QT interval duration in 24-hour Holter monitoring after different interventional treatment of coronary artery disease in patients after the myocardial infarction.

QT interval prolongation is discussed as a possible risk factor of dangerous arrhythmias. The aim of this study was to evaluate the influence of different interventional treatment of coronary artery disease in patients after myocardial infarction on QT interval duration. Two groups of patients were analyzed. The first group (G1) consisted of 37 patients in whom PTCA was performed; the second group (G2)--42 pts after surgical myocardial revascularisation (CABG). The 24-hour electrocardiography monitoring was performed in all the patients. Results were analyzed especially considering the average daily values of QT, QTp, QTc and RR duration. In patients after CABG we observed statistically significant prolongation of QTc interval duration what was not noticeable in patients after PTCA. The cardiosurgical procedure of coronary by-pass grafting in patients with coronary artery disease after the myocardial infarction in contrary of PTCA may lead to significant prolongation of QTc interval duration. This problem needs further investigation.

[Unstable coronary disease--clinical course and significance of exercise tests in patients with left coronary artery stenosis]. / Niestabilna choroba wiencowa--obraz kliniczny i wartosc próby wysilkowej u chorych ze zwezeniem pnia lewej tetnicy wiencowej.

This study aimed at evaluating predictive value of exercise tests in case of left coronary artery stenosis. The study involved 57 patients with left coronary artery stenosis, including 10 patients with isolated left main stenosis (group X), and 47 patients with left coronary artery stenosis and multivessel involvement (group Y). Unstable angina was staged according to Booth et al. classification as type I or II. Exercise tests were performed according to Bruce's protocol. Unstable angina of type I was diagnosed in 51 (89%) patients, and type II in 6 (11%) patients. Electrocardiographic evidence of myocardial ischemia both et rest and anginal pain was seen in 46 (80%) patients. Electrocardiographic recording was within normal limits in 11 (20%) patients at rest. Clinical and ECG improvement was seen in 38 (66%) patients. Exercise tests in all of these patients were positive at low load work--mean 50 W. The obtained results suggest that patients with left coronary stenosis constitute heterogenous group. Therefore, prediction of the left main stenosis on the clinical ground alone is impossible. Exercise tests producing positive results at low load indicate with high probability critical multivessel lesions and/or left main stenosis in such patients.

[Cordipine in the treatment of patients with exacerbated coronary disease]. / Cordipina w leczeniu chorych z choroba wiencowaw fazie zaostrzenia.

The results of pharmacological treatment are presented in a group of 60 patients with exacerbation of coronary disease. The patients were divided into two subgroups: subgroup 1 of 26 patients with intensification of angina of effort, subgroup II of 34 patients with unstable angina. Combined pharmacological treatment was given: nitrates, B-adrenolytic drugs and nifedipine (Cordipin, Krka) Addition of Cordipin produced clinical and electrocardiographic improvement in 44 cases (73%): all patients in subgroup I and 18 (53%) in subgroup II. Cordipin was well tolerated, and produced no serious side effects.

[Personal observations of dobutamine effectiveness after surgery with extracorporeal circulation]. / Wlasne spostrzezenia w stosowaniu dobutaminy po operacjach w krazeniu pozaustrojowym.

This report describes the use of dobutamine in patients presenting a low output syndrome after cardiosurgical operations i EEC. Of 565 patients operated on valvular heart defects and coronary artery disease in 89 patients (15.7%) a low output syndrome was diagnosed and treated. Dobutamine proved to be effective in patients with moderate impairment of the left ventricular contractility. In those with severe left ventricular dysfunction, dobutamine was ineffective and other catecholamines ought to be used. The authors support the view that combined administration of dobutamine (or other catecholamines) and nitroglycerin in patients with low output syndrome proves to be superior to the effect of each single drug.

[Usefulness of Doppler echocardiography for evaluation of pulmonary hypertension based on the analysis of blood flow through the pulmonary artery]. / Przydatnosc echokardiografii dopplerowskiej dla oceny nadcisnienia plucnego, na podstawie analizy przeplywu krwi przez tetnice plucna.

In 41 patients with cardiac defects cardiac catheterization and echocardiographic examination were performed to evaluate the usefulness of Doppler echocardiography for estimation the grade of pulmonary hypertension. Parameter for noninvasive estimation of mean pulmonary artery pressure was the acceleration time (AcT) calculated basing on pulsed Doppler recordings of blood flow through the right ventricular outflow tract. Technics of examination and calculation of mean pulmonary artery pressure (MPAP) were concordant with Kitabatake's methodology. Patients were divided into 3 groups according to MPAP values measured by the invasive method. MPAP values obtained using Doppler method were not identical with results of direct measurements, but in the majority of patients (85%) Doppler method allowed to properly qualify patients to a respective group--with normal, moderate or very high pulmonary artery pressure. We think that the presented method is a semiquantitative one and useful for monitoring of pulmonary pressure in patients with cardiac defects.

[A case of glossopharyngeal neuralgia with paroxysmal asystole]. / Przypadek nerwobólu nerwu jezykowo-gardlowego z napadowa asystolia serca.

A 74-year-old patients is described who had typical attacks of glossopharyngeal neuralgia associated with very frequent episodes of cardiac arrest. Pacemaker implantation made possible controlling of episodes of cardiac arrest while full remission of attacks was obtained after carbamazepine treatment 900 mg daily.

[Comparative analysis of conservative and surgical treatment of the imminent myocardial infarct]. / Komparative Analyse der konservativen und chirurgischen Therapie des drohenden Herzinfarktes.

It is reported on 108 patients with the symptoms of the impending myocardial infarction, of whom 80 patients were treated conservatively. 51 patients developed a fresh definitive myocardial infarction. 28 patients were surgically treated, 5 of them died. Therefore, in patients with instable angina pectoris the possibility of an early coronary-surgical intervention should be taken into consideration to prevent the development of a definitive myocardial infarction.