ABSTRACT
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.
Subject(s)
Cardiopulmonary Resuscitation/education , Cough , Death, Sudden, Cardiac/prevention & control , Adult , Aged , Aged, 80 and over , Coronary Artery Bypass , Emergency Medical Services/supply & distribution , Female , Humans , Male , Middle AgedABSTRACT
In 50 patients (30F, 20M), aged 47 +/- 8 who underwent artificial heart valve implantation, the transient ST segment elevation (uST) of at least 0.1 mV on ECG immediately after electrical cardioversion (KE) of atrial fibrillation (MP) was evaluated. uST of 2 +/- 0.7 mV, lasting for 1.5 +/- 0.8 minutes was observed in 52% of cases (15F, 9M). Occurrence of uST correlated significantly with the following parameters: enlarged left atrium, high values of energy delivered during KE, history of more than cardiosurgical operation. Inversely, uST did not depend on duration of MP, efficacy of KE, BMI and the time span between the operation and KE.
Subject(s)
Atrial Fibrillation/therapy , Electric Countershock/adverse effects , Electrocardiography , Adult , Atrial Fibrillation/complications , Atrial Fibrillation/diagnosis , Atrial Fibrillation/physiopathology , Cardiomegaly/complications , Female , Heart Valve Prosthesis Implantation , Humans , Male , Middle Aged , Reoperation , Risk FactorsABSTRACT
Five patients were operated on because of ruptured aneurysm of the sinus of Valsalva. In the cases with no concomitant VSD the surgical access from the aorta was used. The aorta was opened and the Fogarty catheter was introduced to the fistula. The "wind sock" of the aneurysm was pulled back to the aorta and excised. The opening was closed with double-line pledgetted polypropylene sutures. In severe aortic incompetence mechanical prostheses were implanted. One patient had bacterial endocarditis with reopening of the fistula and aortic valve incompetence that required reoperation. All patients are in a good clinical state. We recommend the use of Dacron patches even in small aneurysms to avoid re-opening of the fistula.
Subject(s)
Aortic Rupture/surgery , Sinus of Valsalva , Adult , Aortic Rupture/diagnosis , Aortic Rupture/etiology , Aortic Valve Insufficiency/etiology , Aortic Valve Insufficiency/surgery , Cardiac Catheterization , Echocardiography, Transesophageal , Female , Heart Valve Prosthesis , Humans , Male , Polyethylene Terephthalates , Polypropylenes , Prostheses and Implants , Reoperation , SuturesABSTRACT
Findings are reported on a prototype mini set for iontophoresis used to topically anesthetise the puncture spot before injection. The anesthetizing drug applied was a 2% solution of lignocaine which was iontophoresed for 10 min at a current of 1-2.5 mA. Observations were made according to a double-blind trial. After the lignocaine iontophoresis had been performed, 76% of injections were painless and 24% were reported painful. After the placebo iontophoresis, however, 87% of injections were painful. The difference is statistically significant. We conclude that iontophoresis by means of the mini set protects effectively against injection pain. The electronic structure of the device is unique and makes possible safe outpatient use.
