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Biomedical subjects

J A Spittell

Publications and source records attributed to J A Spittell.

At least 37 records · Page 2Linked to original sources
PubMed1985

Evaluation of the patient with intermittent claudication.

The most common cause of intermittent claudication is atherosclerotic occlusive arterial disease. Differentiation of the common musculoskeletal and neurologic conditions that may mimic intermittent claudication is often possible with a careful history, but when insufficient detail is provided or multiple conditions exist, the findings on physical examination and noninvasive studies are useful. While physical examination provides a rough estimate of the degree of ischemia, assessment of functional impairment produced by occlusive arterial disease is best made with noninvasive studies before and after standard exercise. Arteriography is reserved for the patient for whom restoration of pulsatile flow is planned.

Angiography↗
PubMed1983

Hypertension and arterial aneurysm.

The rather common coexistence of arterial aneurysm and systemic hypertension may be attributed to their respective frequency as clinical findings. The development of hypertension secondary to renal ischemia that can occur as a complication of certain types of aneurysmal disease is well recognized. Less well appreciated is the evidence to implicate hypertension as a factor in the pathogenesis of arterial aneurysms, perhaps in their progressive enlargement, and even in rupture. Furthermore, after resection of an aneurysm, systemic hypertension adversely influences survival, and it is an important contributing factor in the development of false aneurysms. A relation between hypertension and aortic dissection has received more recognition. Just how systemic hypertension contributes to the occurrence of aortic dissection is not clear, but the effective control of hypertension has the potential for decreasing the incidence of aortic dissection. The curious clinical association of hypertension with the location of the primary tear in the proximal part of the descending aorta (type III or type B) has several plausible explanations.

Aneurysm↗
PubMed1982

Occlusive peripheral arterial disease. Guidelines for office management.

Occlusive peripheral arterial disease is rather easy to diagnose because of its characteristic symptoms and the ease with which the extremities and their circulation can be examined. Elevation and dependency tests give a rough but reliable estimate of the degree of ischemia, and if more objective data are desired, the systolic blood pressure index can be determined. Management should be individualized according to the degree of disability and ischemia, the expected natural history, and the patient's general health.

Age Factors↗
PubMed1981

Intra-aortic balloon counterpulsation as adjunct to aneurysmectomy in high-risk patients.

Patients with severe coronary artery disease that is not amenable to coronary artery bypass surgery face formidable risks when major aortic surgery becomes necessary. In this report we present such a patient, who successfully underwent abdominal aortic aneurysm resection and graft replacement with the prophylactic use of intra-aortic balloon counterpulsation. The use of intra-aortic balloon counterpulsation at the time of surgery has the potential of improving cardiac function in patients with left ventricular dysfunction and favorably influencing the perioperative and postoperative mortality in these patients. Its use also appears worthy of trial in patients with ruptured abdominal aortic aneurysm and shock, in the hope that it will result in improved survival in these patients.

Aorta, Abdominal↗