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Biomedical subjects

A M Hutter

Publications and source records attributed to A M Hutter.

At least 73 records · Page 4Linked to original sources
PubMed1976

Plasma heparin neutralizing activity in coronary artery disease.

Platelets contain heparin neutralizing activity that is released into plasma after platelet aggregation. Increased amounts of plasma heparin neutralizing activity were found in patients with acute myocardial infarction, unstable angina pectoris and stable arteriographically confirmed coronary artery disease. Plasma heparin neutralizing activity levels provide additional evidence for a role of platelet aggregation in coronary artery disease.

Angina Pectoris↗
PubMed1976

Atrial tachyarrhythmias in acute myocardial infarction.

Causative factors, clinical consequences and treatment of atrial tachyarrhythmias were reviewed in 917 monitored patients with definite acute myocardial infarction. Significant atrial tachyarrhythmias were found in 104 (11 per cent) of them and included atrial fibrillation in 67, atrial flutter in 29 and paroxysmal atrial tachycardia in 33. These episodes were single in 79 patients and multiple in 25, and began within the first four days of acute myocardial infarction in 90 per cent of the patients. Fifty per cent of these atrial tachyarrhythmias were heralded by premature atrial contractions. The incidence of atrial tachyarrhythmia was not related to the location of the acute myocardial infarction or to the presence or degree of power failure; however, atrial tachyarrhythmias were significantly more frequent in patients with pericarditis. Atrial tachyarrhythmias were well tolerated in almost one fifth of the patients, caused marginal compromise in almost two thirds and led to severe clinical deterioration in one fifth. Paroxysmal atrial tachycardia rarely required specific treatment, atrial fibrillation was best managed with intravenous administration of digoxin except when associated with severe clinical compromise, and atrial flutter generally required cardioversion or rapid intravenous therapy and usually caused severe clinical deterioration. Over-all, atrial tachyarrhythmia was not associated with a significantly increased mortality, and in those who died, death was not related specifically to the atrial tachyarrhythmia but rather to the severity of the underlying acute myocardial infarction. However, persisting atrial tachyarrhythmias, particularly atrial flutter which tends to be refractory to both heart rate control and cardioversion, may contribute indirectly to morbidity and mortality.

Adult↗
PubMed1975

The significance of bundle branch block during acute myocardial infarction.

Analysis of the course of 71 patients with acute myocardial infarction complicated by bundle branch block (BBB) confirms a high incidence of atrioventricular (A-V) block (42 per cent) and severe pump failure (35 per cent) in these patients. Hospital mortality was not correlated with BBB per se, but rather with the associated development of second or third degree A-V block (57 per cent with A-V block vs. 12 per cent without A-V block; p less than .0005) or severe pump failure (35 per cent with vs. 11 per cent without severe pump failure; p less than .001). However, late mortality was high and not significantly different among those surviving hospitalization whether transient A-V block was present or absent. Eight of 11 late deaths were sudden. Temporary pacing could not be shown to alter hospital survival statistically, but made the onset of complete heart block a hemodynamically smooth and clinically undetectable event in several patients who later survived. The place of permanent pacing in these patients cannot be clearly determined on the basis of this study or in the available literature. More data obtained either by pooling the experience of several centers or from a prospective randomized study are needed to determine the indications for permanent pacemakers.

Adult↗
PubMed1975

Variant angina pectoris: Clinical and anatomic spectrum and results of coronary bypass surgery.

Twenty patients are described with the variant angina syndrome (recurrent angina at rest with S-T segment elevations occurring only during pain and no evolution of infarction). In contrast to patients previously reported on, all but one had progressive unstable angina before hospitalization. Angina was frequently associated with arrhythmias, including ventricular fibrillation (2 instances), ventricular tachycardia (4), frequent ventricular premature beats (5), atrioventricular block (4), sinus bradycardia (2), sinoatrial exit block (1) and supraventricular tachycardia (1). Seventeen patients had significant proximal stenosis of one or more coronary arteries with good distal vessels. Bypass surgery in 15 of these patients resulted in one noncardiac postoperative death, one perioperative infarction and relief of pain in all 14 survivors. After a 17 month mean follow-up period (range 4 to 38 months), all survivors are pain-free. Three patients had no significant coronary disease; one of these became asymptomatic with medical therapy, one continues to have angina and one died suddenly. Patients with normal coronary arteries could not be distinguished clinically or by electrocardiogram from those with severe obstructive lesions. This experience suggests that all patients with the variant angina syndrome should be studied by coronary angiography, and that most patients with significant fixed coronary lesions will do well after coronary bypass surgery.

Adult↗