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Biomedical subjects

D Burckhardt

Publications and source records attributed to D Burckhardt.

At least 127 records · Page 7Linked to original sources
PubMed1976

[Value of long-term ECG monitoring in the diagnosis of coronary disease--comparison of 8-hour ECG monitoring and double Master exercise test with a clinical coronary index].

The use of the long term Ecg (dynamic Ecg) in the diagnosis of coronary artery disease (CAD) has been investigated in 83 patients and its sensitivity compared with the double Master two step test. The average ECG registration time was 8 hours. The presence of CAD was assumed when the clinical index according to Cohn et al. revealed a pathological value. If a horizontal or downsloping ST-segment depression of greater than or equal to 0,5 mm was chosen for the diagnosis of CAD a sensitivity of 82% resp. 64% was found for the dynamic Ecg and the double Master two step test. The specificity of the dynamic Ecg however was with 77% slightly inferior compared with the Master-test. The superiority in sensitivity of the dynamic Ecg was also present when the diagnosis of CAD was based on a ST-segment depression of greater than or equal to 1,0 mm. We believe that the dynamic Ecg can provide besides arrhythmia detection valuable information in the diagnosis of CAD and careful interpretation of the ST-segment should therefore be undertaken. The number of false positive results in the diagnosis of CAD was not influenced by the women included in the study.

Adult↗
PubMed1976

[Frequency and type of arrhythmias in patients with chronic coronary disease].

Serious arrhythmias are accepted to be the main cause of sudden death in acute coronary artery disease (CAD). The purpose of this study was to evaluate the frequency and type of cardiac arrhythmias in patients with chronic CAD. 67 patients with suspected chronic CAD, documented by history and/or Ecg-changes, were investigated by means of a dynamic Ecg (Holter Avionics) with an average of 11 hours monitoring. On the basis of concomitant ST-segment depressions the patients were divided into 3 groups (A: greater than 0.1mV; B: 0.05-0.09mV; C: less than 0.05mV). The frequency of serious arrhythmias increased significantly with a greater degree of ST-segment depression. Serious arrhythmias were observed in 54% in group A, in 46% in group B, but only in 24% in group C. The frequency of minor arrhythmias such as occasional (less than 12/min atrial or ventricular premature contractions was essentially the same in all 3 groups. In 12 patients more than one serious arrhythmia were documented. Of the serious arrhythmias observed, 94% were tachycardias and/or secondary to increased myocardial irritability and therefore could respond favourably to beta-blocking agents. We believe that arrhythmias in patients with known chronic CAD should be taken seriously and longterm treatment with beta-blockers considered.

Adult↗
PubMed1976

Assessment of the mid systolic click late systolic murmur syndrome by noninvasive methods.

In patients with the mid systolic click/late systolic murmur syndrome (MSC/LSM Sy) a ballooning, billowing or aneurysmal protrusion of one or both mitral leaflets has previously been described in angiographic studies. It is accepted that besides angiography noninvasive methods such as dynamic electrocardiography, phonocardiography, apexcardiography and echocardiography can provide valuable information in the diagnosis of this syndrome. Little is known however about diagnostic value and sensitivity of these methods. The dynamic Ecg, recorded during an average of 10 hours, showed in 8/20 patients (40%) one or several significant arrhythmias such as frequent ventricular premature contractions (VPCs) (greater than 12/min), multifocal VPCs, VPCs in a row or ventricular tachycardia, or 2 degrees SA-block. 12/20 patients (60%) showed in the phonocardiogram a movement of the click toward the first heart sound when the patients' position was changed from supine to sitting. In 40% of the patients a double or triple click was recorded. A late systolic bulge in the apexcardiogram was seen in 13/20 patients (65%). In one patient the recording was not successful. Echocardiographic signs of abnormal posterior movement (prolapse) of one or both mitral leaflets were recorded in 15/20 patients (75%). Five echocardiograms did not show any abnormality, but all these cases demonstrated in their apexcardiogram a late systolic bulge. We believe that in patients with the MSC/LSM Sy a mitral valve abnormality can be documented adequately by noninvasive methods.

Adolescent↗
PubMed1975

[The scimitar syndrome: abnormal venous drainage of the hypoplastic right lung into the inferior vena cava in dextroposition of the heart].

