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Biomedical subjects

J V Talano

Publications and source records attributed to J V Talano.

At least 37 records · Page 2Linked to original sources
PubMed1984

Echographic early systolic partial closure (notching) of the aortic valve in congestive cardiomyopathy.

We investigated the prevalence and significance of aortic valve early systolic partial closure (notching) in congestive cardiomyopathy by reviewing clinical and M-mode echocardiographic findings in 33 patients. We also compared their echocardiographic aortic root and valve findings to those in 17 aortic regurgitation patients and 24 normal subjects. Thirteen cardiomyopathy patients (39%) exhibited aortic valve partial closure--similar to the prevalence in the aortic regurgitation (41%) and normal (33%) groups. However, patients with dilated cardiomyopathy and aortic valve notching exhibited a higher mean percentage of partial closure (18% +/- 10) than those with notching in either the aortic regurgitation (8% +/- 9) or normal (5% +/- 2) group. There was no significant difference in age, body surface area, left ventricular dimension, systolic function, or presence of mitral regurgitation between cardiomyopathy patients with and without aortic valve notching, but the former had slightly greater aortic root dimensions and maximal aortic leaflet separation. Although the reason for this difference is unknown, a wider aortic root may result in low-pressure areas bordering the aortic flow stream during early systole, which may favor partial aortic valve closure.

Adult↗
PubMed1984

Torsade de pointes induced by N-acetylprocainamide.

N-Acetylprocainamide (NAPA), a class III antiarrhythmic drug, caused torsade de pointes in a 72 year old woman who had this arrhythmia on two previous occasions while being treated with quinidine and disopyramide. Initial evaluation with an intravenous infusion of NAPA indicated a favorable antiarrhythmic response. The QTC interval was prolonged, but the 2.4 ms/microgram per ml incremental QTC interval lengthening caused by NAPA was not greater than usual. During subsequent oral therapy with NAPA, torsade de pointes developed at plasma levels of this drug that appeared to be well tolerated during the initial evaluation.

Acecainide↗
PubMed1983

Atrial fibrillation and flutter. Immediate control and conversion with intravenously administered verapamil.

The safety and efficacy of the intravenous (IV) calcium channel blocker, verapamil, in controlling the ventricular response or converting to sinus rhythm patients with atrial flutter or atrial fibrillation were assessed. Seventeen patients (nine with atrial flutter and eight with atrial fibrillation) with these arrhythmias that were difficult to control pharmacologically were chosen for the study. All patients at the time of study were receiving digoxin. Either verapamil or placebo was chosen randomly and a bolus of 0.075 mg/kg (up to 5 mg) was administered. Twelve patients had a marked reduction in their ventricular response after IV administration of verapamil (seven with atrial flutter and five with atrial fibrillation). None of these 12 patients converted (nonconverters). The average reduction in heart rate was from 120 +/- 6 beats per minute to a minimum of 83 +/- 13 beats per minute within 20 minutes after drug administration. Verapamil was found to convert five patients with atrial arrhythmias to sinus rhythm (two with atrial flutter and three with atrial fibrillation) (converters). In addition, three patients with atrial arrhythmias of less than one month who did not convert with parenteral drug therapy converted within 24 hours while receiving the oral drug. Converters had their supraventricular arrhythmias of significantly shorter duration (median, three hours v 30 days) and tended to have smaller left atrial size (3.8 +/- 0.7 cm v 4.3 +/- 1.3 cm) compared with the nonconverters. We conclude that verapamil is safe and effective when administered IV to patients with atrial flutter and fibrillation for control of ventricular response. In short duration atrial arrhythmias, conversion to sinus rhythm is likely once the ventricular response is controlled.

Adult↗
PubMed1981

Systolic anterior motion in the absence of asymmetric septal hypertrophy. A buckling phenomenon of the chordae tendineae.

Systolic anterior motion (SAM) of the mitral valve in the absence of asymmetric septal hypertrophy or concentric left ventricular hypertrophy has been reported in several conditions. In this report we describe the clinical and echocardiographic findings in 15 patients who demonstrated SAM without associated organic heart disease (group 1, 10 patients) or in association with mitral valve prolapse (group 2, five patients). Cross-sectional echocardiography revealed the etiology of SAM in both groups to be early systolic anterior angular motion ("buckling") of mitral chordal structures, rather than movement of the body of the anterior mitral leaflet into the left ventricular outflow tract. In contrast to normal subjects and group 1, group 2 patients had auscultatory evidence of mitral prolapse, a slightly greater mean left ventricular ejection fraction (p < 0.05) (normals, 69 +/- 5.2%, group 1, 72 +/- 3.8%, group 2, 75+/- 5.6%), and a greater mean diastolic mitral valve (D-E) excursion (p < 0.05) (normals, 1.8 +/- 0.2 cm, group 1, 2.2 +/- 0.3 cm, and group 2, 2.6 +/- 0.4 cm). This spectrum of mitral excursion and left ventricular ejection fraction supports the concept that the mitral valve prolapse syndrome may have as its basis a mitral valve abnormality and/or a hyperdynamic state that predispose to both chordal buckling and mitral leaflet prolapse.

Adult↗
PubMed1980

Intracardiac injections during cardiopulmonary resuscitation. A low-risk procedure.

Fifty-three patients were observed prospectively for the development of complications resulting from 147 intracardiac injections (ICIs) received during cardiopulmonary resuscitation (CPR). Although pericardial effusion was noted in six of 17 echocardiograms and a hemopericardium found in eight of 28 autopsies, cardiac tamponade was not observed. A pneumothorax developed in one patient. None of the autopsies disclosed coronary artery or ventricular lacerations. Percutaneous puncture of the heart during CPR seldom results in serious complications. When other sites are not readily available, ICIs are safe and valid for the administration of emergency medication.

Epinephrine↗