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Biomedical subjects

L Gould

Publications and source records attributed to L Gould.

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

Electrophysiologic properties of ethacrynic acid in man.

Ethacrynic acid is a potent oral diuretic and saluretic agent. It has been used extensively in the treatment of heart failure and its effects on cardiovascular dynamics are well established. The clinical relief of the symptoms of pulmonary congestion frequently precedes any demonstrable diuretic effect suggesting that extra renal factors may also be involved. In spite of ethacrynic acid's wide use in the treatment of heart failure and hypertension, there is no information on the electrophysiologic properties of the drug in man. The present study involving 10 human subjects was undertaken to determine what effect intravenously administered ethacrynic acid has on the human conduction system.

Adolescent↗
PubMed1983

Electroconvulsive therapy-induced ECG changes simulating a myocardial infarction.

Electroconvulsive therapy (ECT) can produce various cardiac arrhythmias; however, to our knowledge, no other alterations have been described in the ECG. A 75-year-old woman was admitted to the Methodist Hospital in Brooklyn, NY, because of depression. She had had no cardiac symptoms and had been in good health. She was not receiving any medications. Physical examination showed no abnormalities. Findings from the routine laboratory tests, a chest roentgenogram, and the initial ECG were normal. In view of the severe depression, a series of ECTs were given to the patient during a two-week period. A repeated ECG showed deep T-wave inversions in leads I, II, III, aVF, and V1 to V6. The patient was completely asymptomatic. Serial enzyme determinations were normal. A brain scan, gated-pool scan, computed tomography scan of the head, and a technetium Tc 99m pyrophosphate scan were all normal. Serial ECGs showed a persistence of the deep T-wave inversions. There were no QRS changes. There was no evidence of a cerebral vascular accident or pericarditis. The T-wave changes in our patient were not due to a myocardial infarction. Thus, ECT can produce striking T-wave abnormalities in the ECG that can simulate an acute myocardial infarction.

Aged↗
PubMed1983

Congestive cardiomyopathy and left ventricular thrombus.

A left ventricular thrombus was detected by echocardiography in a 54-year-old man with congestive cardiomyopathy. With the use of anticoagulants, the thrombus completely disappeared. Patients with congestive cardiomyopathy who are at high risk for thrombus formation should be screened with two-dimensional echocardiography. If a thrombus is recognized, anticoagulation therapy can then be instituted.

Cardiomyopathy, Alcoholic↗
PubMed1982

Effect of isoetharine on cardiac conduction in man.

The effects of isoetharine on the His bundle electrogram were studied in 10 patients with heart disease. Recordings were made at varied heart rates using atrial pacing. Isoetharine significantly reduced the AH interval with atrial pacing, but it had no effect on the HV interval. Second degree heart block occurred at higher pacing rates after isoetharine treatment as compared to the control state. The heart rate and blood pressure showed no significant change after isoetharine. The functional and effective refractory period were measured with the use of the extra-stimulus technique. The functional refractory period of the AV node, as well as the effective refractory period of the atrium, significantly decreased after isoetharine. Thus, isoetharine can improve conduction through the atrioventricular node. The drug does have a cardiac effect as measured by its action on the human conduction system.

Adrenergic beta-Agonists↗
PubMed1982

Left ventricular wall motion improvement after phentolamine: a case report.

Left ventricular wall motion abnormalities are commonly seen in coronary artery disease patients. The differentiation between reversibly ischemic areas an irreversibly damaged areas is 1 was of predicting which patient might gain improved ventricular function from surgical correction. One patient with coronary artery disease is presented here who showed poor septal movement on his echocardiogram. After the IV administration of phentolamine, the septal movement became normal. Thus, phentolamine should be considered as an agent that can detect reversible areas of wall motion abnormalities.

Coronary Disease↗
PubMed1982

Paradoxical response to the vasodilators.

A 52-year-old male was admitted to the hospital in congestive heart failure. Mitral stenosis as well as an aortic valve prosthesis were the underlying cardiac abnormalities. A Swan-Ganz catheter was inserted and various vasodilators were administered. Phentolamine, nitrates, nitroprusside, and hydralazine all produced an unexpected and at times an alarming increase in the pulmonary artery pressure. The explanation of this paradoxical hemodynamic response is unknown but demonstrates the importance of hemodynamic monitoring with vasodilator therapy

Blood Pressure↗
PubMed1982

Effect of nebulized isoproterenol on cardiac conduction in man.

The effects of Isuprel administered by means of a mistometer were studied in 8 patients with heart disease. Recordings were made at varied heart rates using atrial pacing. In addition, the functional and effective refractory periods were measured with the use of the extra stimulus technique. Four inhalations of the mistometer were administered to each patient (0.5 mg). The AH interval was 100 +/- 13 msec before and 93 +/- 23 msec 5 minutes after the Isuprel administration (p less than 0.05). Isuprel significantly reduced the AH interval with atrial pacing. The AH interval at an atrial pacing rate of 100/minute was 148 +/- 70 msec before and 131 +/- 51 msec after Isuprel (p less than 0.05). Isuprel had no significant effect on the HV interval. The effective and functional refractory period of the atrioventricular node was not significantly changed after Isuprel. The heart rate and blood pressure showed no significant change after Isuprel. No cardiac arrhythmias were seen. (The systemic absorption of the drug was probably minimal.) Isuprel administered by means of the mistometer can improve conduction through the atrioventricular node. Nevertheless, the potent bronchodilating effects of Isuprel and the absence of tachycardia and cardiac arrhythmias does attest to the safety of this agent.

Administration, Oral↗
PubMed1981

Electrocardiographic normalization after cerebral vascular accident.

A 59 year old female sustained an anterior subendocardial infarction with deep T wave inversions in leads I, AVL and V2-V6. She subsequently developed a cerebral vascular accident. The ECG now revealed upright T waves in the leads that previously showed deep T wave inversions. A review of the literature failed to reveal a similar case of normalization of the ECG after a cerebral vascular accident.

Cerebrovascular Disorders↗
PubMed1981

Electrophysiologic properties of cimetidine in man.

Severe bradycardia has been reported with the use of cimetidine. This observation has been explained by histamines' known action in increasing the contraction rate of the spontaneously beating right atrium, strips of ventricular muscle, and whole heart of guinea pigs. Histamine can also produce cardiac arrhythmias in animals. There is evidence for H2 receptors in the heart. Black and his associates have shown that the characteristic effect of histamine on isolated guinea pig atrium could be selectively blocked by anti-H2 drugs. Thus cimetidine probably can produce a sinus bradycardia by blocking the H2-receptor site in the heart. Recently Engel and Luck reported that 300 mgs of intravenously administered cimetidine did not affect heart rate, sinus node recovery time, or sinoatrial conduction time. These workers concluded that there is insufficient evidence to demonstrate that cimetidine caused appreciable sinus node dysfunction in man. In view of the disparity in these reports, we investigated the effects of 300 mgs of intravenously administered cimetidine on the human conduction system.

Adolescent↗