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Biomedical subjects

C Halphen

Publications and source records attributed to C Halphen.

At least 37 records · Page 2Linked to original sources
PubMed1987

[Auricular fibrillation: a cause of reversible myocardiopathy].

A chronic supraventricular tachycardia may alone be responsible for a picture of severe congestive cardiac insufficiency, which is totally reversible after return to a sinus rhythm. The two cases reported here emphasize this particular fact, the physiopathology of which still remains unknown. There is also a prognostic advantage to such cases: in the presence of a congestive cardiopathy with atrial fibrillation, apparently idiopathic, it is important to try to obtain a sinus rhythm and to study from a distance the left ventricular performance indexes which may return to normal after regularization of the rhythm.

Atrial Fibrillation↗
PubMed1986

[Value of echocardiography in the study of the embolic origin of a cerebral ischemic accident].

One hundred consecutive patients aged from 35 to 82 years (mean : 74 years) admitted to a Neurology unit for cerebral ischaemic accident of suspected embolic origin were examined by two-dimensional echocardiography, then divided into two groups. Group I patients (n = 24) had a cardiopathy detectable by ultrasound, such as valve disease (n = 5), ischaemic cardiopathy (n = 10), myocardial dilatation (n = 4) or hypertrophic obstructive cardiomyopathy (n = 1). Group II patients (n = 74) had no cardiopathy detectable by ultrasound. Among group I patients, a thrombus was detected in 3 cases (12.5%), and 16 patients (66.7%) had echographic signs of potentially emboligenic cardiopathy without thrombus, including mitral or aortic valve stenosis (5 cases), parietal ectasia (6 cases), severe abnormality in left ventricular contractility (4 cases) and left atrial dilatation (4 cases). No thrombus was visualized in group II patients, but 10 (13.2%) had signs of potentially emboligenic cardiopathy, including mitral valve prolapse in 6 and left atrial dilatation in 4 cases. Altogether, therefore, a potentially emboligenic cardiopathy was detected by echocardiography in 29% of these 100 patients, but it had already been diagnosed prior to this examination in 24%. A thrombus could be visualized in only 3% of the cases. It is concluded that echocardiography need not be systematically performed in all patients with cerebral ischaemic accident, but only in young patients in search of a cause amenable to curative or actively prophylactic treatment.

Adult↗
PubMed1985

[Splenic abscess disclosing endocarditis].

A 54 year old man, hospitalised for thoraco-abdominal pain resulting from a septicemia which gives positive hemocultures for streptococcus D Bovis, is diagnosed to have a splenic abscess which will require splenectomy. At the same time, an endocarditis develops and gets worse, with auriculo-ventricular blockade and, especially, major aortic insufficiency, which is the cause of death by a brutal and massive pulmonary oedema. In the progression of an endocarditis, the occurrence of a splenic abscess, primary localisation of the initial septicemia or the secondary of an arterial septic embolism, is a rare contingency compared to the frequency of splenomegaly or splenic infarction: less than 2 percent of the cases in the literature. This very atypical and exceptional case serves as a reminder, on the one hand, of the diagnostic inadequacy of echocardiography which cannot visualise vegetation in the course of progressive endocarditis, and, on the other, of the prognostic importance of auriculoventricular blockade in septal and aortic endocardial lesions.

Abscess↗
PubMed1984

Silent pericardial effusion in late pregnancy: a new entity.

Of 123 healthy pregnant women examined systematically by M-mode and two-dimensional echocardiography at various stages of gestation, 46 were in their late pregnancy (32nd-38th week) of whom 19 (41.3%) showed unexpected signs of pericardial effusion on the echocardiogram. Following Horowitz's criteria, the effusion was large in 2, moderate in 4, and small in 13 cases; in all women the condition was clinically silent. Clinical examination was normal in all but 3 women, in whom high blood pressure returned to normal after delivery. The ECG was usually normal (16 of 19 cases) or showed nonspecific ST-T changes. The entity appeared in late pregnancy (not before the 32nd week), was transient, and no longer could be seen within a month after delivery of a normal child. Cause of the effusion was attributed to excessive water and salt retention in those women with an abnormal echocardiogram who at this late stage of gestation had a mean weight gain significantly higher (P less than 0.03) than in others (13.60 +/- 4.28 vs 10.96 +/- 3.7 kg) - an observation not reported before in normal pregnancy. Since pericardial effusion cannot be detected by clinical examination or ECG, echocardiography affords a safe and reliable diagnostic approach.

