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Biomedical subjects

E Grenadier

Publications and source records attributed to E Grenadier.

78 records · Page 5Linked to original sources

The MB isoenzyme of creatine kinase as an indicator of severity of myocardial ischaemia.

86 patients with ischaemic heart-disease were assessed for the presence of the MB isoenzyme of creatine kinase (C.K.-MB). Raised C.K.-MB levels with normal total C.K. were found in 10 patients with a clinical picture, but no electrocardiographic evidence, of acute myocardial infarction. 4 of these patients later had an infarction, but the remaining 6 have remained undiagnosed. Of 26 patients with unstable angina, 11 (42%) had high levels of C.K.-MB in the presence of normal total C.K. Of 50 patients with effort angina and a positive ergometric stress test, 3 (6%) with crescendo angina had high C.K.-MB levels in the presence of normal total C.K. In patients with angina, myocardial necrosis was excluded by normal serum-myoglobin levels. In both groups with angina, those with raised C.K.-MB levels had a more severe clinical picture, greater depressions of the ST segment, and lower threshold to ergometry. Raised C.K.-MB levels may indicate myocardial ischaemia.

Acute Disease↗

Serial two-dimensional echocardiography for detection of coarctation of the aorta in the postnatal period.

We describe the ultrasound appearance of postnatal development of an angiographically proven coarctation of the aorta in a full-term infant. The diagnosis of a discrete coarctation was subsequently supported on a repeat two-dimensional echocardiogram, after an initial clinical and two-dimensional study at 6 h of age that had revealed only minimal juxtaductal aortic deformity. We stress the importance of two-dimensional echocardiography as a reliable noninvasive method for detecting the change in aortic contour occurring with ductal closure in infants with predisposing aortic anatomy who will go on to develop coarctation of the aorta.

Aortic Coarctation↗

[Clinical applications of Doppler echocardiography].

In this review, we demonstrate the normal patterns of flow and some quantitative applications of Doppler echocardiography combined with two-dimensional imaging. Flow information can be accurately measured and valve gradient calculations can be made in patients with stenotic diseases. Further corroborative work in this area is necessary before definitive statements can be made, but this appears to be a promising noninvasive technique which can be applied at the bedside or in an ambulatory setting with a fair degree of confidence.

Atrial Function↗

Complete atrioventricular block, shock, and hyperkalemia induced by toxic adenoma of the thyroid gland.

The case of a 74-year-old woman with toxic thyroid adenoma, presenting as complete heart block, is described. Upon admission the patient was in a state of circulatory collapse with metabolic acidosis and hyperkalemia. After initiation of right ventricular pacing the circulatory and metabolic disorders rapidly normalized without any other specific therapy. Since treatment and attainment of the euthyroid state the patient has had no conduction delays or arrhythmias. Complete heart block in thyrotoxicosis is uncommon and previous reports relate to its occurrence in Graves' disease, usually complicated by infectious disorders. This is the only case known to us of complete heart block in toxic thyroid adenoma.

Aged↗