Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 27
Filter
1.
Chest ; 105(2): 604-5, 1994 Feb.
Article in English | MEDLINE | ID: mdl-8306773

ABSTRACT

We describe a case of prolonged sinus arrest resolved by external cardiac massage following intravenous infusion of dipyridamole, during a thallium myocardial perfusion test. The arrhythmia, presumably due to an acute drug adverse effect, had not been previously described (to our knowledge) as a complication of dipyridamole stress testing.


Subject(s)
Dipyridamole/adverse effects , Heart Arrest/chemically induced , Arrhythmia, Sinus/chemically induced , Bradycardia/chemically induced , Dipyridamole/administration & dosage , Exercise Test/adverse effects , Humans , Infusions, Intravenous , Male , Middle Aged , Syncope/chemically induced
4.
Pacing Clin Electrophysiol ; 14(7): 1093-7, 1991 Jul.
Article in English | MEDLINE | ID: mdl-1715545

ABSTRACT

Five years prior to presentation, a 29-year-old woman received a transvenous pacemaker (DDD) for sick sinus syndrome and nodo-hisian pathology. After pacemaker insertion, she complained of recurrent febrile episodes. Her pacemaker related endocarditis was quite unusual for the infecting organism (a micrococcus) and for an acquired tricuspid valve stenosis. The suspected cause was confirmed at surgery.


Subject(s)
Endocarditis, Bacterial/etiology , Pacemaker, Artificial , Postoperative Complications , Tricuspid Valve Stenosis/etiology , Adult , Echocardiography , Endocarditis, Bacterial/diagnostic imaging , Female , Humans , Micrococcus , Radiography, Thoracic , Tricuspid Valve Stenosis/diagnostic imaging
5.
Chest ; 95(1): 124-9, 1989 Jan.
Article in English | MEDLINE | ID: mdl-2642405

ABSTRACT

We report our prospective experience with sensitivity, specificity, predictive values and efficiency of echocardiography in diagnosing AD involving the ascending aorta (type A). We studied two groups of patients with both echocardiography and aortography. Group 1 was made up by 46 consecutive patients with clinical suspicion of AD. Type A AD was confirmed in 23 cases. Group 2 was comprised of 509 adult patients who had been studied during the same period with both aortography and echocardiography (including 46 patients from group 1); prevalence of type A AD in this group was 4.9 percent. We conclude that the diagnostic usefulness of echocardiography in patients with suspected type A AD is limited by its moderate sensitivity and predictive positive value. Aortography remains the major step in diagnosis. Within these limitations, echocardiography is useful in confirmation of clinical suspicion if all three main echocardiographic signs are present (predictive positive value: 100 percent).


Subject(s)
Aortic Aneurysm/diagnosis , Aortic Dissection/diagnosis , Echocardiography , Adult , Aged , Aged, 80 and over , Aortic Dissection/diagnostic imaging , Aortic Aneurysm/diagnostic imaging , Aortography , Female , Humans , Male , Middle Aged , Predictive Value of Tests , Prospective Studies , Sensitivity and Specificity
7.
Chest ; 91(2): 277-8, 1987 Feb.
Article in English | MEDLINE | ID: mdl-3802945

ABSTRACT

We used amiodarone as the only drug in three consecutive patients with hypertrophic cardiomyopathy, marked systolic anterior motion of the mitral valve on M-mode echocardiogram, and paroxysmal atrial fibrillation. The effective control of atrial fibrillation was associated with good symptomatic relief and with reduction until disappearance of the systolic anterior motion of the mitral valve. These data were confirmed in a follow-up of 46, 30 and 30 months.


Subject(s)
Amiodarone/therapeutic use , Cardiomyopathy, Hypertrophic/physiopathology , Mitral Valve/physiopathology , Adult , Cardiomyopathy, Hypertrophic/drug therapy , Electrocardiography , Female , Follow-Up Studies , Humans , Male , Middle Aged , Mitral Valve/drug effects
8.
G Ital Cardiol ; 16(5): 401-10, 1986 May.
Article in Italian | MEDLINE | ID: mdl-3732725

