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G Ducloux

Publications and source records attributed to G Ducloux.

At least 91 records · Page 5Linked to original sources
PubMed1988

[Value of pericardioscopy in pericardial effusion. Apropos of 20 patients].

The value of pericardioscopy in pericardial effusion of uncertain origin was evaluated in 20 patients, aged from 18 to 77 years, whose pericardial effusion had been diagnosed by ultrasonography; 2 patients presented with clinical signs of tamponade. The cause of the pericarditis was unknown, but the clinical context suggested a malignant disease in 13 patients, tuberculosis in 5 patients and another cause in 2 patients. The pericardium was explored by means of a direct vision, cold-light endoscope, usually a mediastinoscope, introduced by the retroxiphoidal route under general of local anaesthesia. This method made it possible to study the pericardial fluid, examine the pericardial serous membrane, perform biopsies at a distance from the orifice of entry and cleanse the pericardium thoroughly in cases with blood or pus collection. Apart from 2 cases where the examination could not be completed because of an anterior mediastinal mass and a pericardial symphysis, valuable information could be obtained in purulent pericarditis (n = 1), chronic radiation induced lesions (n = 2), metastases (n = 2), haemopericardium (n = 2), and biopsies could be performed in tumoral or suspicious areas. These guided biopsies revealed a metastasis in 3 cases where the pericardial window was negative. No sign of tuberculosis was found in the 5 cases where the disease was suspected. The final diagnoses were: neoplastic pericarditis in 4 cases, radiation-induced pericarditis in 2 cases, purulent pericarditis in 2 cases, haemopericardium in 3 cases and idiopathic or reactive pericarditis in 9 cases. The post-operative period was uneventful, with no major complication ascribable to the procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

[Chronic aortic dissection disclosed by pericardial effusion. Apropos of 3 cases].

Three exceptional cases of chronic aortic dissection revealed by a pericardial effusion are reported. The patients were two men and a woman admitted for thoracic pain or fever. Initial diagnoses were myocardial infarction, infective endocarditis and tuberculous pericarditis. The effusions were drained on two occasions. Because the pericardial fluid was a mixture of serum and blood, computerized tomography of the thorax and abdomen was performed. All three cases were then diagnosed as aortic dissection (type II in two cases and type III in one case, with retrograde extension to the ascending aorta). The authors underline the utility of drainage and the need for systematic CT scans in patients with sero-haematic pericardial effusion of uncertain origin.

Aged↗
PubMed1988

[Cough and inhibitors of the angiotensin-converting enzyme].

Regarding 5 recent cases of cough induced by inhibitors of angiotensin conversion enzyme (CEI), the authors emphasize the still underestimated frequency of this annoying and sometimes disabling side-effect (10 to 15% of cases). They remind of their clinical and evolutive characteristics: dry cough, predominantly at night, often occurring rapidly, sometimes delayed (up to 17 months) after introduction of the CEI and unrelated to the dosage. The cough usually disappears in two to three days (up to 8 days) upon discontinuation of the treatment. The test of discontinuation-reintroduction, possibly crossed (captopril/enalapril) is used in questionable cases as a diagnostic test. Besides, this diagnosis must be made rapidly in order to avoid costly, unnecessary laboratory tests which are sometimes unpleasant for the patient. The cough could be explained by an irritation of the bronchial mucosa secondary to bradykinin and pulmonary E2 prostaglandins elevation, under CEI.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1987

[Silent aortic insufficiency mimicking dilated cardiomyopathy].

The authors report 6 cases of severe and silent aortic insufficiency having simulated in all aspects the picture of a dilated cardiomyopathy at the stage of cardiac insufficiency with primary manifestations. They insist on signs leading to the diagnosis of this clinical entity: past history of rheumatism, signs of electrical left ventricular hypertrophy in the absence of arterial hypertension, aortic calcifications and mostly presence of a discrete mitral diastolic fluttering during echocardiographic examination. Supra-sigmoid aortic angiography confirms the diagnosis of severe aortic regurgitation. In order to explain the non-perception of the murmur, they invoke the alteration of the transmission secondary to an air cushion (3 cases the association of another valvulopathy with murmur (1 case) and mainly the decrease of the leakage by increase of the left ventricular telediastolic pressure and the decrease of the diastolic aortic pressure, with diminution of the turbulences. The advantage of knowing this entity rests on the possibility of valve replacement, even at the stage of myocardial failure, since the satisfactory long-term post-operative evolution in 4 patients stands in contrast with the dangerous nature of a spontaneous evolution.

Aortic Valve Insufficiency↗
PubMed1987

The ergometrine test: effects on esophageal motility in patients with chest pain and normal coronary arteries.

Ergometrine can evoke coronary spasm in patients with variant angina. The cause of ergometrine-induced chest pain in the absence of coronary spasm is not clear. To determine whether ergometrine produced esophageal dysfunction and chest pain, we evaluated 28 patients by esophageal manometry. Six had chest pain in response to ergometrine during cardiac catheterization (group I) and 22 did not (group II). Results of cardiac catheterization were normal in all patients. Seven volunteers with no history of chest pain formed a control group (group III). Esophageal manometry was performed before and after ergometrine administration (0.4 mg I.V.). Ergometrine provocation during esophageal manometry caused significant deterioration in esophageal motility associated with familiar pain in 5/6 group 1 patients. The motility disorders were characterized by repetitive contracts of high amplitude and long duration in the distal esophagus. No patient from group II or III experienced chest pain after ergometrine and only 2 from group II developed long duration contractions. Thus, we conclude that in patients with normal coronary angiograms, ergometrine-induced chest pain without associated coronary spasm suggests that esophageal motility disorders originate chest pain.

