[Polarcardiographic diagnosis of an infarct of the anterior wall of the heart in its subacute and chronic stages]. / Polarkardiografska diagnoza na infarkt na prednata stena na surtseto v podostur i khronichen stadii.

One hundred and ten patients, with clinically confirmed acute myocardial infarction of the anterior wall in subacute and/or chronic stage were polarcardiographically examined. The polarcardiograms were recorded with e velocity of the record 100 mm/s by an original little analogue computer, designed at RIMT, Ministry of Public Health, connected to a 6-channel ECG apparatus, programmed for orthogonal Frank leads. The recorded curves of space magnitude (M), transversal magnitude (tm) and length were quantitatively analyzed for amplitudes and time intervals. The results obtained were compared with the data from the polarcardiographic studies on a control group of 114 healthy subjects. Positive ECG criteria for the diagnosis of myocardial infarction were found in 82 patients (74.54 per cent). Polarcardiographic criteria for myocardial infarction of the anterior wall (11-16) were found in another 28 patients (25.45%). Thus, myocardial infarction was polarcardiographically diagnosed in 108 patients (98.18%). Infarction criteria were polarcardiographically established in three healthy subjects, i.e. 2.63 per cent false positive diagnoses. The polarcardiography is a valuable additional method to the conventional ECG in making the diagnosis of myocardial infarction of the anterior wall in subacute and/or chronic stage, easily applicable in the cardiological practice.

[Effect of the use of lidocaine on patients with acute myocardial infarct]. / Efekt ot prilozhenieto na lidokain pri bolni s ostur miokarden infarkt.

In 411 patients with acute myocardial infarction (AMI) the effect of intravenous lidocaineeee administration was studied in a suboptimal dose - under 1,5 mg/min (to 1979) and in the optimal dose - over 1,5 mg/min, minimum 2 mg/min during the first 12 hours, with an average 24 h dose, 3,0 g in the course of 48 hours. The patients were grouped into three prognostic groups, depending on their initial assessment according to the coronaryprognostic index of M. R. Norris (1969). The indices, via which the drug effect was determined; were 13, the more significant ones beind: ventricular arrhythmias, early lethality rate, postinfarction angina pectoris and regression fo lesion-ischemic ST-T alterations. It was established, after the analysis of the data obtained, that the prophylactic and therapeutic use of lidocain, considerably reduced the incidence of ventricular arrhythmias in patients with AMI. Lidocain, in an optimal dose, reduces the incidence, justifying its routine administration. Lidocain effect on ventricular arrhythmias, the early lethality rate and certain complications (postinfarction angina pectoris, early cardiac insufficiency, regression of ST-T alterations) in AMI, depend on the initial prognosis and the stage of the hemodynamic disorders.

[Polarcardiographic diagnosis of posterior wall myocardial infarct in the subacute and chronic stages]. / Polarkardiografska diagnoza no miokardniia infarkta na zadnata stena v podostur i khronichen stadii.

One hundred and thirty patients with clinically confirmed myocardial infarction of the left ventricle posterior wall were polarcardiographically and electrocardiographically examined. Polarcardiograph was constructed at the RIMT, Ministry of Public Health. The spatial, sagittal size and gamma length were quantitatively analyzed. The results are compared with the PCG analysis of 114 healthy subjects. PCG is with 18.4 per cent more sensitive as compared with the single ECG with 12 leads, in making the diagnosis of myocardial infarction of the posterior wall in subacute and/or chronic stage.

[Changes in uricemia in acute myocardial infarct]. / Promeni v urikemiiata pri ostur miokarden infarkt.

The authors studied in dynamics the concentration of uric acid in 84 patients in the acute stage of myocardial, in 28 patients with non-stable stenocardia. The average value of uricemia, in the first 1--2 days post infarction is 6.35 +/- 2.23 mg%, considerably higher than that in case of non-stable stenocardia--4.75 +/- 1.25 mg%. In all the patients with myocardial infarction, 34.04 per cent have uricemia over 6 mg% (upper limit of the norm). The hypouricemia was normalized by the 14--15 day after the onset of infarction--4.25 mg%. The highest values of uric acid (up to 13 mg%) were found in case of severely progressing infarctions. A parallelism was established between serum concentration of uric acid and the creatinine-phosphokinase level. The possible pathogenic mechanisms of hyperuricemia in the acute stage of myocardial infarction are discussed.