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Biomedical subjects

J C Potier

Publications and source records attributed to J C Potier.

At least 91 records · Page 5Linked to original sources
PubMed1985

Role of coronary spasm in the genesis of myocardial infarction: study of a case treated by isosorbide dinitrate in situ then by transluminal angioplasty.

We report the observation of a 62-year-old patient who was admitted for unstable angina. A prolonged chest pain (more than two hours) with a major electrocardiographic lesion in the posterior leads needed an urgent coronary arteriography in order to attempt a recanalization. Antecedents of arteriopathy of the lower limbs with aortobifemoral bypass required an axillary artery right side approach. A selective right coronary opacification showed complete occlusion at the junction of segments 1 and 2. An intracoronary injection of isosorbide dinitrate relieved a coronary spasm and allowed a complete visualization of the right coronary artery. This appeared to be very atherosclerotic with several severe narrowings, and a subocclusive lesion at the site of the initial occlusion. Percutaneous transluminal coronary angioplasties (PTCA) were performed and led to real 'restructuring' of the right coronary artery. The clinical outcome was excellent without recurrent angina pectoris. An angiographic control performed 6 months after PTCA demonstrated the persistence of the coronary recanalization and an evident improvement of the segmental contractility. This report emphasizes the role of coronary spasm in the genesis of myocardial infarction and shows that PTCA may be performed as a first approach at the acute phase of myocardial infarction; to our knowledge it is the first PTCA performed by an axillary approach at the acute stage of myocardial infarction.

Angina Pectoris, Variant↗
PubMed1985

[Tumoral vascularization in a case of asymptomatic myxoma].

A 67 year old woman was admitted for assessment of asymptomatic aortic stenosis. A large left atrial myxoma was demonstrated by 2D and M mode echocardiography. Coronary angiography was performed as part of the investigation of the aortic stenosis and showed that the tumour depended on the right coronary artery for its blood supply. Careful frame-by-frame study showed the presence of a true right coronary-left coronary fistula through the tumour. The authors discuss the different clinical presentations of left atrial myxomas and their vascularisation in the rare cases in which it has been described.

Aged↗
PubMed1985

[A possible application of percutaneous transluminal angioplasty: remodelling of an occluded aortocoronary bypass].

The authors report the case of a 53 year old patient who had undergone triple coronary bypass surgery for unstable angina. Recurrence of chest pain 4 months after surgery led to control coronary angiography which showed severe stenosis of the proximal and distal parts of the aorto-right coronary graft. Endoluminal dilatation was performed a few days later but, during angiography, complete occlusion of the graft was observed. This was repermeabilised without difficulty and a "remodelling" of the graft was carried out. The outcome was favourable with the complete regression of symptoms. The following alternatives to surgery are discussed: in cases of thrombosis which usually occur in the month following surgery, fibrinolysis may be attempted with a high success rate but a significant risk of haemo-pericardium: in cases of fibrous proliferation of the intima leading to stenosis or occlusion, endoluminal dilatation seems to be the procedure of choice, but this must always be carried out under surgical cover.

Angioplasty, Balloon↗
PubMed1985

[Cardiac insufficiency in acromegaly. Apropos of a case].

The authors report the case of a patient with acromegaly. The clinical history was dominated by left ventricular failure, for which acromegaly was the only evident cause. The cardiac index, pulmonary arterial pressure and the average pulmonary capillary pressure were measured before ablation of the hypophyseal tumour; the measurements were repeated 3 months and 8 years later. The postoperative course followed two phases: transient improvement of the haemodynamic parameters, then relapse of cardiac failure. This case confirms the possibility of a true cardiomyopathy during acromegaly; but the fact that the cardiac failure did not regress despite the decreased growth hormone levels was unusual and raises several physiopathological hypotheses.

Acromegaly↗
PubMed1985

[Cardiac tumors with neonatal disclosure. Apropos of a case with spontaneously favorable development].

The authors report the case of a cardiac tumour documented by 2 D echocardiography, presenting in the newborn with cardiac arrest. The echocardiographic features of multiple nodules disseminated in the ventricular walls suggested a diagnosis of rhabdomyoma. The initial course was complicated by poorly tolerated attacks of tachycardia which were rapidly brought under control with amiodarone. The long term outcome was clinically favourable with a rapid regression of the number and size of the tumours on echocardiography, and a tendency to normalisation of the electrocardiogramme. The possibility of regression, which has already been reported by many investigators, suggests that these cardiac tumours may have a better prognosis than previously thought.

Echocardiography↗
PubMed1985

[Rare mechanical complications of right ventricle infarction. Value of two-dimensional echocardiography].

Two rare mechanical complications of right ventricular infarction are reported: myocardial dissection and rupture of the RV free wall. The diagnosis was made by 2D echocardiography in both cases. Myocardial dissection resulted in the formation of an oblong, expansive, intraparietal space. The rupture of the RV free wall was visualised as a breach of the continuity of the ventricular wall. These cases underline the importance of 2D echocardiography in the acute phase of myocardial infarction for the diagnosis of these complications.

