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Biomedical subjects

A T Weiss

Publications and source records attributed to A T Weiss.

83 records · Page 5Linked to original sources
PubMed1983

Nuclear left ventriculography at rest and during atrial pacing in the evaluation of coronary artery disease.

This study was undertaken to examine the value of rapid atrial pacing (RAP) combined with left-ventricular nuclear (LVN) angiography in the diagnosis of ischemic heart disease. It included 32 patients: 12 normal subjects and 20 with clinical coronary artery disease (CAD) and greater than 50% narrowing of a coronary artery (significant CAD). The ECG and an LVN angiogram (LVNA) were recorded at rest and during graded RAP. In the normal subjects, left-ventricular wall motion was normal at rest and during atrial pacing, but a wall motion abnormality (WMA) appeared in one subject. Left-ventricular ejection fraction (EF) did not change significantly. In the 20 patients with significant CAD, the diagnostic sensitivity of the ECG during RAP was 100% and 90% for the nuclear angiogram (presence or appearance of WMA at rest and during RAP). The mean EF in this group decreased from 0.38 to 0.31. WMA on the LVNA was present in 79% of patients with significant left-anterior descending, in 44% of those with right, and in 33% of those with circumflex coronary artery disease. WMA (at rest or on pacing) occurred in 17% of patients with 50 to 89% narrowing of an artery, in 50% with 90 to 99% narrowing and in 68% with total obstructions. The LVNA (rest and/or RAP) identified patients with significant single-vessel disease, but underestimated the extent of double-and triple-vessel disease. The LVNA at rest and during atrial pacing was an excellent method of evaluating significant coronary artery disease.

Adult↗
PubMed1982

Long-term effect of verapamil in hypertrophic cardiomyopathy.

We studied the long-term effects of oral verapamil (240-720 mg) daily on 10 patients with hypertrophic cardiomyopathy. Symptomatic improvement of chest pain or shortness of breath occurred in all the patients although 4 deteriorated after 1 year. Side effects occurred in 3 patients. The electrocardiogram improved in 4 subjects. Quantitative echocardiography showed a significant (P less than 0.05) decrease in left ventricular contractility (% delta S decreased from 44 +/- 9 to 38 +/- 9, mean +/- SD), septal hypertrophy (1.6 +/- 0.5 to 1.4 +/- 0.5 cm) and % thickening of the left ventricular free wall (79 +/- 29 to 57 +/- 22). There was also moderate evidence of improvement in left ventricular compliance; mitral valve EF slope increased from 38 to 55 mm/sec and left atrial diameter decreased.

Adult↗
PubMed1982

Sub-valvular pseudo-aneurysm after aortic valve replacement. A case report.

Subvalvular pseudo-aneurysm is a rare and potentially lethal complication of aortic valve replacement. The demonstration of such pathology by cardiac catheterization should be considered an indication for surgery. Recommendations for prevention of this false aneurysm and for surgical repair of the left ventricular outflow tract are discussed in this case report.

Aorta, Thoracic↗
PubMed1981

Cardiac rupture and ventricular septal defect in isolated right coronary artery disease.

A patient is described who had both ventricular septal defect and then cardiac rupture with death within 24 hours of the onset of acute posteroinferior myocardial infarction. At autopsy he was found to have single-vessel disease involving the right coronary artery. Isolated disease of the right coronary artery can produce unexpected, fatal mechanical complications.

Aged↗
PubMed1981

The use of thallium 201 myocardial imaging to exclude myocardial infarction after dissection in congenital coarctation of the aorta.

The use of a mobile gamma camera with thallium 201 myocardial imaging is described to exclude myocardial infarction in a patient admitted to the coronary care unit in shock and with clinical, enzyme, and ECG changes consistent with infarction. The patient suffered from acute aortic dissection associated with congenital coarctation of the aorta. The myocardial scan excluded transmural myocardial injury.