Adult↗
PubMed1984

[Electrocardiographic study of left ventricular performance in normal pregnancy].

This study was undertaken to determine the changes of left ventricular function during normal pregnancy. Fifteen women aged 23 to 36 years old were studied by M mode and 2D echocardiography at 3, 6 and 9 months and during the post partum period (30 days). The M mode recordings were analysed on an ID.01 computer. The principal parameters rose significantly from the 3rd to the 9th month, and then fell during the post partum period: heart rate, 73 +/- 5 to 80 +/- 9 and then to 70 +/- 8 beats/min: LV end diastolic parameter 46 +/- 2 to 49 +/- 3 mm: LV end diastolic volume 102 +/- 16 to 120 +/- 30 and then 102 +/- 22 cm3; stroke volume: 72 +/- 15 to 87 +/- 25 and then to 70 +/- 16 ml; cardiac output: 5.6 +/- 1.2 to 7.1 +/- 2.3 and then to 5.0 +/- 1.4 l/min; cardiac index: 3.5 +/- 0.7 to 4.1 +/- 1.3 and then to 3.0 +/- 0.8 l/min/m2; LV mass: 69 +/- 14 to 91 +/- 39 and then to 82 +/- 27 g; the ratio of mass/volume also increased from 0.97 +/- 0.14 to 1.10 +/- 0.5. On the other hand, the following parameters did not change significantly: LV end systolic diameter: 30 +/- 3 to 31 +/- 3 and then to 30 +/- 4 mm; ejection fraction: 0.70 +/- 0.72 and then to 0.68; LV fractional shortening: 34 +/- 5 to 36 +/- 5 and then 33 +/- 6; velocity of circumferential fibre shortening: 1.2 +/- 0.2 to 1.2 +/- 0.1 and then 1.1 +/- 0.2 circ/s.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

[Echocardiographic detection of asymptomatic pericardial effusion during normal pregnancy].

A series of 123 healthy pregnant women (average age: 28 years) was studied by M mode and 2D echocardiography to evaluate the hemodynamic changes due to pregnancy. Latent and asymptomatic pericardial effusion was detected in 19 of the 46 patients in the last stages of pregnancy (32nd to 38th week). The effusion was slight in 13 cases, moderate in 4 cases and voluminous in 2 cases. This was a transient finding, occurring at the end of pregnancy (never before the 32nd week) and regressing totally in the two months post partum. The pregnancy ran its natural course in all 19 patients. None had any specific past medical history or clinical signs of toxemia. Cardiovascular examination was normal in all cases with no signs of pericardial friction rub or of heart failure. However, the blood pressure was raised in 3 of the 19 patients. The ECG was normal in 16 of the 19 cases; non-specific ST-T wave changes were observed in 3 cases. Pericardial effusion was probably related to salt and water retention which often occurs at the end of pregnancy: at this stage the average weight gain was significantly higher (p less than 0,03) in the 19 patients with pericardial effusion than in the 27 patients without (13,6 +/- 4,3 kg compared to 10,9 +/- 3,7 kg). Therefore, pericardial effusion of variable volume but always asymptomatic and latent was observed in 40,1 p. 100 of patients at the end of pregnancy on echocardiographic examination. This previously undocumented finding requires further study to determine the underlying physiopathological mechanism and its exact significance.

Adult↗
PubMed1982

[Silent pericardial effusion in late pregnancy: echocardiographic detection in the third trimester of pregnancy (author's transl)].

