Subject(s)
Echocardiography/methods , Ventricular Function , Adult , Exercise Test , Female , Humans , Male , MotionSubject(s)
Coronary Vessel Anomalies/complications , Death, Sudden/etiology , Adolescent , Adult , Child , Child, Preschool , Coronary Disease/etiology , Coronary Vessel Anomalies/diagnosis , Coronary Vessel Anomalies/surgery , Electrocardiography , Female , Hemodynamics , Humans , Infant , Male , Middle AgedABSTRACT
Myocardial perfusion scintigraphy by means of the microsphere technique is a valuable method for detecting regional myocardial scars. The use of the microsphere technique is indicated in all patients who have had myocardial infarction and before coronary bypass operations. In a certain group of patients with severe but atypical angina pectoris and a normal coronary arteriogram and in some arrhythmias the perfusion scintigram can provide information on changes coronary microcirculation. The assessment of myocardial blood flow redistribution under pharmacological intervention is a further indication for the microsphere technique.
Subject(s)
Heart/diagnostic imaging , Myocardial Infarction/diagnostic imaging , Angina Pectoris/diagnostic imaging , Arrhythmias, Cardiac/diagnostic imaging , Coronary Artery Bypass , Electrocardiography , Follow-Up Studies , Humans , Methods , Microcirculation , Myocardial Infarction/physiopathology , Myocardial Infarction/surgery , Radionuclide ImagingABSTRACT
Secundum ASD was diagnosed in five members of three generations of one family. Three of them had prolonged A-V conduction. These findings and those reported in the literature suggest that the combination of secundum ASD with prolonged A-V conduction is an autosomal dominant hereditary disease.
Subject(s)
Heart Septal Defects, Atrial/genetics , Electrocardiography , Heart Septal Defects, Atrial/diagnosis , Humans , Karyotyping , Male , Middle Aged , Pedigree , PhonocardiographyABSTRACT
A numerical index was developed for reproducible and comparative judgement of the degree of coronary sclerosis. This graded index method takes into account the amount of stenosis as well as its distance from the ostium. 152 selective coronary angiograms were evaluated by this method. There was a close correlation between the degree of sclerosis and collaterals; the index of 63 patients with collaterals was 3.5 times that of patients without collaterals. Anastomoses and collaterals showed typical localisations depending on the antomical position of stenoses. For the evaluation of the clinical importance of collaterals, a classification into one, two and three vessel disease is not adequate; the reduction in perfusion cannot be reliably estimated and should be judged by a more detailed index method.
Subject(s)
Arteriosclerosis/pathology , Collateral Circulation , Coronary Disease/pathology , Angiography , Coronary Angiography , Humans , MathematicsABSTRACT
While coronary angiography was within normal limits in three patients with recurrent severe attacks of angina and non-transmural postero-lateral wall myocardial infarction, myocardial perfusion scintigraphy demonstrated an abnormal distribution pattern. In addition to recanalised thrombosis, embolism or spasm, abnormalities in the microcirculation are possible causes of the discrepancy between the coronary arteriogram and the scintigram. Myocardial perfusion scintigraphy is of particular diagnostic significance in this group of patients with coronary heart disease but normal coronary angiography. Treatment in the presence of this finding consists of administration of platelet-aggregation inhibitors.
Subject(s)
Coronary Circulation , Myocardial Infarction/physiopathology , Adult , Coronary Angiography , Heart/diagnostic imaging , Humans , Male , Microcirculation , Myocardial Infarction/diagnostic imaging , Radionuclide ImagingABSTRACT
In 7 patients with arrhythmias of various origin the myocardial scintigram displayed either a diffuse or circumscript defect of the perfusion. The coronary arteriogram was normal in all patients. The localized defect of the perfusion in 2 patients was in the region of the upper part of the interventricular septum. Both had a left bundle brunch block. A correlation between the perfusion defect and the electrophysiological abnormality seems probable. The perfusion defect in one of the patients is most probably caused by a previous myocarditis followed by fibrous changes. In the other 6 patients the cause for the perfusion defect is not obvious. A history of myocarditis is missing. The presence of "small vessel disease" in those patients has however to be considered. Our results point to the relation between an abnormality of the microcirculation and arrhythmias in younger patients.
