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Biomedical subjects

J W Hurst

Publications and source records attributed to J W Hurst.

At least 109 records · Page 6Linked to original sources
PubMed1979

Cardiology--II.

Explore the source record for details and available documents.

Coronary Disease↗
PubMed1978

Value of coronary bypass surgery. Controversies in cardiology: Part I.

The value of coronary bypass surgery has been studied carefully during the last decade. Four methods, none perfect, have been used to compare the results of such surgery with the results of medical therapy. New data are likely to be merely supportive rather than the outcome of a definitive study with a new and a acceptable experimental design. It is therefore time to analyze the available data in light of the treacherousness of the disease and to determine if a clear trend is evident. There appears to be sufficient evidence to state that properly performed coronary bypass surgery will increase coronary blood flow and relieve angina pectoris in 90 percent of patients; total relief of angina can be expected in 60 percent and partial relief in 30 percent. Compared with modern medical therapy, properly performed coronary bypass surgery appears to prolong the life of patients who have obstruction of the left main coronary artery or triple or double vessel disease. There is not adequate evidence to state that the procedure will prolong the life of patients with single vessel obstruction. However, patients with single vessel obstruction and unacceptable angina pectoris should be considered for bypass surgery (especially patients with obstruction of the left anterior descending coronary artery). In practice, at Emory University Hospital, Atlanta, bypass surgery is recommended for young people with few symptoms if compelling obstructing lesions are present and in older patients only if their symptoms require it. Medical therapy is given before and after bypass surgery. When bypass surgery is performed in an excellent fashion (operative risk 1 percent) a great deal of "controversy" about this problem vanishes.

Angina Pectoris↗
PubMed1977

Phonocardiographic study of sounds produced by a circulatory assist device: report of a patient with a ruptured ventricular system.

A patient had a ruptured ventricular septum due to an acute anterior myocardial infarction. An aortic balloon pump was inserted and a subsequent phonocardiographic study was made showing inflation and deflation sounds and the diastolic pulse wave generated. This study defines the extra sounds and pulses generated by such a device so that they may be better understood for clinical interpretation.

Aged↗
PubMed1976

Duration of hospitalization in "uncomplicated completed acute myocardial infarction". An Ad Hoc Committee review.

The clinical and laboratory findings diagnostic of acute myocardial infarction include at least two of the following: (1) a history of pain consistent with myocardial ischemia, (2) electorcardiographic findings consistent with infarction, and (3) a rise in the serum level of specific cardiac enzymes. By the 4th or 5th day of illness, specific criteria can be applied to assign certain patients to a subset with "uncomplicated completed acute myocardial infarction." These criteria include the absence of evidence of (1) continuing cardiac ischemia, (2) left ventricular failure, (3) shock, (4) important cardiac arrhythmias, (5) conduction disturbances, and (6) other serious illnesses in patients with an established acute myocardial infarction. In terms of prognosis and management, patients in this subset should be regarded as substantively different from patients in other subsets. They should respond favorably to short periods of immobilization and hospitalization than those generally used. They may remain at bed rest (modified in regard to sitting and the use of a commode) for 4 days. Subsequently, mobilization with a program of progressive activity over the ensuing 5 to 10 days should reduce the duration of hospitalization to less than the current average of 17.5 to 20.8 days for patients with acute myocardial infarction. Nine to 14 days should suffice in most instances. Current and future trials may indicate that still earlier mobilization and shorter hospitalization periods can be applied to certain patient groups, but the evidence on this point is incomplete. For the individual patient, many factors will determine the optimal duration of bed rest and hospital stay. The patient's physician must consider the therapeutic benefits that may attend earlier mobilization and shorter hospitalization while weighing potential disadvantages. When the responsible physician does not regularly care for the patient, consultation with an experienced cardiologist is desirable. Patients whose condition is classified as "uncomplicated" may manifest deterioration during their illness and require assignment to a subset with a different prognosis and requiring different forms of treatment. For patients with uncomplicated acute myocardial infarction, as well as those in other subsets, absolute rules for therapy are unwise and application of broader principles by the alert physician is more likely to be beneficial.

Arrhythmias, Cardiac↗
PubMed1976

Myotonia dystrophica: ventricular arrhythmias, intraventricular conduction abnormalities, atrioventricular block and Stokes-Adams attacks successfully treated with permanent transvenous pacemaker.

In a patient with myotonia dystrophica multiple ventricular arrhythmias and high degree atrioventricular block requiring a permanent pacemaker developed. Patients with skeletal muscle disease may present with disproportionately advanced manifestations of associated cardiac disease. Early recognition of potential serious underlying cardiac disease is important in patients with this condition.

Arrhythmias, Cardiac↗
PubMed1976

Myocardial infarction in young women.

This study of 24 women under age 40 years with myocardial infarction demonstrates that even in young women myocardial infarction is most commonly due to coronary atherosclerotic heart disease. Other causes of coronary occlusion were documented in 17% of these patients, indicating that these lesser causes of myocardial infarction are more common in young women than in older persons or in young men. In those patients with coronary atherosclerosis one or more significant risk factors could usually, but not always, be documented. The clinical manifestation of the coronary occlusion in the study group was not unlike its manifestation in groups of different ages or sex, or both.

Adolescent↗