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Biomedical subjects

H Egeblad

Publications and source records attributed to H Egeblad.

At least 91 records · Page 5Linked to original sources
PubMed1980

Reduction of digoxin-induced inotropism during quinidine administration.

A kinetic and dynamic study of digoxin was performed in 6 healthy subjects, and repeated in the same subjects after administration of quinidine for 1 wk. Myocardial performance evaluated by systolic time intervals increased in parallel with plasma digoxin concentration, whereas left ventricular end-diastolic diameter on echocardiography and arterial blood pressure remained constant. The positive inotropic effect of digoxin was abolished during concomitant treatment with quinidine. Quinidine has been reported to increase the risk of digitoxicity, and therefore the treatment with digoxin and quinidine in combination should be reconsidered.

Adult↗
PubMed1980

Non-invasive diagnosis in clinically suspected atrial septal defect of secundum or sinus venosus type. Value of combining chest x-ray, phonocardiography, and M-mode echocardiography.

Twenty-three consecutive patients with clinical (auscultatory and electrocardiographic) signs of uncomplicated atrial septal defect of secundum or sinus venosus type were examined by chest x-ray, phonocardiography, and echocardiography, before right heart catheterisation. Seventeen (74%) had atrial septal defect, two patients (9%) had insignificant pulmonary stenosis, and four subjects (17%) were normal. No false positive diagnosis of atrial septal defect was made by chest x-ray examination, whereas increased vascular markings were incorrectly interpreted as pulmonary congestion in one case. Four patients had x-ray films showing questionable signs of left-to-right shunt. Six of 15 patients with a large left-to-right shunt were correctly selected for surgery based on radiological findings. One false negative but no false positive diagnosis of atrial septal defect was made by phonocardiography. Four cases with and four cases without atrial septal defect were classified as having questionable phonocardiographic signs of atrial septal defect. Echocardiographic distinction between those with atrial septal defect and those without atrial septal defect was correct in all cases; quantitative measurement of left-to-right shunt, however, was unsatisfactory. Combined normal findings by x-ray film and echocardiography appeared adequate in all cases for the exclusion of atrial septal defect (six patients). When the six patients who were correctly identified for surgery from the radiological findings are included, there was a total of 12 patients out of 23 (52%:95% confidence limits 31 to 73%) who were evaluated definitively by the non-invasive tests.

Adolescent↗
PubMed1980

Correlation between changes in systolic time intervals and left ventricular end-diastolic diameter after preload reduction. Non-invasive monitoring of pharmacological intervention.

In order to measure the effect of a decrease in preload on systolic time intervals and left ventricular end-diastolic diameter (LVEDD) measured by echocardiography, eight healthy young subjects were given 40 mg frusemide intravenously. The pre-ejection period index (PEPI) increased and the left ventricular end-diastolic diameter decreased. A correlation between delta PEPI and delta LVEDD was shown. Using changes in systolic time intervals in the evaluation of changes in contractility it is important to correct for changes in preload. For normal subjects it is suggested that the relation between delta PEPI and delta LVEDD as a percentage of the mean values should be used for this correction. A method is suggested for estimating the changes in pre-ejection period index induced by changes in left ventricular end-diastolic diameter.

Adult↗
PubMed1979

Echocardiographic findings in ventricular septal rupture and anterior wall aneurysm complicating myocardial infarction.

Echocardiographic findings in a patient with ventricular septal rupture and anterolateral wall aneurysm complicating myocardial infarction are presented. The findings were confirmed by cardiac catheterization and surgery. Using M-mode ultrasonocardiography one was able to demonstrate and localize the aneurysm as well as the ventricular septal defect which presented as an oblique interventricular communication appearing only during systole. Thus echocardiography supplemented the invasive examinations in exactly revealing the site of ventricular septal rupture. Other echocardiographic features of ventricular septal rupture were right ventricular dilatation, pathological septal motion and abnormal tricuspid valve motion as recently reported by other authors.

Cardiac Catheterization↗
PubMed1979

The diagnostic challenge of left atrial myxoma. Importance of echocardiographic screening.