Angina Pectoris↗
PubMed1987

[Popliteal venous aneurysm. Apropos of 3 cases].

The popliteal venous aneurysm is a rare cause of recurrent phlebitis and pulmonary embolus. In reference to 3 personal cases, their etiology, their role in the occurrence of phlebitis, the place of phlebography and vascular sonotomography respectively, are discussed. The treatment is essentially surgical.

Adult↗
PubMed1986

[Therapeutic value of a combination of trimetazidine with a calcium inhibitor in the treatment of chronic coronary insufficiency].

This double-blind, placebo-controlled study sought to examine the short-term benefit of adding 60 mg of trimetazidine to the daily therapeutic regimen of 29 male patients with coronary insufficiency who had persistent ST depression on exercise tolerance test (greater than or equal to 1 mm), despite treatment with nifedipine 40 mg per day. As compared with the placebo group, after only 14 days, the patients treated with trimetazidine showed statistically significant increases in the maximum workload level attained before ST depression occurred (31% versus - 6%; P = 0.009), the total work performed (31% versus 2%; P = 0.024) and a significant decrease in the systolic tension time (double product)/workload ratio (-5% versus +11%; P = 0.005). Throughout the study the clinical acceptability was excellent, with no side effects attributable to trimetazidine being recorded. This study shows that the addition of trimetazidine to a calcium antagonist brings a valuable improvement in therapeutic results.

Chronic Disease↗
PubMed1986

[Aneurysm of the sinus of Valsalva in children and young adults. Apropos of 9 cases].

Nine cases (7 boys and 2 girls) of aneurysm of the sinus of Valsalva (SVA) diagnosed before 19 years of age are reported. Group 1 comprised 5 children aged 5 to 14 years without rupture of the aneurysm; 3 had an associated ventricular septal defect (VSD). The diseased sinus was the right anterior sinus in 4 cases and the posterior sinus in one case. The diagnosis was made by 2D echocardiography, performed in 3 patients for follow-up of a VSD and in 2 patients to investigate a systolic murmur. Group 2 comprised 4 patients under 19 years of age with SVA which ruptured into in the right heart cavities. One of these patients had a known right anterior SVA diagnosed at angiography performed to investigate a VSD when the child was 4 years old. The rupture occurred suddenly when the child was 14. These cases of SVA involved the right anterior sinus with rupture into the right ventricle (3 cases) and the posterior non-coronary sinus with rupture into the right atrium (1 case). A rupture syndrome was observed in 3 of the 4 patients with pulmonary oedema in 2 cases. The authors emphasise the rarity of SVA diagnosed before rupture and the low frequency of rupture before adulthood. Echocardiography is certainly the best method for diagnosing the condition and for following up these patients.

Adolescent↗
PubMed1986

[Double superior vena cava with drainage of the right superior vena cava into the left auricle. Presentation as a cerebral abscess in an adult].

A 44 year old man presented with a cerebral abscess, the location of which suggested a septicaemic origin. Although the patient was not cyanosed, a cardiological work-up was requested to exclude a right-to-left shunt. This showed a double abnormality of the systemic venous drainage: presence of an abnormal left superior vena cava draining into the coronary sinus and of a right superior vena cava draining into the left atrium. These two vena cava intercommunicated by anastomoses. Angiography in the right superior vena cava after occlusion by balloon catheter at its junction with the left atrium showed flow from the right to the left superior vena cava and to the azygos system. Simple ligature of the right superior vena cava was therefore performed to prevent recurrence of cerebral abscess. This case is rare and of interest because of the presence of two superior vena cavae, one on the right draining into the left atrium and the other on the left draining into the coronary sinus, with anastomoses between the two superior vena cavae. This double abnormality of systemic venous drainage explains the absence of cyanosis and therefore the relatively late detection of this malformation.

Adult↗
PubMed1986

[Comparison of the effects of bepridil and diltiazem in Prinzmetal's angina. Crossed, randomized, double-blind study. Apropos of 14 cases].

The efficacy of bepridil was compared with that of diltiazem in treatment of Prinzmetal's angina, in a crossed, randomized double-blind study of 14 observations using repeated Holter recordings (a total of 9 for each patient). Clinical and electrical monitoring showed that the efficacy of bepridil is comparable to that of diltiazem in treatment of spastic angina.

Adult↗
PubMed1986

[Myocardiopathy disclosing a centronuclear myopathy in an adult].

The authors report the case of a primary myocardiopathy of the young adult, related in fact to a rare muscular congenital disease: centro-nuclear myopathy. The case is different from the classic picture in that it is revealed late, by its cardiac manifestations which dominate the clinical picture and lead to an irreducible cardiac insufficiency requiring a heart transplant. Only a muscular biopsy with histological and histo chemical study permits to make the diagnosis, while the lesions of the myocardium are non-specific.

Adult↗