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Biomedical subjects

M H Choo

Publications and source records attributed to M H Choo.

52 records · Page 3Linked to original sources

Musical murmur and cardiac shudder.

When echocardiographic studies show several structures vibrating at a similar frequency to an associated musical cardiac murmur, the structure vibrating most strongly may localize the origin of the murmur.

Adolescent↗

Cardiopulmonary resuscitation at the Singapore General Hospital.

Effective use of Cardiopulmonary Resuscitation (CPR) saves lives both in and out of hospitals. Yet, in Singapore, this practical skill is rarely taught even within the medical community. Observations from a CPR pilot training programme at the Singapore General Hospital expose this glaring deficiency in our health system. Urgent remedial measures are needed.

Education, Continuing↗

Haemodynamic response to intravenous hydralazine in patients with pulmonary hypertension.

The acute pulmonary and systemic haemodynamic response to low (0.15 mg/kg) and high (0.30 mg/kg) doses of intravenous hydralazine was evaluated in 26 consecutive patients with severe pulmonary hypertension due to cor pulmonale (nine patients), primary pulmonary hypertension (11 patients), or pulmonary embolism (six patients). Hydralazine did not cause a significant change in pulmonary arterial resistance or pressure in any group but produced a significant reduction in systemic resistance, which correlated with plasma concentration, and a significant increase in pulmonary blood flow index in all groups. Ten patients who experienced a reduction in pulmonary arterial resistance of at least 5 U X m2 after administration of hydralazine had higher initial values for pulmonary arterial resistance and systemic resistance and a lower pulmonary blood flow index than those who did not respond. Maintenance oral hydralazine treatment during nine to 36 months of follow up did not seem to affect symptoms or mortality. These results indicate that hydralazine has limited value in acutely reducing pulmonary arterial pressure or affecting clinical outcome in patients with pulmonary hypertension.

Adolescent↗

Anomalous chordae tendinae. A source of echocardiographic confusion.

A unique instance of an anomalous chorda tendinae visualized in the left ventricular outflow tract during M-Mode and two-dimensional echocardiography, and subsequently confirmed during surgery for concomitant severe rheumatic valvular disease, is described. The M-Mode appearance can be confused with more serious forms of heart disease manifesting extraneous echoes in the outflow tract, and an approach to these echoes is described, based on a review of the literature.

Adult↗

Cardiac amyloidosis--diagnosis by 2-dimensional echocardiography.

In the past, the precise diagnosis of amyloid cardiomyopathy without resort to invasive techniques has been difficult. Recent experience with 2-dimensional echocardiography in cardiac amyloidosis has suggested that there are characteristic, and perhaps unique, features that are regularly imaged. We describe a case where usage of this non-invasive technique allowed accurate definition of cardiac involvement by amyloid.

Adult↗

Permanent pacemaker infections: characterization and management.

From January 1974 to June 1980, a total of 46 patients were treated for infections involving permanent pacing systems. Demographic characteristics, types of infecting organisms, specific clinical features, significance of an infected foreign body and various medical and surgical treatment methods are described. Likely infecting organisms depend on the mode of presentation and the time course of the infection. Optimal treatment for the large majority of patients requires removal of the entire infected pacing system. In a subgroup of patients, a short course of antibiotic therapy followed by one stage surgery involving implantation of a new pacing system and concurrent explanation of the infected pacemaker was used safely with excellent results.

Adult↗

Diffuse conduction abnormalities in an adolescent with familial sinus node disease.

We report a case of familial sinus node disease with associated conduction abnormalities in the atrioventricular node and distal conduction system Spontaneous atrial pacemaker activity was absent though the atrium could be depolarized. The pacemaker activity of the heart resided in the atrioventricular junction. The AV node showed impaired automaticity and abnormal conduction properties which partially improved after vagal blockage.

Adolescent↗

Infected epicardial pacemaker systems. Partial versus total removal.

Nine patients with infected epicardial pacemakers are described. All of the patients had infection localized to the generator pocket. Staphylococcus epidermidis, the most common organism isolated, was found in seven (77.8%). Conservative nonsurgical treatment was initially attempted in five patients. This failed in all and necessitated subsequent operation. At the time of the initial operation, lead transection and partial removal of the system was performed in seven patients. In four of them (57%), persistent infection necessitated further operation and complete extraction to eradicate the infection. In contrast, in all six patients (100%) in whom total removal was achieved (two at the time of initial operation and four at the time of subsequent operation), there was successful resolution of the infection. Therefore, complete extraction of the entire pacing system should be carried out, whenever possible, to achieve the greatest likelihood of eradicating the infection.

Aged↗