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Biomedical subjects

M E Assey

Publications and source records attributed to M E Assey.

35 records · Page 2Linked to original sources
PubMed1985

Comparative study of mexiletine and quinidine in the treatment of ventricular ectopia.

Mexiletine is an antiarrhythmic agent, structurally similar to lidocaine, but useful orally as well as intravenously. The safety and efficacy of mexiletine was compared with quinidine in a double-blind, parallel, randomized study of patients with chronic ventricular ectopia of various causes. Mexiletine was statistically more effective (P less than .05) than quinidine, though the total number of patients studied was small. Like quinidine, side effects limited the usefulness of mexiletine in certain patients, but these side effects are quite distinct from those of quinidine and other type I antiarrhythmic drugs. Mexiletine should be a useful addition to the armamentarium of antiarrhythmic drugs when it is released for clinical use in the United States.

Administration, Oral↗
PubMed1985

Angina after aortocoronary bypass grafting: combined medical therapy including nifedipine.

A second coronary artery revascularization procedure often yields poor results. Nifedipine, a calcium antagonist, was added to the current medical therapy consisting of maximal doses of beta blockers and nitrates in a group of 18 patients who had had one revascularization procedure and subsequently had class 3 and 4 angina pectoris. The overall favorable clinical response was 72%. The average dose of nifedipine to achieve a clinical response was 90 mg/day. Left ventricular function improved with time. We believe nifedipine is an important adjunct in the management of angina after coronary bypass operation.

Adrenergic beta-Antagonists↗
PubMed1984

Congenital heart disease in adults.

From January 1972 to April 1982, 125 adults underwent operation for congenital heart disease at the Medical University of South Carolina. Age ranged from 18 to 73 years, with an average age of 31 years. A variety of defects were seen. Atrial septal defect (59 patients), ventricular septal defect (15 patients), patent ductus arteriosus (14 patients), tetralogy of Fallot (14 patients), and coarctation of the aorta (9 patients) were the most common. There were 48 men and 77 women in the study. Most patients presented with recent onset of dyspnea on exertion or at rest, but 16 patients were asymptomatic. Eight patients died after surgery for an overall operative mortality rate of 6 per cent. The most common postoperative complication was arrhythmia (13 patients, 10%). Despite recent advances in the diagnosis and treatment of congenital heart disease in infants, a significant number of patients apparently escape detection and first present with congenital heart disease as adults. Prompt diagnosis and surgical intervention will usually produce excellent results and relief of symptoms in these patients.

Adolescent↗
PubMed1981

Echocardiography in diagnosing and managing aortic valve endocarditis.

During a 36-month period, 14 patients were admitted with endocarditis of the native aortic valve. Echocardiography made a specific contribution to the diagnosis and/or therapeutic management in ten of the 14 (71%). Thirteen patients had aortic valve replacement because of congestive heart failure; only two were stable enough to complete antibiotic therapy prior to operation. There were 12 survivors, all of them alive and clinically improved at nine to 44 months (mean 27 months) of follow-up. There were no instances of recurrent endocarditis. The only medically treated patient died suddenly during the third week of antibiotic therapy. Ten of 14 patients were identified as having valvular vegetations by M-mode or two-dimensional sector echocardiography. Surgical or necropsy corroboration revealed 100% specificity (no false-positive results) and 71% sensitivity of this echocardiographic finding. Aortic valve endocarditis appears to be primarily a surgical disease in which echocardiography plays an important role.

Adolescent↗
PubMed1980

The management of congestive heart failure.

The symptoms and physical findings of congestive heart failure are learned during the early stages of medical education. They are considered prominently in physical diagnosis courses even before a medical student's clinical clerkships begin. Yet, the diagnosis and proper management of congestive heart failure may still represent a challenge even for the most experienced clinician. Obviously, there is more to this syndrome than a collection of symptoms and signs. In fact, it is probably best to reject entirely the concept of congestive heart failure as a syndrome and consider it merely a descriptive term that requires an application of knowledge and skills learned in physiology, pharmacology and clinical medicine if the patient is to receive proper care. Many fine monographs and textbooks have been written about congestive heart failure, from the standpoint of myocardial mechanics, pathophysiology, cardiovascular pharmacology and biochemistry. It is our aim in this monograph to provide clinical insights into the management of congestive heart failure, including such factors as myocardial mechanics and cardiovascular pharmacology only when applicable in a clinical sense. Several cases recently encountered are included to underscore certain concepts.

Diet, Sodium-Restricted↗
PubMed1979

Development of aortic valvular vegetations during appropriate antibiotic therapy. Demonstration through serial echocardiograms.

The development of echocardiographically demonstrable vegetations on cardiac valves while the patient is receiving appropriate antibiotic therapy has not been previously reported. We report a case of alpha-hemolytic streptococcal endocarditis involving the aortic valve. Echocardiographically visualized vegetations were noted to occur on the 11th day of hospitalization. We discuss the role of serial echocardiograms in the management of patients with bacteremias and suspected endocarditis but absence of vegetations on the initial echocardiogram.

Aortic Valve↗
PubMedDate not supplied

Heart disease in the elderly.

This article has emphasized some of the new information that is useful i in understanding the differences that exist in the physiological responses and treatment of various diseases in the elderly when compared with those of the young.

Adrenergic beta-Antagonists↗