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Biomedical subjects

H Just

Publications and source records attributed to H Just.

At least 343 records · Page 19Linked to original sources

Q-T prolongation and torsades de pointes in a patient with subarachnoid hemorrhage.

An extreme Q-T prolongation in a patient with subarachnoid hemorrhage was observed. Multiple torsades de pointes occurred. Lidocaine, metoprolol, and atropine were not effective in controlling the arrhythmia, whereas shortening the Q-T interval by intravenous administration of orciprenaline or overdrive ventricular pacing was successful. The occurrence of T wave alternations was a sign of increased sympathetic activity.

Aged↗

Increased incidence of side effects after encainide: a newly developed antiarrhythmic drug.

In a clinical trial the efficacy of encainide, a newly developed class I antiarrhythmic agent, was compared with the well-known mexiletine. Nine patients with different underlying cardiac disease and chronic complex ventricular ectopies (documented by 24-h Holter monitoring, confirmed during the initial placebo period) entered the study. The dosage of encainide was increased from 25 to 75 mg three times daily and the antiarrhythmic effect monitored by repeated 24-h Holter registration and in some patients by treadmill exercise testing. During the clinical followup we noted a high incidence of so-called "minor side effects" (headache, dizziness, blurred vision, tremor, and nausea), which caused us to terminate the study. In all instances adverse effects emerged before ectopic activity was suppressed satisfactorily prohibiting further increment of dosage. These results indicate that encainide cannot be regarded as an antiarrhythmic drug of first choice in routine clinical application.

Adult↗

Sudden cardiac death recorded during ambulatory electrocardiographic monitoring.

Two case reports of sudden cardiac death are detailed here. Holter monitoring plays an important role in documenting arrhythmias leading to sudden cardiac death. In addition, the importance of the Lown grading concept should not be underestimated. Our two case reports and a subsequent review of the literature demonstrate both points.

Aged↗

[The effect of various cutaneously administered nitroglycerin preparations on coronary heart disease].

Sublingually administered nitroglycerin provides marked benefit in the treatment of angina pectoris due to occlusive coronary disease. Because of its brief duration of action, its usefulness as a prophylactic agent is limited. One way to prolong the beneficial effects is cutaneous administration of a nitroglycerin ointment, and the effects and duration of action of three different preparations of topical nitroglycerin on exercise performance have therefore been studied in a double-blind randomized manner in 44 patients with well documented coronary artery disease and stable angina pectoris. 30 mg 2% nitroglycerin ointment((Plantorgan Co.) produced significant improvement in maximal exercise capacity one and six hours after application; concomitantly there was a decrease in the sum of exercise induced ST-segment depression especially one hour, but less markedly six hours, later. 10 mg 2% nitroglycerin ointment (Pohl Boskamp Co.) also produced an increase in maximal exercise tolerance and a reduction in the degree of myocardial ischemia estimated by the magnitude of exercise-induced ST-segment depression one hour after application, but no clear effect could be measured four hours later. 25 mg nitroglycerin in the "transdermal therapeutic system" (Ciba Geigy) produced a significant improvement in maximal exercise capacity and a significant decrease in the sum of exercise-induced ST-segment depression one and five hours after cutaneous application. Side effects were not observed during these studies, and the topical compatibility of the different ointments was good.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Topical↗

[Invasive diagnosis of coronary heart disease: recent developments in coronary angiography].

Coronary angiography as a diagnostic procedure has been increasingly perfected over the last 25 years. Technical and pharmacological developments have revealed several new aspects of coronary angiography. The optical and spatial resolution of coronary lesions has been enhanced by improvement of X-ray equipment and the introduction of biplane isocentric coronary angiography with hemiaxial views. Functional diagnosis of coronary arteries has been improved by the introduction of selective pharmacological methods, especially in the search for coronary spasms. The latest development is the introduction of coronary angiography as a therapeutic procedure for intracoronary thrombolysis in evolving myocardial infarction and percutaneous transluminal angioplasty.

Cardiac Catheterization↗

[Prognostic significance of the QT-interval following myocardial infarction].

The prognostic value of QT prolongation was evaluated in 109 patients with myocardial infarction. Patients who suffered from reinfarction during the first month or developed ventricular fibrillation and sudden death did not have longer QT intervals than patients without these complications. On the other hand, QT prolongation was of prognostic value in the prediction of late reinfarction. The reasons for varying results from different investigators are discussed.

Adult↗

[The significance of improved angiocardiography systems in the quantitative assessment of proximal coronary stenosis. Comparison of angiographic and hemodynamic measurements in vivo].

The use of high resolution X-ray techniques for biplane coronary angiography can improve the quantitative assessment of coronary stenoses when perpendicular projections in both views can be achieved. Angiograms thus obtained of coronary stenoses before (n = 17) and after (n = 14) coronary dilatation were evaluated for mean and minimal stenosis diameters of two planes and for percent narrowing of stenoses (caliper measurements). Comparisons with transstenotic pressure gradients showed significant or highly significant correlations for all dimensional parameters. It is concluded that quantitative angiographic analysis of coronary stenoses yields highly reliable results of hemodynamic relevance. In addition, a mean diameter of less than 1.6 mm could be identified as indicating hemodynamically significant stenosis.

Angiocardiography↗

Flecainide-induced aggravation of ventricular tachycardia.

Flecainide acetate is a new class I antiarrhythmic agent which slows atrial, A-V nodal and ventricular conduction velocity, and prolongs refractoriness of these structures (Borchard et al., 1982; Hodess et al., 1979). Recent studies with oral flecainide therapy suggested its high potential for suppression of ventricular tachycardia in humans (Anderson et al., 1981; Duff et al., 1981; Hodges et al., 1982). Its favorable pharmacokinetics with an average plasma half-time of about 20 hours allows in most patients twice daily dosing (Duff et al., 1981). Usually, the drug seemed to be well tolerated and side-effects, such as blurred vision, could be resolved with smaller but still effective doses (Duff et al., 1981). Actually, the ideal antiarrhythmic agent which represents a high degree of effectiveness, a low level of toxicity, a wide therapeutic range, and a prolonged antiarrhythmic action does not exist (Dreifus and Ogawa, 1977). In this report we describe a patient with flecainide-induced aggravation of ventricular tachycardia necessitating resuscitation because of severe hemodynamic deterioration.

Anti-Arrhythmia Agents↗