Adult↗
PubMed1981

Diagnosis of coronary artery disease by multigated radionuclide angiography during right atrial pacing.

Right atrial pacing in conjunction with radionuclide angiography was used as a method to augment gradually myocardial oxygen demand in seven normal subjects and 11 patients with angiographically documented coronary artery disease (CAD). In five of the seven normal subjects the ECG during atrial pacing was normal and falsely pathologic in the two others; in all seven the ejection fraction (64 +/- 8 percent) did not change during the pacing. The atrial pacing was positive in seven of the eleven patients with CAD and falsely negative in four. In comparison, nine of these patients had more than 15 percent reduction in ejection fraction, while only two were regarded as negative. A maximal decrease of 31 percent in the average ejection fraction was observed in CAD patients at a pacing rate of 160/min. Wall motion pattern remained normal in all seven normal subjects, while new wall motion abnormalities developed during the atrial pacing in nine of the 11 CAD patients. We concluded that changes in ejection fraction induced by atrial pacing are sensitive indicators of myocardial ischemia. In patients with CAD, ejection fraction falls during pacing compared with normal subjects in whom ejection fraction remains unchanged.

Adult↗
PubMed1981

Hydralazine in the management of symptomatic sinus bradycardia.

Hydralazine (Apresoline) was used to increase heart rate in 21 patients (14 hypertensive and 7 normotensive) suffering from symptomatic sinus bradycardia (SSB). Patients were assessed clinically and by 24-h ECG analysis before and after tailored increasing doses of the drug. Heart rates measured were resting (basal) rate, minimum rate during sleep, maximal rate during the day, and mean rate during the 24-h period (from hourly strips). The longest sinus pause or period of sinus arrest (when present) was also measured. Hydralazine ameliorated symptoms and produced a 20% or greater increase in heart rate in just under two-thirds of the hypertensive and half of the normotensive patients. Blood pressure decreased slightly in hypertensive but not in normotensive patients, and there were no important side-effects. Hydralazine appears to be a useful and effective drug to increase heart rate in patients with SSB.

Adult↗
PubMed1979

Diagnostic value of cross-sectional echocardiography in left atrial myxoma.

Atrial myxoma is a rare condition that may have unusual clinical manifestations. Two patients with left atrial myxoma are described. One presented with paroxysmal nocturnal dyspnea and no abnormal physical signs on clinical examination; the second presented with palpitations and physical findings suggestive of mild mixed mitral valve disease. Echocardiography and cross-sectional echocardiography confirmed the diagnosis of atrial myxoma in both patients, and the tumors were successfully removed by operation. Cross-sectional echocardiography may obviate the need for cardiac catheterization in patients with left atrial tumors.

Echocardiography↗
PubMedDate not supplied

Age- and gender-related differences in success, major and minor complication rates and the duration of hospitalization after percutaneous transluminal coronary angioplasty.

This report describes the effect of age and gender on the results of balloon angioplasty using current technique and indications. A consecutive group of 2,067 patients who underwent angioplasty at a single institution after 1990 is described. Angioplastic success was 92.2% and similar among men and women and the various age groups. Sixteen patients (0.8%) died, and mortality among women was significantly higher (1.4 vs. 0.6%, p < 0.001). There were no age or gender differences in the rate of Q-wave myocardial infarction and the need for coronary artery bypass. Minor complications such as groin complications (10.5% women, 5.0% men; p < 0.001) and infections (6.4% women, 3.7% men; p < 0.05) were more common in women, and as a result the duration of hospitalization after angioplasty was longer. The length of hospitalization after angioplasty was longer with advanced age, mainly as a result of higher groin complications (p < 0.001), infections (p < 0.01) and renal failure (p < 0.05). We conclude that using current indications and technique, angioplasty can be performed safely with a high success rate. Mortality is higher among women. The length of hospitalization after angioplasty is longer in women and, at advanced age, due to higher rate of minor complications.

Age Factors↗