Of 123 healthy pregnant women (mean age 28 yrs) who have been studied at various stages of their gestation by Tm and two dimensional echocardiography, 46 were in their late pregnancy (32nd to 38th week of pregnancy). Echocardiograms showed definite signs of pericardial effusion (PE) in 19 of those 46 women: the effusion was large in two, moderate in four and small in thirteen cases. PE was clinically silent as neither precordial pain nor pericardial friction rub was present. In all cases, pregnancies were uncomplicated; clinical examination was normal; however blood pressure was slightly elevated in three women. The electrocardiogram was normal or showed non specific ST-T change. PE appeared in the late pregnancy and did not occur before the 32 nd week; it was always transient and could not any longer be seen within the two months following delivery. It was likely to result from water and salt inflation as the mean weight gain was significantly higher in the group of women with PE. PE has not been reported so far during normal pregnancy. Echocardiography affords a safe and reliable approach of its diagnostic.

Adult↗
PubMed1981

[Recurrent ventricular tachycardia due to right ventricular dysplasia. Association with left ventricular anomalies].

The authors report a case of arrhythmogenic right ventricular dysplasia in a 61year old male with a 9 year history of recurrent ventricular tachycardia with a left bundle branch block configuration and without any signs of cardiac failure. A right ventricular angiography showed morphological changes suggestive of Uhl's anomaly and left ventricular angiography showed segmental wall dysfunction. In the absence of coronary artery disease, this case raises the questions of left ventricular extension of right ventricular dysplasia and of the value of left ventricular angiography in adult forms of Uhl's anomaly.

Bundle-Branch Block↗
PubMed1980

[Electroplethysmographic study of nitroglycerin microcapsule preparation at two concentrations: 2.5 and 7.5 mg (author's transl)].

In a double-blind, cross-over study involving 15 subjects (10 healthy volunteers and 5 patients with chronic coronary disease) the authors have compared the activity of two nitroglycerin microcapsule preparations containing 2.5 and 7.5 mg respectively. The hemodynamic effects were assessed by electroplethysmography, which is based on variations of impedance in the precordial area. The method records plethysmographic changes in the aorta and measures parameters exploring ventricular stroke. Both concentrations were found to be active. The effects lasted about 1 to 3 hours with the 2.5 mg preparation and more than 4 hours with the 7.5 mg preparation. The response to the 7.5 mg dose was approximately 50% greater than that to the 2.5 mg dose. These findings were supported by the occurence of headaches of six hours duration in 3 out of the 10 healthy subjects.

Adult↗
PubMed1979

Prognostic value of exercise testing soon after myocardial infarction.

The prognostic value of a limited treadmill exercises test performed one day before hospital discharge after acute myocardial infarction was studied in 210 consecutive patients who had no over heart failure and had been free of chest pain for at least four days. No complications occurred. During a one-year follow-up period 28 of 43 patients (65 per cent) who had chest pain during the test reported angina, as compared with 60 of 167 (36 per cent) who had no chest pain during test (P less than 0.001). The one-year mortality rates were 2.1 per cent (three of 146) in patients without changes in the S-T segment during exercise and 27 per cent (17 of 64) in those with depression of the S-T segment (P less than 0.001). Sudden death occurred in one of 146 (0.7 per cent) patients who showed no change in the S-T segment and in 10 of 64 (16 per cent) with depression of the segment (P less than 0.001). Thus, a limited treadmill exercise test performed before hospital discharge after acute myocardial infarction is safe and can predict mortality in the subsequent year.

Adult↗
PubMed1979

[Aortocoronary bypass for the threatened spread of acute myocardial infarction].

21 patients with unstable angina in the acute myocardial infarction period were treated by early surgery, on average on the 3th day after infarction. Resistance to medical therapy given in the coronary care unit, associating modern pharmacological agents and circulatory assistance, on the one hand, and the presence of lesions on the coronary arteries accessible to surgery on the other, were the surgical indications. The absence of operative mortality and of electrical changes after operation seem to be related to the many advances made in the various stages of the medico-surgical management. These results suggest that revascularisation surgery with an acceptable risk may be proposed to patients with unstable angina after a recent myocardial infarction.

Acute Disease↗