ABSTRACT
Three members of one family had cardiomyopathy of the congestive type. Autopsies of 2 brothers revealed marked dilatation of the left ventricle with diffuse interstitial fibrosis of unknown origin. The father's diagnosis was based on clinical findings. In one brother, a positive latex fixation test for rheumatoid factor had been documented when he were healthy. Another brother had a positive test for rheumatoid factor almost simultaneously with the onset of the disease. It remained positive until both died. Thus, the positive rheumatoid factor presumably reflected primary or independent immunologic defects rather than a secondary immunologic mechanism in these cases of familial congestive cardiomyopathy.
Subject(s)
Cardiomyopathy, Hypertrophic/genetics , Rheumatoid Factor/analysis , Cardiomyopathy, Hypertrophic/diagnosis , Cardiomyopathy, Hypertrophic/etiology , Electrocardiography , HLA Antigens/genetics , Humans , Male , Middle Aged , Pedigree , Radiography, Thoracic , Rheumatoid Factor/immunologyABSTRACT
Prinzmetal's variant agina occurred in a 52-year-old man 10-11 h after the ingestion of alcohol, when blood levels of alcohol decreased almost to the zero level. Coronary arteriograms revealed significant narrowing in the left circumflex artery and the left anterior descending artery and minimal wall irregularity in the right coronary artery; however, both exercise and pharmacologic stress tests were negative. A withdrawal from an acute exposure to alcohol was discussed as a possible causative mechanism of the alcohol-induced Prinzmetal's variant angina in this case.
Subject(s)
Angina Pectoris, Variant/etiology , Coronary Vasospasm/etiology , Ethanol/adverse effects , Electrocardiography , Ethanol/blood , Humans , Male , Middle AgedABSTRACT
Serum concentrations of digitoxin and digoxin were measured in 145 cases with various heart diseases receiving maintenance doses of digitalis. Digitalis toxicity was seen in only 2 cases (1.4%). Day-to-day variation of serum concentration while taking the same daily dose was small in digitoxin therapy (13.8%), but a considerable variation was seen in digoxin therapy (24.4%). Serum concentrations of both digitoxin and digoxin were measured in the patients receiving digitoxin, and there was a positive correlation between the two (r = 0.66, p less than 0.001). This fact suggested that the effect of digitoxin was the sum of the effects of digitoxin and its metabolite, digoxin. In the patients taking digoxin, digitoxin was not detected in the serum. Serum digitoxin level had a significantly positive correlation to serum albumin level, presumably because digitoxin was retained in serum in the bound form to albumin. Minimal effective level, 10 ng/ml, was however obtained with higher daily dose of digitoxin in patients with lower serum albumin.