ABSTRACT

We evaluated sensitivity, specificity and predictive values of echocardiography in detecting aortic dissection. We studied in the same period of time two groups of consecutive patients with good quality echocardiographic examination. Group I, with high prevalence of the disease (76%), was composed of 25 patients; 19 patients with aortic dissection (11 of the type A and 8 of the type B) and 6 patients with clinical and echocardiographic suggestion of aortic dissection which was not confirmed by angiography. Group II, with lower prevalence of the disease (4%), was composed of 382 adult patients who underwent aortic angiography for different reasons. In this second group there were 16 out of the 19 patients of the first group, with aortic dissection, who underwent aortic angiography and the 6 patients with suspicion of aortic dissection which was not confirmed by angiography. Type A dissection: The finding of intimal flap on echocardiography was highly specific (98%) but relatively insensitive (45%); its positive predictive value was low (50% in the first and 34% in the second group). The specificity of increased thickness of aortic wall was lower (89%) and the sensitivity higher (81%); its positive predictive value was satisfactory in the first group (81%) and very low in the second (13%). Aortic root dilatation was fairly specific (76%); the sensitivity of this finding was high (87%) but its positive predictive value was still low (66% in the first and 7% in the second group). To conclude: the positive predictive value of the 3 echocardiographic signs of aortic dissection varied, in relation to the different prevalence of the disease, from 50, 81 and 66% in the first group to 34, 13 and 7% in the second group; the diagnostic utility of the echocardiographic examination appeared limited, in these patients, by the low values of sensitivity and positive predictive values; aortography is still the most valuable technique in the diagnosis of aortic dissection; echocardiography was useful in the early evaluation of some emergency cases (chest pain, shock, collapse...) suggesting sometimes the correct diagnostic hypothesis of aortic dissection; in the presence of a typical clinical picture, the contemporary presence of the 3 echocardiographic signs, though having the lowest sensitivity (36%), was highly predictive of the type A dissection. Type B dissection: In these patients the clinical picture, in contrast with type A dissection, Type A, was not indicating careful and complete echocardiographic aortic scan. Then the echocardiographic examination was even more disappointing: sensitivity 25%.


Subject(s)
Aortic Aneurysm/diagnosis , Aortic Dissection/diagnosis , Echocardiography , Adult , Aged , Aortic Dissection/diagnostic imaging , Aortic Aneurysm/diagnostic imaging , Evaluation Studies as Topic , Female , Humans , Male , Middle Aged , Radiography
9.
Boll Ist Sieroter Milan ; 65(4): 249-53, 1986.
Article in English | MEDLINE | ID: mdl-3539148

ABSTRACT

Short retrospective review of 77 cases of bacterial endocarditis, observed in the 1980-84 period, and diagnosed by means of echography and blood culture. Alfa haemolytic streptococcus strains were isolated (47.6% of 42 isolated strains) followed by Staphylococcus aureus (16.7%) and Staphylococcus epidermidis (11.9%). Positive bloodculture were more frequent in the patients with valvular prosthesis. The results are analysed and some comments are done.


Subject(s)
Endocarditis/diagnosis , Adolescent , Adult , Aged , Blood Cells/analysis , Cells, Cultured , Echocardiography , Endocarditis/microbiology , Female , Humans , Male , Middle Aged , Retrospective Studies
10.
G Ital Cardiol ; 15(7): 685-94, 1985 Jul.
Article in Italian | MEDLINE | ID: mdl-4076702

ABSTRACT

42 consecutive patients with infective endocarditis on native valves, according to Pelletier and Petersdorf's criteria of definite (13 pts), probable (12 pts.) and possible (17 pts) endocarditis, were identified and prospectively followed-up with M-mode and two-dimensional echocardiography, since 1980. We compared: 1) these three groups; 2) survivors not referred for surgery versus surgical patients plus nonsurvivors; 3) patients who suffered embolic events versus those who did not; 4) patients with severe-moderate heart failure versus those with no failure or mild failure; 5) patients with aortic valve echocardiographic vegetations versus those with mitral valve vegetations. Furthermore 11 of these patients who did not undergo surgery (9 with mitral and 2 with mitro-aortic vegetations on echo) were serially followed-up with echocardiography for 6-42 months (average: 32 months). The presence of ultrasound detectable vegetations itself and their size, without considering their site, did not identify a major risk of embolization, heart failure, death or need of surgery. The site of vegetations was the only significant feature in our series. It identified a high-risk group and a relatively low-risk group. Aortic valve involvement, with echocardiographic vegetations, was related to severe or moderate heart failure (P less than 0.01), death or need of surgery (P less than 0.05). Mitral valve involvement carried on a relatively low risk. The 9 patients with mitral valve vegetations only, not referred for surgery and followed-up, did well on medical treatment and returned to work. They did not have relapses or embolization. On serial echocardiographic examinations, mitral vegetations become smaller in the long run. Two years after the acute episode, usually echocardiography did not allow identification of vegetations.


