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Biomedical subjects

F Fiorista

Publications and source records attributed to F Fiorista.

30 records · Page 2Linked to original sources
PubMed1985

[Auriculo-ventricular block upon swallowing].

A case of recurrent syncopal attacks in a 70-year-old woman with oesophageal hiatus hernia is reported. Dynamic ECG recording showed paroxysmal II and III degree A-V block during solid food swallowing. Electrophysiologic examination was normal in the basal condition and showed a II degree A-V nodal block with 2: 1 conduction ratio during solid food swallowing. This phenomenon was not reproducible after atropine administration. A permanent cardiac pacemaker (VVIP) rendered the patient completely symptomfree. The likely pathogenetic mechanism of "swallowing A-V block" is described.

Aged↗
PubMed1982

[Dyssynergia of the left ventricle in idiopathic prolapse of the mitral valve. Kinetocardiographic study of 50 cases].

Fifty patients with idiopathic mitral valve prolapse (MVP), diagnosed by M-mode ecocardiography and free of other cardiovascular disease, were studied by kinetocardiography (KCG), to detect the presence of left ventricular dyssynergy. Kinetocardiography showed paradoxical outward movements (POM) in 27 patients: these movements were pansystolic in 13 patients. The results were normal in 20 patients, unclear in 3 patients. POM were more frequently found in positions K4, K3 and K5. A comparison among results obtained with KCG and the other noninvasive techniques we used (ECG, ecocardiography and phonocardiography) showed that ectopic beats were more frequently associated with POM, which also were more frequent in patients with prolapse of both mitral leaflets and with pansistolic prolapse. Finally POM were recorded in patients with atypical or silent MVP. We conclude that KCG is an useful noninvasive technique to discover left ventricular dyssynergy in patients with MVP.

Adolescent↗
PubMed1981

Myocardial infarction in a child aged ten with Duchenne muscular dystrophy.

The authors describe the clinical picture, ECG, vectorcardiographic, and serum enzyme assays in one case of acute myocardial infarction occurring after a severe physical exertion in a child aged 10 with progressive muscular dystrophy of the Duchenne type. The picture differs considerably from the electrical aspects of "pseudonecrosis" that interstitial fibrosis of some portions of the left ventricle may produce in this myopathy.

Child↗
PubMed1978

[Long-term cardiac pacing: survival above 10 years (author's transl)].

The authors reports data of pacemaker patients surviving above 10 years. They have considered 241 patients undergone pace-maker first insertion from January 1961 to June 1967 (168 treated with epicardial and 73 with transvenous electrodes). At the last control on July 1977, 52 (27 males and 25 females) were surviving, equivalent to 21% of all patients treated in that period. The age of these patients ranged from 5 to 83 (mean 60 years) at first implantation. At present 51 patients are treated with transvenous systems, only 1 patient is stimulated with epicardial pace-maker. 382 pace-makers were used in these 52 patients: the average life of every pacer was 20 months. Complications relative to epicardial and endocardial pacing are reported: with the transvenous system the percent of complications was lower (15,6% to 50,4%). Finally present clinical states of the 52 patients are reported, basing on the reccomendations of Criteria Committee of the New Heart Association.

Adolescent↗
PubMed1978

[Permanent endocardial pacing. Experience on 1678 patients. (De Gasperis Cardiology Center--Ente Ospedaliero Niguarda--Milano) (author's transl)].

The Authors report on eleven years and six months experience with permanent endocardial pacing in the treatment of various conduction disturbances. This experience relates to 1678 patients, 3617 pacers were used. The age of the patients ranges from 60 to 80 (70%), 30% referring to the remaining decades, minimum 14--maximum 94. Fixed rate pacers were used in 31% of cases, QRS synchronous or QRS inhibited pacers were used in 69%. Average life of the pacers varies from 25 to 29 months; the average life of fixed rate pacer is higher. Complications and causes of failures, among which electrode dislodgement is the most relevant and frequent, as well as the relative therapeutical treatments, are described. Early mortality is about 1% and late mortality 20%; the survival rate calculated altogether after 11 years and 6 months treatment with implantable pervenous pacing is about 16%.

Aged↗
PubMed1978

[Cardiac pacing as prophylaxis in surgical operations (author's transl)].