Left atrial myxomas are extremely difficult to diagnose since their variable manifestations mimic a host of clinical entities more commonly seen, e.g. mitral stenosis, endocarditis, rheumatic fever, cardiomyopathy or mesenchymosis. At the same time, early diagnosis followed by prompt surgical removal are mandatory to prevent mutilating or lethal complications of the tumor. Six cases of left atrial myxoma were diagnosed in our hospital during 2 1/2 years. We present the case histories, diagnostic procedures and surgical findings, consolidating the unique role of echocardiography in detecting left atrial myxomas. We propose the use of echocardiography as a screening examination for atrial myxomas in the following settings: suspected mitral obstructive disease, suspected endocarditis with negative blood cultures, peripheral embolism or thrombosis in young patients, unexplained cardiac failure and mesenchymosis with uncharacteristic presentation.

Adult↗
PubMed1979

Mitral valve replacement in infective endocarditis as prophylaxis against embolism. Identification of patients at risk by 2-dimensional echocardiography.

A 36-yr-old woman and a 46-yr-old man had infective endocarditis of the mitral valve. Examination by 2-dimensional dynamic echocardiography demonstrated large mobile vegetations in both patients, and the display pointed to an ominous risk of embolism. Heart surgery with valve replacement was performed, the main indication being prophylaxis against embolism; the operative findings seemed to justify the assumption of imminent risk of embolism. It is suggested that the display of dynamic morphology of valvular vegetations by 2-dimensional echocardiography can be useful in identifying a subset of patients at high risk of embolism during infective endocarditis. However, more experience is needed before definite conclusions can be drawn regarding the role of early operation as prophylaxis against impending embolism.

Adult↗
PubMed1975

Ultrasonic identification and examination of fetal heart structures.

Ultrasonic studies were performed on normal fetuses ranging from 36 to 40 weeks gestational age in an attempt to visualize anatomical details of the fetal heart. We were able to visualize cardiac structures hitherto thought to be unidentifiable. Two-dimensional B-scan exposures of sections showed transverse and longitudinal sections of the fetal heart, including the cardiac septa and inlet and outlet sites of the large vessels. To attempt to elucidate the dynamics of the fetal heart, the motility patterns of the cardiac structures were examined by time-motion mode scanning and the patterns obtained were compared to those observed in the postnatal heart. The reliability of the theories advanced and the further prospects are discussed.

Coronary Vessels↗
PubMedDate not supplied

A five-chambered heart: rare coronary artery anomaly with fistula draining into a separate interventricular cavity.

The combination of color flow Doppler imaging, contrast echocardiography, magnetic resonance imaging, and coronary arteriography documented the presence of a right coronary artery fistula that opened into a separate cavity in the anterior part of the interventricular septum in a 32-year-old man. Although a traumatic origin could not be excluded, the abnormality was most likely a congenital anomaly. Because there were no significant symptoms and no signs of hemodynamic burden on the heart, a conservative management was decided and no complications occurred during 3 years of follow-up. So far the literature includes only one similar case described by autopsy findings.

Adult↗
PubMedDate not supplied

Pediatric multiplane transesophageal echocardiography in congenital heart disease: new possibilities with a miniaturized probe.

In recent years, transducers for multiplane Doppler echocardiography have demonstrated their superior imaging performance in adult patients. To date, the size of these probes has limited their use in pediatric patients. In this article, we report our initial experience with a recently developed miniaturized transducer with all conventional imaging and Doppler modalities. The study focused primarily on imaging performance by comparing standard biplane images with those obtained in oblique planes. The investigations were carried out intraoperatively or during interventional catheterization in patients with congenital heart disease. We observed no complications in a study population of 15 children (weight range of 5 to 63 kg and an age range of 96 days to 11 years). The probe was easy to handle and provided excellent images. Additional information was obtained in several cases and documentation of clinical findings was easier because an optimal image plane almost always could be displayed. We concluded that pediatric multiplane Doppler echocardiography has considerably improved investigative performance compared with the conventional monoplane or biplane studies normally available for this age group. In neonates, however, investigation with the multiplane technique is limited by the size of the patient.

Child↗