Report on a 28-year-old female patient with classic "scimitar syndrome" (dextroposition of the heart, hypoplasia of the right lung and pulmonary veins opening into the inferior vena cava). The condition was diagnosed on the basis of chest X-ray findings in which the most striking feature was the scimitar-like course of the right pulmonary veins which gives the syndrome its name. The diagnosis was confirmed and the shunt volume determined by cardiac catheterization. Since in this case there were no additional deformities such as atrial septum defect, ventricular septum defect or patent ductus botalli and the shunt volume was small, surgical correction was not required.

Adult↗
PubMed1975

[Proceedings: The echocardiogram in the differential diagnosis of mitral valve insufficiency].

54 patients with mitral incompetence of varying origin have been studied by echocardiography. Echocardiography was usually not helpful in the diagnosis of pure mitral incompetence of mixed mitral valve lesions. However, it proved to be a sensitive method for recognition of the typical anomaly in "mid systolic click/late systolic murmur syndrome", which is ballooning of one or both leaflets toward the left atrium (17 out of 22 patients). The echo was equally useful for documentation of an abnormal systolic motion of the anterior mitral leaflet toward the septum, which was found in 7 of the 11 studied cases of hypertrophic obstructive cardiomyopathy.

Echocardiography↗
PubMed1975

[Proceedings: Frequency and form of arrhythmia and changes in ECG in juvenile healthy volunteers. Studies with long-term electrocardiography].

In 35 healthy volunteers with a mean age of 24 years an ECG recording for detection of arrhythmias and ECG changes was made by means of a Holter Avionics tape recording system for an average of 7.5 h. Ventricular and supraventricular premature contractions (VPC'S, APCs) were recorded occasionally in 31% and with greater frequency in 6%. Multifocal VPCs and serial VPCs were found in one person (3%). ST-depressions of greater than or equal to 0.1 mV were seen in 9% and a wandering atrial pacemaker in a further 9%. An intermittent increase in P-wave amplitude (greater than or equal to 0.25 mV) was observed in 17%. A surprising finding was frequent (49%) recording of a sinus arrest of short duration, usually followed by an atrial escape rhythm. In view of the frequency of this phenomenon it must be accepted as a normal variant in young people.

Adult↗
PubMed1975

Cardiac changes during 2-deoxy-d-glucose test. A study in patients with selective vagotomy and pyloroplasty.

2-Deoxy-D-glucose (2-DG), a potent vagal stimulator, is used for testing the completeness of surgical vagotomies. 2-DG has however not yet been employed routinely for the postoperative testing of bagotomized patients because of possible cardiotoxic effects. In a previous study, we have shown the effects of 2-DG on the resting ECG in 48 patients. We did not observe any significant changes besides nonspecific T wave flattening and QT prolongation. The present investigation included 37 additional patients. In 27 patients, a continuous ECG tape recording for detection of arrhythmias was performed and in 10 patients, the systolic time intervals for non-invasive assessment of the myocardial contractility was recorded before and after 2-DG. Serious arrhythmias were not provoked by 2-DG. Premature contractions were, as a whole, not incrased by the drug. 2-DG did not have any cardiodepressive action. On the contrary myocardial contractility evaluated by the systolic time intervals was enhanced.

Cardiac Output↗
PubMed1975

[Clinical aspects and hemodynamics of idiopathic dilatation of pulmonary artery].

1. The following clinical findings were seen with increased frequency in patients with idiopathic pulmonary artery dilatation: pulmonary ejection click, systolic ejection murmur in the pulmonic area and abnormally wide splitting of second heart sound. 2. Hemodynamically these patients present often a pressure gradient on the pulmonic valve of minor degree and a slightly elevated cardiac index. A congenitally increased elasticity of the tissue of the common pulmonary artery has to be considered as the possible etiology of this lesion. 3. The diagnosis of idiopathic dilatation of the pulmonary artery can be established by non invasive methods, excluding pulmonary valvular stenosis, pulmonary hypertension and left-to-right shunts.

Adolescent↗
PubMed1975

[Systolic prolapse ("ballooning") of the mitral valves with secondary atrial septal defect: a still not much known combination].

Two case with the combination of a ballooning mitral valve and a secundum type ASD are described. The possibility of correct identification of the two anomalies by using relatively simple noninvasive methods is emphasized. Furthermore, a short review of the etiology of the clinical "mid systolic click/late systolic murmur" syndrome is given and the evidence for and against the existence of a true congenital combination of the two abovementioned defects is discussed.

Adult↗