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Biomedical subjects

A S Gooch

Publications and source records attributed to A S Gooch.

At least 37 records · Page 2Linked to original sources

Exercise testing and portable ECG recording in arrhythmia-prone patients.

To detect transient arrhythmias or conduction disturbances, 200 patients with the symptoms of palpitations, syncope or dizziness, and patients with coronary heart disease, angina pectoris, arrhythmias or conduction disturbances on resting 12-lead electrocardiogram, were studied by submaximal treadmill exercise and portable Holter recording. Thirty-nine patients (19.5%) had arrhythmias on the resting 12-lead ECG, 136 patients (68%) showed arrhythmias either on treadmill or Holter recording or both. Eighty-nine patients (44.5%) showed arrhythmias on exercise, while 123 patients (61.5%) had rhythm or conduction disturbances on Holter recording. Twenty-two patients (11%) had arrhythmias only on treadmill walking, while 68 (34%) had arrhythmias only with the Holter. In six patients different arrhythmias was noted by each method. Although the Holter recording technique affords a higher yield of recording transient arrhythmias than did exercise testing, both methods are useful and complementary in evaluating the ambulatory patients suspected of having rhythm or conduction disturbances.

Adolescent↗

Prolapse of the tricuspid leaflets in the systolic murmer-click syndrome.

Right ventriculography was used to assess the tricuspid valve in 61 patients with systolic murmur-click syndrome. Systolic murmurs were present in 47 cases, and 32 had clicks. Mitral valve prolapse was present in 52 patients. Late systolic prolapse of the tricuspid valve was demonstrated in 32 patients (52.4%). In 9 cases, prolapse involved the tricuspid valve alone. In the systolic murmur-click syndrome, prolapse may involve either or both of the atrioventricular valves.

Adolescent↗

The influence of exercise on atrial flutter.

To study the effect of exercise on atrial flutter the electrocardiogram was recorded continuously before, during and after low level treadmill walking in twenty-two ambulatory patients. Atrial flutter rates increased during exercise testing in four patients. Improved A-V conduction with consequent higher ventricular rates occurred during exercise in thirteen subjects. One patient, with 4:1 conduction at rest, continued with 4:1 block throughout exercise testing, was believed to be over-digitalized. During the recovery period after exercise, ten patients transiently developed periods of Wenckebach A-V block. Walking exercise induced 1:1 conduction in six patients and was promoted by the following circumstances: 1) atrial rates of 250/min or less; 2) inadequate dosage of digitalis; and 3) the administration of quinidine. For the patient with chronic atrial flutter, treadmill testing provides a simple method for demonstrating the range of changes of A-V conduction and for deriving implications for appropriate drug therapy.

Adult↗