Subject(s)
Echocardiography , Endocarditis, Bacterial/diagnosis , Heart Valve Diseases/diagnosis , Embolism/etiology , Endocarditis, Bacterial/complications , Endocarditis, Bacterial/surgery , Female , Follow-Up Studies , Heart Failure/etiology , Humans , Male , Prognosis
11.
Chest ; 86(5): 791-3, 1984 Nov.
Article in English | MEDLINE | ID: mdl-6488925

ABSTRACT

An unusual M-mode echocardiographic feature of mitral valve endocarditis is described: systolic anterior motion of the mitral valve, likely due to mitral valve vegetations, protruding during systole into the left ventricular outflow tract. The presence of mitral valve vegetation was confirmed at operation.


Subject(s)
Echocardiography , Endocarditis, Bacterial/diagnosis , Mitral Valve , Humans , Male , Middle Aged , Streptococcal Infections/diagnosis
12.
G Ital Cardiol ; 14(7): 479-91, 1984 Jul.
Article in Italian | MEDLINE | ID: mdl-6489659

ABSTRACT

We estimated sensitivity, specificity, predictive value and efficiency of echocardiography in detecting vegetations and ruptured valves in patients with aortic and/or mitral valves infective endocarditis. We studied two groups of patients, in whom both high quality echocardiography examination and surgical inspection of heart valves were available. Group I: 16 patients (32 valves) with aortic and/or mitral valves endocarditis and surgical demonstration of vegetations and/or ruptured valves. In this group the prevalence of vegetations was 65.6%, the prevalence of ruptured valves was 43.7%. Group II was composed of the 16 patients of group I with endocarditis and of 93 other patients without endocarditis. In this group (139 valves) the prevalence of vegetations was 15%, the prevalence of ruptured valves was 13.6%. Echocardiographic detection of valve vegetations. Sensitivity (71.4%) was the same in group I and II. Specificity was 91% in group I and 91.5% in group II. The positive predictive value was 93.7% in group I and 60% in group II. The negative predictive value was 62.5% and 94.7% respectively. Echocardiographic detection of ruptured valves: sensitivity was 50% in I and 42% in group II. Specificity was 94.4% in group I and 99% in group II. The positive predictive value was 87.5% in group I and 89% in group II. The negative predictive value was 70.8% in group I and 91.5% in group II. The echocardiographic efficiency was higher in group II: 88.4% for vegetations and 91.3% for ruptured valves. This reflects the high specificity and the high definition of normal valves in this unselected low-risk group. The efficiency was lower in group I: 78% for vegetations and 75% for ruptured valves. This reflects the poor sensitivity and the failure of the test to identify all the vegetations or the ruptured valves in this selected high-risk group.


Subject(s)
Echocardiography , Endocarditis, Bacterial/diagnosis , Adolescent , Adult , Aortic Valve/pathology , Endocarditis, Bacterial/pathology , Female , Humans , Male , Middle Aged , Mitral Valve/pathology , Prospective Studies , Rupture, Spontaneous
14.
G Ital Cardiol ; 13(11): 347-50, 1983 Nov.
Article in Italian | MEDLINE | ID: mdl-6667822

ABSTRACT

We describe a patient with mitral valve endocarditis and valve obstruction due to a large vegetation on a previously normal mitral orifice. The diagnosis was suggested before surgery by two-dimensional echocardiography. We review the clinical features of 13 previously reported patients. In view of its ominous prognosis, accurate diagnosis of acute mitral obstruction is vital. This condition requires emergency surgery.


Subject(s)
Endocarditis, Bacterial/complications , Mitral Valve Stenosis/etiology , Adolescent , Adult , Aged , Echocardiography , Female , Humans , Male , Middle Aged , Mitral Valve Stenosis/diagnosis
16.
G Ital Cardiol ; 12(2): 157-60, 1982.
Article in Italian | MEDLINE | ID: mdl-7173543

ABSTRACT

In two patients with infective endocarditis and prolapsing echoes in the left ventricular outflow tract (patient with aortic valve involvement) and in the left atrium (patient with mitral valve involvement), easy differentiation between prolapsing vegetation and flail valve leaflet was made possible by means of M-mode and cross-sectional echocardiography.


Subject(s)
Echocardiography/methods , Endocarditis, Bacterial/diagnosis , Adolescent , Aortic Valve , Diagnosis, Differential , Female , Heart Injuries/diagnosis , Heart Neoplasms/diagnosis , Heart Valve Diseases/diagnosis , Heart Ventricles/physiopathology , Humans , Male , Middle Aged , Myxoma/diagnosis
SELECTION OF CITATIONS
SEARCH DETAIL
...