Aged↗
PubMed1985

[Echocardiographic diagnosis of a rare mechanical complication of biventricular infarction. Rupture of the free wall of the right ventricle].

The authors report a case of rupture of the free wall of the right ventricle, diagnosed by two dimensional echocardiography. This examination revealed an intrapericardial clot associated with a fissure of the diaphragmatic wall of the right ventricle. This case emphasises the value of two dimensional echocardiography in the acute phase of myocardial infarction for the diagnosis of complications which require urgent surgical treatment.

Aged↗
PubMed1985

[Cardiac manifestations of atrophying polychondritis. Apropos of a case disclosed by pericardial effusion and auricular flutter].

We report the case of a 50 year old patient, hospitalised with a clinical record suggestive of acute pericarditis and disturbance of auricular rhythm of the flutter type. The consciousness of muscular pain, subcutaneous peri-articular nodules developing over periods of 10 to 15 days and the appearance of chondritis of the right auricle on the 2nd day of hospitalisation led to a diagnosis of atrophying polychondritis. A two-dimensional, TM echocardiographic examination confirms the presence of a discrete, pericardial effusion and presents evidence for a concentric hypertrophy and a heterogeneous aspect of the left ventricular myocardium. In atrophying polychondritis, a rare systemic disease the diagnosis for which is essentially clinical, complications readily set in the form of cardiovascular attacks, sometimes lethal (valvulopathies essentially aortic, aneurysm of the ascending aorta, disturbances of rhythm and conduction, myocardial necrosis, etc). A pericardial attack has already been reported for this condition but uniquely according to electrocardiographic criteria, the lack of specificity of which is known. Our case report confirms the possibility of a pericardial reaction and, in addition, permits the observation of a hypertrophy and a heterogeneous aspect of the myocardium which has not yet been reported in the literature.

Atrial Flutter↗
PubMed1985

[Acute cardiac liver following a pulmonary embolism. Apropos of 2 cases].

The authors report 2 cases of acute hepatic failure secondary to a pulmonary embolism, the [atypical] symptomatology of which considerably interfered with diagnosis. A review of the literature confirms the rarity of embolic pathology as causing acute cardiac liver. The authors emphasize the importance of echotomography (cardiac and abdominal) in seeking dilatation of the right heart cavities, as well as of the inferior vena cava and hepatic veins.

Acute Disease↗
PubMed1984

[A possible alternative in failure of percutaneous intracoronary fibrinolysis: percutaneous endoluminal dilatation].

The authors report three cases of myocardial infarction in which an attempt at intra-coronary fibrinolysis in the acute phase was either transiently effective or totally ineffective. In these three cases, percutaneous endoluminal dilatation was possible allowing restoration of correct coronary flow. The place of percutaneous angioplasty is therefore discussed either immediately after fibrinolysis, when the risk of re-thrombosis appears to be greatest or perhaps in the absence of an attempt at clot lysis, when fibrinolytic treatment is contra-indicated.

Angioplasty, Balloon↗
PubMed1984

[Abnormal origin of the left coronary artery from the pulmonary artery, fortuitously discovered in an adult].

The authors report a case of an anomalous left coronary artery discovered by chance in a totally asymptomatic 39 year old man. Appearances of anterior myocardial infarction were observed on routine preoperative ECG in a man with multiple injuries. Coronary angiography showed an anomalous left coronary artery arising from the main pulmonary artery. Left ventricular function was poor with associated mitral regurgitation. Surgical correction consisted in an end-to-end venous graft between the ostium of the coronary artery detached from the pulmonary artery and the right anterior border of the ascending aorta. Left ventricular function did not improve four months after surgical correction. The irreversibility of the myocardial lesions argues in favour of an early correction of this malformation.

Adult↗
PubMed1984

[Associated septal and intrapericardial rupture of the heart in the acute phase of myocardial infarction. Apropos of a case surgically treated with success].

The authors report the case of a double rupture of the heart (septal and parietal intrapericardial) on the 5th day of primary transmural anterior myocardial infarction in a 73 year old women. The diagnosis of septal rupture was made after cardiac arrest and the findings of a systolic murmur, and by echocardiography. Intrapericardial free wall rupture was diagnosed at surgery. The incidence, predisposing factors, gravity, prognostic factors and different medico-surgical therapeutic approaches to septoparietal complications of acute myocardial infarction are reviewed.

Aged↗
PubMed1984

[Transitory appearance of collateral circulation during coronary spasm].

The authors report the case of a patient with coronary spasm characterised on exercise stress testing by an initial depression of the ST segment followed by ST elevation at the 3rd minute of recovery. Coronary angiography showed an important, transient collateral system arising from the left coronary artery, probably minimising the effects of complete occlusion of a dominant right coronary artery. The authors discuss effort-induced spasm and collateral circulation.

Collateral Circulation↗