes during exercise were examined by means of the radio-electrocardiograph and compared with the changes in the postexercise period in 70 patients with coronary artery disease. This method permitted the recording of one-lead tracings during exercise with a stable baseline and minimal interference. In addition, it has the advantage of permitting free exercise because of the absence of wire connections between the patient and the recording machine. Tracings may be taken on patients performing exercise at a distance of up to several hundred feet from the electrocardiograph.The criteria for abnormality based on double Master two-step tests in 127 normal individuals below the age of 40 years were appearance or increase in ischemic S-T-segment depression of 1 mm. or more, appearance or increase of S-T-segment elevation of 1 mm. or more, inversion of a positive or reversion of a negative T wave, frank inversion of the U wave, widening or narrowing (of a previously widened) QRS complex, and appearance of multiple premature beats.Thirty-seven of the 70 patients (53 per cent) showed electrocardiographic abnormalities during the period of exercise (single Master two-step test), while only 24 (34 per cent) had similar changes in the postexercise period. Twenty-three of the 70 patients had normal resting electrocardiograms. Of these, 11 (48 per cent) had abnormal alterations during, and six (26 per cent) after exercise. Forty-seven of the 70 patients had abnormal resting electrocardiograms. Twenty-six of these (55 per cent) had abnormal changes during exercise and 18 (38 per cent) after exercise.The advantage of recording the electrocardiogram during exercise is shown by the fact that in 17 of the 37 patients with abnormal responses, the changes were limited to the actual period of exercise and the immediate postexercise period, and would probably be missed were the postexercise tracing taken alone. Possible improvements in technic aimed at increasing the incidence of positive responses are discussed. It is suggested that the recording of the electrocardiogram both during and after exercise should replace the presently used technic in the Master two-step test.

ISSN:0009-7322    

出版商:OVID    

年代:1962

数据来源: OVID

摘要:

Experiences with 450 transseptal left heart catheterizations are reviewed. There were no mortalities in this series, and the only significant complication was accidental puncture of the aorta in three patients. The equipment and technic employed in the current method, by which a radiopaque catheter of large caliber is introduced into the left ventricle, are described in detail. The advantages of this modification are outlined.

ISSN:0009-7322    

出版商:OVID    

年代:1962

数据来源: OVID

摘要:

In two Series of 69 patients with acute cerebral infarction and 21 patients with intracranial hemorrhage, 11 and 15 respectively showed electrocardiographic changes that could not be ascribed to the usual cardiac or other extracerebral causes. These changesoften simulate myocardial ischemia or even infarction.

ISSN:0009-7322    

出版商:OVID    

年代:1962

数据来源: OVID

摘要:

Open operation by means of extracorporeal circulation has been used on 47 patients with congenital aortic stenosis at the Mayo Clinic between April 1955 and July 1, 1960; 33 patients had valvular stenosis, 11 had subvalvular stenosis, and three had supravalvular stenosis. The over-all operative mortality rate was 13 per cent; 6 per cent of patients with valvular aortic stenosis died in the hospital.Severe aortic insufficiency did not develop in any patient operated on for valvular aortic stenosis although a diastolic murmur was present after operation in some. Rarely, however, was the transvalvular gradient completely eliminated by operation although 90 per cent of the surviving patients were either asymptomatic or had definite clinical improvement. Late follow-up hemodynamic studies suggest that a persistent transvalvular gradient may regress in time.Relief of obstruction caused by subvalvular variety of aortic stenosis is difficult whether stenosis is localized or diffuse. Even in this gruop, however, it has been possible to achieve good results with careful attention to certain technical details.Patients with congenital aortic stenosis should be operated on before the development of the sequelae of severe left ventricular hypertension.

ISSN:0009-7322    

出版商:OVID    

年代:1962

数据来源: OVID

摘要:

Two cases of phlegmasia cerulea dolens are presented with acute venous obstruction, arterial spasm, and compromise of circulation to the extremity.

ISSN:0009-7322    

出版商:OVID    

年代:1962

数据来源: OVID

摘要:

Orthogonal electrocardiographic leads of 85 normal and 104 abnormal subjects obtained with a new lead system were examined for the counterparts of clinically significant findings in conventional 12-lead electrocardiograms. Most of the findings judged significant in conventional leads had easily recognizable counterparts in orthogonal leads. Excluding findings suggestive of ventricular enlargement, the conventional tracings of 40 subjects showed QRS abnormalities, and counterparts of these were identified in the orthogonal leads of all but one subject. Counterparts of findings suggesting ventricular enlargement could not be evaluated, since the range of normal variation of orthogonal leads obtained with the system used has not been established in quantitative terms. Conventional records of 99 subjects showed abnormalities of the S-T segments or T waves or both, and recognizable abnormalities of these portions of the curves were present in the orthogonal leads of 97 of the subjects.

ISSN:0009-7322    

出版商:OVID    

年代:1962

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1962

数据来源: OVID

摘要:

The high rate of necropsy in deaths among permanent residents of Rochester, Minnesota, provided a unique opportunity to study the prevalence of coronary heart disease and the frequency and mode of death resulting from this disease. In this community of approximately 30,000 population, necropsy was done in 73 per cent of all resident deaths during the years 1947 through 1952. Included in this group were 691 necropsies that represented 67 per cent of the 1,026 deaths of persons 20 years of age or older.Coronary heart disease caused death in 221 patients (23 per cent of all necropsies and 32 per cent of all necropsies on adults). These 221 coronary deaths in adults represented 41 per cent of the men and 22 per cent of the women. The coronary deaths were attributed to acute coronary failure (sudden death) in 94 patients (43 per cent), acute myocardial infarction in 87 patients (39 per cent), congestive heart failure in 32 patients (14 per cent) and thromboembolism in eight patients (4 per cent). The 87 patients dying during acute myocardial infarction died of congestive heart failure (30 per cent), myocardial rupture (24 per cent), acute coronary failure (23 per cent), and thromboembolism (14 per cent), with the remaining 9 per cent dyingof a combination of acute myocardial infarction and additional serious systemic disease.The greatest number of deaths from coronary heart disease occurred during the seventh decade of life in men and the eighth decade in women. At least one coronary artery exhibited from 25 to 100 per cent obstruction from atherosclerosis in 513 hearts (74 per cent of the adult necropsies).These necropsies, representing two thirds of all deaths in adults in this community, disclosed that significant coronary-artery disease was present in three of four adults and was the cause of death in four of 10 men and two of 10 women.

ISSN:0009-7322    

出版商:OVID    

年代:1962

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1962

数据来源: OVID