[Rib fractures and broncho-pneumophathies].
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Biomedical subjects
Publications and source records attributed to G Ducloux.
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The purpose of this study was to assess the value of methylergonovine maleate administration as challenge test for abnormal oesophageal contractions. Manometric exploration of the oesophagus was performed before and after administration of methylergonovine maleate 0.4 mg in 28 patients suffering from retrosternal pain of proven extracardiac origin. Six patients had unexplainably suffered when receiving the drug during coronary arteriography (group A), while 22 had experienced no pain (group B). A group of 7 control subjects were explored at the same time and with the same procedure (group C). Methylergonovine maleate produced painful oesophageal abnormal contractions in 5 of the 6 patients in group A. The 6th patient in this group and 2 patients in group B had abnormal contractions without pain. Another group B patient developed coronary arterial spasm reversed by sublingual nitroglycerin. In the 2 group A patients who received nitroglycerin, the drug rapidly relieved the retrosternal pain and the abnormal contractions induced by methylergonovine maleate. This study demonstrates the value of oesophageal manometry with methylergonovine maleate test in patients with anginal pain but normal coronary arteriography. It also highlights the need for continuous ECG monitoring during the test, even when the patients had responded negatively to methylergonovine maleate during coronary arteriography.
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We report a rare case of congenital left ventricular aneurysm, diagnosed by spiral CT angiography. Despite 1 s time acquisition, spiral CT, with adequate acquisition parameters and bolus injection of contrast medium, produced sufficiently good images to permit visualization of the aneurysm. Subsequently, reconstructions (shaded surface display and multiplanar reformation) were performed to demonstrate the relationship of the aneurysm with the remainder of the left ventricle, the wide neck of the aneurysm, and the absence of contractility, therein permitting differentiation from a congenital diverticulum.
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In this paper, the authors present the case of hypocalcemic cardiopathy observed in a female patient who underwent thyroidectomy which was complicated post-operatively by the development of hypoparathyroidism. Two attacks of heart failure experienced by this patient were improved by the administration of calcium in combination with digitalis treatment. A study of cases published in the medical literature reveals that this condition is a rare cause of heart failure which develops only in the course of chronic hypocalcemia, with few neuromuscular clinical manifestations. The dual negative inotropic and hypovolemic effects caused by hypocalcemia explain the efficacy observed with the administration of calcium therapy, while the usual symptomatic treatment of this condition is inadequate.
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