Effect of heroin dependence on the heart

Heroin abuse and dependence has become a major medical problem. The present study was carried out to assess the cardiac effects of heroin addiction taken by sniffing. Clinical examination, ECG and echocardiographic examination were performed for 22 heroin addicts. The most frequent ECG abnormality was prolonged Q-Tc [27.27%], followed by short P-R interval and accelerated conduction [13.64% each]. Echocardiographic examination revealed that all cardiac valves were normal. The impurity of the heroin taken by sniffing among addicts in the present study might explain the absence of signs of endocarditis. The absence of any sign of endocarditis may be attributed to the small amount of heroin present in the adulterated used form

Systolic time intervals before and after therapy in moderate hypertension

Twenty with moderate hypertension [diastolic pressure 105 mm Hg-115 mm HG] were studied to assess the cardiac performance before and after therapy using STI, patients were devided into two groups where group I received combined triple therapt [0.1 reserpine, 25 mg hydralazine, hydrachlorothiazide 15 mg] in single tablets, group II received capoten 75 mg in divided doses, to compare the efficiency of single drug therapy and combined triple therapy. 10 normotensives were also included as control. It was found that left ventricular performance was significantly impaired in hypertensive patients before therapy without any evidence of heart failure. After therapy B.P fell significantly in both groups, more so in the first, the difference between the reduction of the mean pressure in the two groups was significant; left ventricular performance improved significantly in the first group only

Cardiac size and function in cases of arteriovenous fistula for dialysis in chronic renal failure

Ten patients admitted to the nephrology unit were candidated to arteriovenous fistula for repeated haemodialysis. They were submitted to through history taking, clinical examination, chest X-ray and electrocardiogram. All of them had no evidence of cardiac desease. The same lines of management and the same dosage of drugs were maintained constant all through the study. Echocardiography was performed pre-operatively and again one week after. There was a significant increase in heart rate, decrease diastolic blood pressure while the increase in the mean systolic pressure was insignificant. Also there was significant increase in the stroke volume, ejection fraction and cardiac output

Study of phonocardiographic changes in mitral stenosis before and after mitral valvotomy

Ten patients with pure mitral stenosis were studied before and after mitral valvotomy. All patients were subjected to full clinical examination, phonocardiographic, radiological and electrocardiographic studies. Well's index was calculated as [S[2]-OS]-[Q-S[1]]. S[2]-OS interval showed a better correlation with the severity of mitral stenosis than Q-S[1] interval and Well's index was more useful in assessing the stenosis. postoperatively it was found that there were a significant shortening of Q-S[1] interval, significant elongation of the S[2]-OS interval and significant change in Well's index

Clinical correlates and prognosis of exercise-induced silent myocardial ischemia in patients with coronary artery disease

This study assesses the diagnostic and prognostic significance of silent myocardial ischemia and compares patients who had this response with others who had angina during treadmill exercise testing. Thirty patients, who had positive responses to treadmill exercise testing [at least 1.5 mm ST segment depression for 80 msec after J point] with or without symptoms of angina, were studied. They were divided into two groups: 16 patients with silent ischemia [group I] and 14 patients with painful or symptomatic ischemia [group II]. The mean ages of the two groups were 50 and 45 years, respectively. The incidence of diabetes mellitus, hyperlipidemia, hypertension and smoking cigarettes were studied. The treadmill results were compared between the two groups: Peak exercise heart rate x blood pressure product was more in group I [246 +/- 54 vs 202 +/- 26]; exercise duration more than 5 minutes [21 patients in group I, 7 in group II]. Duration of ST depression was 5 minutes or more [4 patients in group I vs 11 in group II]. HR at onset of ischemia was less than 135 beats/min. [2 patients vs 11 patients]; number of patients experiencing VPBs during exercise was 4 in group I vs 3 in group II. Twenty-six patients [14 in group I, 12 in group II] were followed for a mean period of 16 months. The incidence of cardiac events was 2 in group I vs 5 in group II. It was concluded that, patients with silent ischemia could exercise to a higher HR and had ischemia of shorter duration than patients with painful ischemia. Follow-up revealed fewer incidences of coronary events in the patients with silent ischemia

prevalence and correlates of echocardiographic left ventricular hypertrophy in hypertensive patients

Sixty-one patients with systemic hypertension [HT] aged 28 to 75 years were studied by echocardiography to determine left ventricular hypertrophy [LVH] and its correlates. Fifteen normal controls were studied, also. Patients were divided according to blood pressure [BP] into three classes: Mild, moderate and severe HT. They were divided also according to left ventricular mass index [LVMI] into three groups: Group 1 [LVMI <95 g/m2 [=normal + 2 SD]], group 2 [LVMI 95-120 g/m2] and group 3 [LVMI >120 g/m2 [LVH group]]. Incidence of LVH was 75% [12 out of 16] in severe HT patients, 29% [6 out of 21] in moderate HT, and 4% [1 in 24] in the mild HT patients. Total 31% [19/61]. In the 19 patients with LVH, ECG revealed LVH in 7 [37%], but revealed LVH in 7 other patients. Percent fiber shortening [% FS] was 29% or less in 7 [37%]. Vcf was 0.9 or less in 10 [53%]. Diastolic function was assessed by LV posterior wall velocity in diastole [PWVD], it was 78 +/- 21 mm/s in LVH group, 93 +/- 23 in group 1 and 121 +/- 28 in normotensive controls [P <0.05 and <0.0001, respectively]. In conclusion, LVH was detected by echo in 31% of HT patients and was significantly related to the level of BP. ECG revealed LVH in 14 patients; systolic dysfunction was detected in 53% and 37% as assessed by Vcf and% FS, respectively. Diastolic function was significantly lower in LVH than in hypertensive patients without LVH