During a 24-month period, 37 patients with fascicular blocks (RBB-LAH, alternating bundle-branch block, bundle-branch block with PR prolongation, RBBB-LAH with PR prolongation) were sheduled for operation. The study was undertaken to determine what effect the stress of anesthesia and operation might have on these patients, and to attempt to answer the question whether all patients with fascicular block should have demand pacemakers implanted. All these patients were in stable condition and had no history of transient complete heart block. Patients were monitored continuously intraoperatively and were followed by serial electrocardiograms to the third postoperative day. No instance of complete heart block was found. No significant problem arose both intra- and postoperatively. According to these findings, routine, prophylactic, temporary cardiac pacing in patients with fascicular blocks, before anesthesia and during operation, seems to be not necessary in the absence of cardiac symptoms.

Aged↗
PubMed1977

[Effectiveness of nifedipine on exercise tolerance in patients with angina pectoris. Comparison with a nitroderivative and a beta-blocking agent].

The effect of nifedipine on effort angina was investigated by means of exercise tests with bycicle ergometer and compared, in the same patients, with the effects of a nitroderivative and a betablocking agent. Five patients with stable effort angina entered the study, after an hemodynamic and contrasto-graphic control. According to the protocol of a latin square 5 X 5, all the patients received in a random sequence the following treatments: placebo, 1 c. orally; isosorbide dinitrate, 5 mg sublingually; propranolol, 40 mg orally; nifedipine, 10 mg sublingually; nifedipine, 10 mg orally. No significant change of any of the considered parameters was observed after the placebo. Isosorbide dinitrate and nifedipine produced significant increases of the duration of work before appearance of pain and EKG positivity, and of total work performed before anginal pain. Only the duration of work before EKG positivity was improved by propranolol. The comparisons between treatments showed no significant difference of the effects of the administered doses of isosorbide dinitrate and nifedipine. The improvements observed after propranolol were significantly lower than that observed after isosorbide dinitrate and oral nifedipine. On the basis of the observed changes of cardiac rate, maximal arterial pressure, ejection time index and triple product, the authors evaluate the possible mechanism of action of nifedipine.

Adolescent↗
PubMed1977

[Sublingual isosorbide dinitrate-induced severe hypotension, bradycardia and prelypothymia in patients with acute myocardial infarction (author's transl)].

100 patients with acute myocardial infarction were given 5 mg of sublingual isosorbide dinitrate within 36 hours by the onset of their symptoms. 86 patients did not show any unusual effect after the administration of the drug; their heart rate was only slightly increased and their arterial pressure slightly reduced. 14 patients developed severe systemic arterial hypotension, associated with absolute or relative bradycardia, within 30 minutes of receiving the drug. All the patients complained of fainting and sweating, 1 patient developed a syncope. Symptoms were relieved by raising patients legs in 10 cases, by 0.5 mg Atropina e.v. in 4 cases, 1 case required also external cardiac massage. There was no significant difference between the two groups as regard to the location of myocardial infarction nor to the functional class (according to Killip classification). Possible mechanism producing bradycardia, hypotension and lipothymia after nitrates administration are considered. A vagally mediate reflex possibly elicited by a fall in venous return is the most acceptable hypothesis. The study emphasizes the importance of carefull observation of patients receiving sublingual nitrates during acute myocardial infarction, and the rapid response of bradycardia, hypotension and lipothymia following nitrates administration, to a simple therapy, which avoids other potentially hazardous treatments.

Aged↗
PubMedDate not supplied

[Use of the subclavian vein for permanent cardiac stimulation].

The experience on 101 cases of permanent cardiac stimulation is reported; in all of them, the access was via the subclavian vein. Punction of the subclavian artery, transient injury of the brachial plexus and pneumothorax, were seen in 4.3 and 3% respectively. Early electrode luxation was observed in 5% of the patients. As late complications there where two cases of destruction of the electrode protecting sheet and one electrode rupture. In spite of the potential risks directly related to the vein puncture, the subclavian puncture offers an excellent alternative for placing definitive pacing electrodes.

Adult↗
PubMedDate not supplied

[Informatics in cardiology: proposal for standardized terminology in clinical records and in permanent cardiac electrostimulation].

To make operative two medical computerized programs, one dedicated to the cardiological clinical record (PAC) and the other to permanent cardiac stimulation (PGP), we codified about 4000 terms concerning the general medical field and particularly the cardiological area. The importance of standardization of the medico-cardiological language is emphasized, specially in relation to the systematization of the information, necessary to work with computerized systems.

Cardiology↗