Subject(s)
Arrhythmias, Cardiac/physiopathology , Coronary Circulation , Adult , Arrhythmias, Cardiac/etiology , Bundle-Branch Block/physiopathology , Coronary Angiography , Coronary Disease/complications , Female , Heart Conduction System/physiopathology , Humans , Microcirculation , Middle Aged , Radionuclide ImagingABSTRACT
A supraventricular re-entry tachycardia was successfully treated in a patient with WPW and sick-sinus syndrome by permanent rapid atrial pacing and ventricular demand pacing. The use of a demand pacemaker with bipolar electrode avoided slow ventricular rates resulting from second degree A-V block during rapid atrial pacing. The trigger system of this pacemaker was not disturbed by unipolar atrial stimulation. Ventricular rates responded satisfactorily to physical and to emotional stress as a result of improved A-V conduction in these circumstances. Rapid atrial pacing has prevented the re-entry tachycardia. In an emergency the atrial pacemaker can be inhibited by a magnet, but otherwise discharges permanently at a constant rapid rate.
Subject(s)
Pacemaker, Artificial/methods , Tachycardia/therapy , Electrocardiography , Heart Atria , Heart Block/therapy , Heart Ventricles , Humans , Male , Middle Aged , Sinoatrial Node , Tachycardia/complications , Time Factors , Wolff-Parkinson-White Syndrome/complicationsABSTRACT
In contrast to secondary occlusion idiopathic thrombosis of the superior vena cava occurs rarely. With a good collateral flow through anatomically preformed venous channels the clinical picture may have an insidious course obscuring diagnosis. Collateral circulation via upper oesophageal varices is commonly overlooked. Anticoagulants should be given to prevent progression. Surgically vein transplants, by-pass operations, and thrombectomy have been tried. Follow-up in 4 patients shows that even without surgical intervention the prognosis is good despite the danger of haemorrhage from the varices.
Subject(s)
Thrombophlebitis/diagnosis , Vena Cava, Superior , Adult , Anticoagulants/therapeutic use , Collateral Circulation , Esophageal and Gastric Varices/etiology , Female , Humans , Male , Middle Aged , Prognosis , Thrombophlebitis/complications , Thrombophlebitis/etiology , Thrombophlebitis/therapy , Veins/transplantationABSTRACT
Total lipid, free and esterified cholesterol and triglycerides significantly increase in concentration with increasing age. Palmitic, palmitoleic, oleic and linoleic acid behave in the same way. Free fatty acids, phospholipids and stearic acid show the same concentrations in all groups of age. C20 fatty acids demonstrate a competitive regulatory mechanism of desaturase activity in their age dependant distribution. While the 20:3(n-9), a product of the endogenous (n-9) family, increases, the 20:3(n-6) and 20:4(n-6), both desaturation and chain elongation products of the essential n-6 family, decrease. Such behavior has been demonstrated in many feeding studies (12, 13, 15, 16, 17, 29) and is interpreted as a result of competitive substrate interaction on desaturase activity.
Subject(s)
Fatty Acids/blood , Lipids/blood , 8,11,14-Eicosatrienoic Acid/blood , Adolescent , Adult , Age Factors , Aged , Arachidonic Acids/blood , Child , Child, Preschool , Cholesterol/blood , Fatty Acids, Nonesterified/blood , Humans , Infant , Linoleic Acids/blood , Male , Middle Aged , Oleic Acids/blood , Palmitic Acids/blood , Phospholipids/blood , Risk , Stearic Acids/blood , Triglycerides/bloodABSTRACT
In patients aged 24 to 45 years with angina pectoris, pathological changes in the exercise electrocardiogram and a normal coronary angiogram, a disturbance of the pattern of myocardial perfusion could be demonstrated in addition by scintigraphy. The cause of this disturbance of myocardial perfusion is unknown. Myocardial scintigraphy is indicated (1) to demonstrate an otherwise undetectable disturbance in the blood flow of the myocardium with a morphologically normal coronary system, (2) in subtotal coronary stenosis before the decision to perform a coronary bypass operation is made, (3) in cases of anginal syndrome with normal coronary angiograms.
