Self--administered cough cardiopulmonary resuscitation (c-CPR) in patients threatened by MAS events of cardiovascular origin.

Sudden cardiac death caused by cardiac arrhythmia's or asystolies in patients with coronary heart disease can often be avoided if resuscitation is administered immediately, preferably before the patient loses consciousness. In cases when rapid help is not available usually death occurs. We have studied a method of cardiopulmonary resuscitation (CPR) which can be self--administered by patients trained in recognizing imminent arrival of life-threatening Morgani Adams Stokes (MAS) events. The recent study comprised the three methods of investigation in three separate groups of patients: the first group underwent invasive procedures (20 pts), the second non invasive Doppler studies (31 pts) and the third in-and outhospital clinical observations (115 pts). The results indicate that evoked coughing can effectively prevent fainting and maintaining consciousness until conventional CPR help becomes available.

Pregnancy and delivery prognostic risk score for women with congenital heart disease and acquired valvular heart disease.

Hemodynamic changes related to pregnancy in women with Congenital Heart Disease (ConHD) or Acquired Valvular Heart Disease (AVHD) require special medical care during pregnancy and especially immediately prior to, and after delivery. Following a five year retrospective study (1978-1982), the authors monitored prospectively over a period of 12 years (1983-1994), 378 pregnancies in 252 women with ConHD and AVHD. Based on the results of the initial clinical examination and monthly follow-up visits, a numerical risk score was assigned for each patient. The study showed good conformity between the predictive risk score values and the patient's condition in the course of pregnancy and delivery. Thus, this method represents a novel and potentially very useful clinical tool for management of pregnancy in patients with ConHD and AVHD.

Outpatient cardiac catheterizations: analysis of patients requiring admission.

The purpose of this study was to review the results of the first 1,000 outpatient cardiac catheterizations performed at our hospital with special emphasis on patients who were hospitalized. Nearly all patients had percutaneous femoral artery catheterization using #8F catheters. There were no deaths. The major complications included two myocardial infarctions and four cerebral emboli. Surgery on the femoral artery was required in 2 patients (1 occlusion and 1 pseudoaneurysm), 7 patients developed unstable angina without subsequent infarction, and 4 patients had ventricular tachycardia or fibrillation. Complications requiring admission were found in 39 patients. Another 59 were admitted, 51 for revascularization procedures. Of the latter 51 patients, 27 had main left coronary stenosis of 50% of greater. We have found outpatient catheterization to be a safe procedure. Complications requiring admission occurred in 3.9% of the patients. The most common reason for admission was to perform urgent bypass surgery in patients with main left coronary stenosis in excess of 50%.