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Biomedical subjects

J F Godin

Publications and source records attributed to J F Godin.

At least 73 records · Page 4Linked to original sources
PubMed1983

[Aortic stenosis in adults: contribution of catheterization to the study of associated lesions. Apropos of 137 cases].

The results of cardiac catheterisation in 137 cases of pure adult aortic stenosis considered to be isolated after non-invasive investigation (clinical examination, carotid pulse tracing, echocardiogramme) are reported. The authors analyse the reliability and risks of this examination to which they attribute a triple objective; evaluation of the severity of the AS, evaluation of LV and/or mitral valve dysfunction and the assessment of the coronary circulation in patients with angina or in all patients over 54 years of age or with coronary calcifications. The aortic valve was crossed in 89,8 p. 100 of patients. Coronary angiography was attempted in 128 cases (93,4 p. 100) and was successful in 110 cases (85,9 p. 100). The investigation was complicated by one death (0,73 p. 100) and one femoral artery thrombosis, and was complete in only 74 p. 100 of cases. The results showed the aortic stenosis to be isolated in only 84 cases (61,3 p. 100). In the other 53 cases (38,7 p. 100) there was unrecognised associated pathology: mitral valve disease was diagnosed in 14 cases (12,3 p. 100); significant coronary artery disease (greater than 50 p. 100 narrowing) was observed in 34 of the 110 patients in whom coronary angiography was successful (30,9 p. 100). In the last 5 cases, catheterisation showed: two ASDs, one partial abnormal pulmonary venous drainage, one fusiform aneurysm of the aortic isthmus, one abnormal origin of the left anterior descending artery in the right coronary sinus with a pre-pulmonary trajectory. The authors discuss the value of the various methods of preoperative assessment of AS. The relative reliability of the different non-invasive techniques is compared.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1982

[Treatment of a severe coronary artery spasm, refractory to complete denervation of the heart (autotransplantation)].

The case reported is that of a 49 year old man with very severe Prinzmetal angina due to spasm of the left circumflex artery. Despite intensive medical treatment he continued to suffer frequent attacks with atrioventricular block. As plexectomy was not possible in this case, complete cardiac denervation was performed. After surgery, he had no further attacks and continuous ECG monitoring showed no ischemic phenomena. Nevertheless, a stress test was still able to induce spasm of the same artery which was painless but associated with ECG changes. Eighteen months postoperatively, resting angina recurred with positive stress tests giving painful attacks. Four hypotheses are discussed: 1) the local factor was very important, with a zone of hyperactivity on the left circumflex artery, 2) one of the mechanisms of coronary artery spasm could be the nervous stimulation of this zone, 3) this zone was insensitive to nervous stimulation after autotransplantation but remained sensitive to methylergometrine, 4) the recurrence of resting angina and painful symptoms on stress testing suggests the possibility of reinnervation of the heart, as has been shown after cardiac transplantation, the autonomic nervous system does not play the role generally attributed to it in the genesis of spasm.

Aged↗
PubMed1982

[Complications of myocardial infarction between the 2d and 4th week].

The complications of myocardial infarction after transfer from the Coronary Care Unit on the 6th day were analysed bu a retrospective study of 3,460 computerised case reports (1973-1980). The mortality rate was 6% (1/3 of hospital deaths) in the period from the 7th day to discharge from hospital (14th to 30th day). Cardiac arrest as not uncommon (20% of all cardiac arrests) but the prognosis was better thn during the initial phase (p less than 0.05) as the mechanism was more commonly ventricular fibrillation or tachycardia (p less than 0.05). This series was compared with a similar population from 1970-1973; an improvement was observed in global hospital mortality (27% previously compared to 17%, in the study series, p less than 0.001). As the population were comparable, this phenomenon seems to be related to better treatment of shock and cardiac failure and the advances in cardiac surgery during the initial phase of infarction. Thd commonest mechanical complication was ventricular aneurysm; its occurrence does not influence the vital prognosis during this period. The incidence of cardiac arrest and death due to cardiac failure is not negligible after the first week of myocardial infarction. Therefore, we do not believe that the hospital period should be reduced after myocardial infarction. Special training of the nursing staff is essential for the successful treatment of these complications. The global prognosis could be improved by the rehabilitation of digitalis therapy and the introduction of new sympathomimetic amines in the acute phase of myocardial infarction.

Adult↗
PubMed1978

[Intimal coronary fibrous dysplasia and Prinzmetal's angina].

It is currently considered as exceptional for there to be arterial pathology other than atheroma in Prinzmetal angina. The authors have found five cases of coronary fibrous dysplasia in the literature. They add a case, in a woman, of intimal fibrous dysplasia diffusely involving the three main coronary vessels. Coronary arteriography showed that spasm of the right coronary artery was the cause of attacks with the clinical and electrocardiographic features of Prinzmetal angina. The whole coronary tree was otherwise normal angiographically and also macroscopically at autopsy. The dysplasia was only discovered by histological study of serial sections of the three coronary vessels. Histological examination showed no evidence of an atheromatous lesion. The authors place these coronary artery lesions within the general classification of arterial fibrous dysplasias. It remains hypothetical whether there is a relationship between the occurrence of spasm and this very special histological feature of the coronary artery wall.

Angina Pectoris↗
PubMed1978

[Accidental intoxication with aconitine (author's transl)].

Involuntary ingestion of 3 mg of aconitine induces in a young woman multifocal extrasystoles and alternating periods of sinusal rhythm and junctional arrhythmia. The rhythmogenetic abnormalities disappear spontaneously within two hours. The physiopathology of arrhymias due to aconitine is discussed.

Aconitine↗
PubMed1978

[The heart and drug poisoning, excluding cardiologic treatments].

When considered strictly from the viewpoint of actions on the myocardium, the number of drugs falling into this category is limited, but the resulting conditions may be serious. The prototype for cardiac toxicity is the group of antimitotic drugs (adriamycin or daunomycin). If these drugs are used; frequent and careful follow-up is necessary, the dosage at which the drug becomes cumulative must be known; and patients with a pre-existing cardiac condition must be exluded from treatment. Above all, it is essential not to wait until asystole occurs, but to try to prevent such occurrences by monitoring the patient electrocardiographically. A part from these drugs, recent articles in the literature suggest that similar care should be taken when prescribing emetine and lithium salts. There is insufficient information about other drugs which may have a certain degree of cardiotoxicity. For this reason, it is most important to gather information on accidents and reaction during treatment.

Daunorubicin↗
PubMed1975

[Long term prognosis after circulatory arrest].

24 PATIENTS HAVING SURVIVED MORE THAN 18 MONTHS AFTER AN EPISODE OF CIRCULATORY ARREST WERE EXAMINED WITH THE AIM OF ASSESSING THE PSYCHOLOGICAL REACTIONS TO SUCH AN INCIDENT. The results obtained were encouraging, since immediately after the circulatory arrest there were only monor troubles reflecting the simple bringing into action of defence mechanisms. Long term adaptation was deemed excellent in 80 p.cent of cases which should, nevertheless, lead to any underestimation of those sequelae which, though happily rare, are highly incapacitating.

Adaptation, Psychological↗