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Biomedical subjects

M Gil

Publications and source records attributed to M Gil.

At least 145 records · Page 8Linked to original sources
PubMedDate not supplied

[Electro-vectorcardiographic aspects of diastolic and mixed overloads of the right ventricle].

We studied 400 cases of isolated atrial septal defect without severe pulmonary hypertension, in which the diagnosis was established by the hemodynamic data and it was proven by surgical findings in 257 instances. High fidelity unipolar thoracic and intracardiac records, as well as vectorcardiographic curves in three planes, were obtained. Different types of right ventricular conduction disturbances, which were present in all cases, as well as certain electro-vectorcardiographic aspects related to ventricular depolarization and repolarization, were analyzed. Mean angles of the resulting vectors at 60 msc of the ventricular activation, were determined relating to the types of block. The following points should be emphasized: Besides the right proximal blocks, which are more frequent, right distal ones can also be diagnosed by the presence of slurred R wave and delayed onset of the intrinsicoid deflection in only some right leads. The monofascicular and parietal right blocks are observed when the diastolic overload of the ipsilateral ventricle is low. The activation time of the anterior inferior right septal mass generally permits an objective classification of the degree of a right proximal block. The prolonged Q-Tc interval only in right leads, seems to be a function of the magnitude of the right ventricular diastolic overload.

Adolescent↗
PubMedDate not supplied

[Intravenous streptokinase in acute myocardial infarction. A Mexican multicentric study].

To evaluate the benefits of intravenous streptokinase (SQIV) in acute myocardial infarction (AMI), we joined a group of ten Mexican university hospitals, that were coordinated by the National Institute of Cardiology of Mexico. We included patients less than 70 years of age admitted to the hospital with less than 6 hours from the onset of chest pain during their first myocardial infarction. All patients had ST segment elevation of 1.5 mm or more, and none had contraindication for SQIV. They received 1.5 millions of SQIV in one hour. Reperfusion criteria included absence of pain, ST segment reduction and a rapid rise and fall of enzyme levels. Angiographic criterion for reperfusion was the permeability of the affected coronary vessel. Of 66 patients studied, 57 (86%) had clinical reperfusion; of the 24 available angiographic studies, 92% demonstrated reperfusion. Eight (12%) of the patients had minor complications and 7 (10%) had serious complications. There were 0 deaths. We concluded that SQIV is a useful therapeutic procedure, easy to perform in general hospitals.

Adult↗
PubMedDate not supplied

[Coronary thrombolysis in acute myocardial infarction. Initial experience with an intravenous thrombolytic agent].

Thirteen patients with less than 5 hours of the onset of symptoms of acute myocardial infarction underwent selective coronary angiography. Ten of them had angiographic signs of coronary thrombosis. In these ten patients 15 mgs of an acylated streptokinase-plasminogen complex (BRL 26921 Beecham Farmaceuticals) were administered intravenously. Total angiographic recanalization was observed in 7 patients. The coronary arteries involved were the left anterior descending in 4 cases and the right coronary artery in 3. In 8 out of the 10 patients significant diminution of injury pattern in EKG was registered, however in all of them the necrosis pattern supervened. Prolongation of the thrombin and thromboplastin times, as well as an important fibrinogen disminution were documented in all instances. There were not complications related to the administration of the drug. An increase of muscle enzimes was documented in all cases. The follow-up was uneventfull with excellent results in all the patients. This study proves that with IV trombolitic therapy coronary recanalization can be achieved in the mayority of the patients; however there is no question that myocardial infarction finally ocurred. We speculate about the possibility of avoiding infarction by the administration of the drug within the first hour after the onset of the symptoms.

Adult↗
PubMedDate not supplied

[Apical hypertrophic myocardiopathy. Report of the first case identified on the American continent].

What appears to be the first case of hypertrophic apical myocardiography described in the western hemisphere is presented in this report. The diagnosis was confirmed by angiocardiography and echocardiography. The electrocardiogram showed the characteristic giant T waves. It is of interest that the coronary radioangiography suggested alterations in the microcirculation which could explain the striking electrocardiographic pattern of subepicardial ischemia seen in these patients.

Adult↗
PubMedDate not supplied

[Rupture of the ventricular septum following acute myocardial infarction].

Septal rupture (SR) during acute myocardial infarction (AMI) was found in 23 patients of 4 300 consecutive cases of AMI. In 55% the SR was diagnosed clinically by the appearance of a murmur, in 23% by shock and in 22% by heart failure. Eventually every patient developed a pan-systolic murmur. In 82% of the cases the murmur was best heard at the lower left sternal border. In half of the patients the location of the murmur suggested the possibility of papilary muscle rupture or dysfunction. In 68% of cases the rupture occurred during the first week after the onset of AMI. Cardiac catheterization was performed in 17 patients, pulmonary hypertension was found in all of them. Pulmonary blood flow was twice the systemic blood flow (P less than 0.005). Coronary angiograms performed in 6 patients showed three vessel disease in 5 cases. Five patients underwent surgery. Three of them survived. All of the 17 patients who had medical treatment died. Ten within the first week after AMI, 5 within the first month and 2 late deaths. Autopsy was performed in 15 cases. Eighty percent had coronary narrowing in several vessels. SR measured between 5 and 20 millimeters in 78% and was found in the anterior septum in 61%. In the cases who were in shock, the ventricular myocardium was extensively damaged. We conclude that once the diagnosis of SR is established, the patient should undergo surgical closure of the SR and coronary revascularization if necessary. Early surgical indication is particularly important in patients at risk of developing shock.

Aged↗