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Biomedical subjects

M Vincenzi

Publications and source records attributed to M Vincenzi.

At least 55 records · Page 3Linked to original sources

[Diagnosis of diastolic regurgitation through the atrioventricular valves using pulsed and continuous-wave Doppler. Description of a case].

We describe the case of a diastolic mitral and tricuspid regurgitation in a patient affected by acute myocardial infarction Ecg showed inferior myocardial infarction complicated by atrioventricular block and a junctional rhythm with frequent premature ventricular beats; the mean heart rate was of about 60 per minute. 2D echocardiogram disclosed akinesia of the apical segments of the inferior septum and anterior and infero-lateral walls. Pulsed and continuous wave Doppler showed mild to moderate mitral and tricuspid systolic regurgitation and diastolic regurgitation through both atrioventricular valves. The diastolic regurgitation always occurred during prolonged diastoles, soon after the blocked P waves. The possible mechanism of this finding and its clinical significance are discussed, drawing the conclusion that the atrioventricular diastolic regurgitation is not diagnostic of a specific valvular disease but can be secondary to other conditions, especially the atrioventricular block.

Aged↗

[Primary heart arrest during dynamic ECG in the myocardial infarct patient during convalescence. Contribution of 4 cases].

Four cases of cardiac arrest occurred during Holter monitoring are described. All patients had sustained an acute myocardial infarction thirteen-fourteen days prior to recording and were fully mobilized. In all of them the fatal arrhythmic event was ventricular fibrillation (VF). ECG analysis revealed an increase in heart rate before initiation of VF in one patient only. Warning ventricular arrhythmias were present in two patients. Transient ST segment changes during monitoring were noted in all patients. In three cases the arrhythmia was initiated by an ectopic ventricular beat (EVB) with R-on-T phenomenon; in two of them the EVB occurred after a sinus beat following a long post-ectopic pause. The different electrical events able to induce VF showed a variable and unpredictable pattern of occurrence and association in different patients and at different times in the same patient. Therefore, no specific "trigger" of the fatal arrhythmia could be identified.

Aged↗

[Diverticular aneurysm of the right atrium].

A case of right atrium aneurysm (diverticulum) detected in an asymptomatic 61-year-old woman is described. Diagnosis was made according to echocardiographic and echocontrastographic findings and was confirmed by both angiographic data and surgical pathology. The rarity of this finding and the possibility of a correct non-invasive assessment can be considered the two most peculiar features of this case.

Angiocardiography↗

[Left ventricular fibroma in childhood: 2-dimensional echocardiographic diagnosis and surgical treatment. Description of a case].

We describe the case of a patient 4 months old transferred to our hospital for evaluation of occasionally detected cardiac alterations: ecg showed abnormal Q and negative T waves in D1 - aVL leads and chest x-ray was consistent with enlargement of the left ventricular cavity. After admission, 2D echocardiographic examination disclosed, in the left ventricular cavity, a large mass extending from the papillary muscles to the outflow tract. The mass was of uniform density and easily recognizable as a tumor. Although asymptomatic, the patient underwent operation 10 months later because of the risk of occurrence of severe conduction disturbances or arrhythmias. Histological examination demonstrated that the mass was a fibroma. At post-op echocardiographic and angiographic evaluation the left ventricle appeared abnormally dilated with a large aneurysm of the lateral wall and very poor pump function. Nevertheless the patient did well in the following months until a ventricular fibrillation occurred at home. He was immediately brought to hospital and resuscitation was attempted unsuccessfully. We discuss the role of 2D echocardiography in the diagnosis of cardiac tumors, the indication of the early surgical removal and the possible limitations of the technique we used in this case.

Echocardiography↗

[Bidimensional echocardiographic diagnosis of the pulmonary valve agenesis syndrome in the newborn infant. Description of 2 cases].

We describe the cases of two neonates affected by the syndrome of pulmonary valve agenesis, in whom non-invasive diagnosis was possible by two dimensional echocardiography. The echocardiographic features we describe are the following: enlargement of the right ventricle in association with ventricular septal defect, malalignment type, dilatation of the right ventricular outflow tract, massive dilation of the main and branch pulmonary arteries, annular pulmonary stenosis. At the expected site of the pulmonary valve two ridges were seen, which did not have the typical motion of a fully developed valve. The ventricular septal motion was paradoxical in both cases. The diagnosis was confirmed at cardiac catheterization and the two neonates underwent operation unsuccessfully. The anatomic post-mortem examination confirmed the echocardiographic and angiographic findings. As successful treatment of this syndrome is difficult, we believe that a non-invasive echocardiographic diagnosis is very useful in order to avoid or, at least, delay a high risk cardiac catheterization.

Dilatation, Pathologic↗

[Echocardiographic aspects of persistence of the right valve of the venous sinus].

The aim of this work is to demonstrate the possibility to identify persistent right sinus venous valve and to differentiate it from other right sided heart pathology by two dimensional echocardiography. We report the echocardiographic findings observed in three out of 215 paediatric patients we examined for clinically suspected congenital heart disease in 12 months period. The first patient was a 24 hours old newborn with transient pulmonary hypertension; the second one was a 6 months old child with pulmonary atresia, severe right ventricular hypertrophy, atrial septal defect and patent ductus arteriosus; the third patient, aged 6 months, had atrial septal defect and mild pulmonary stenosis. In all three patients a particular linear structure was seen, as a membrane that crossed the right atrium from the orifice of the inferior vena cava towards the atrial septum. This structure was identified as persistent right sinus venosus valve according to its morphology, its position into the right atrium and its connection to the atrial septum. The incidence of this echocardiographic finding was 1.4% in our series. In the first case contrast echocardiography from the inferior vena cava demonstrated the deviation of blood flow caused by the persistent sinus valve, although no intra-atrial pressure gradient was shown at cardiac catheterization. In the second patient who died during the operative procedure for making a systemic-pulmonary anastomosis, post mortem examination showed a membranous structure connecting the orifice of the inferior vena cava to the atrial septum.(ABSTRACT TRUNCATED AT 250 WORDS)

Echocardiography↗

[Two-dimensional echocardiographic diagnosis of a thromboembolic mass in the right atrium].

We describe the case of a patient with massive pulmonary embolism, in which two-dimensional echocardiography demonstrated the presence of a free-floating mass in the right atrial cavity. The patient was urgently and successfully operated on. We describe the echocardiographic findings and emphasize the value of two dimensional echocardiography in detecting right-sided intracavitary thromboemboli, a condition in which immediate surgical treatment is mandatory.

Aged↗

[Verapamil in effort angina: a multi-centre study].

We have performed a multi-centre study with 47 outpatients in order to evaluate the efficacy of Verapamil (V) in the treatment of stable effort angina, and to compare the effect of two different doses of the drug (240 and 360 mg/die). The protocol consisted of a first period of Placebo, followed by the double-blind randomized cross-over administration of Placebo (P) and Verapamil (V) in doses of 240 and 360 mg/die. The symptomatology, the consumption of TNG, the ECG pattern at rest and during exercise, the maximum exercise tolerance during exercise and the rate of recovery were evaluated at the end of each 1 month period. V. provided a significant reduction of the number of angina attacks and of the consumption of TNG pills with improvement of symptomatology. The maximum exercise performance improved without changes in maximum rate pressure double product. A decrease of double product was observed at rest and during the recovery period. The higher dose of V. (360 mg/die) provides a better improvement in the number of angina attacks, in the symptomatology, in the double product at rest, and in the rate of recovery than the lower dose (240 mg/die). Thus these data indicate that V. provides anti-anginal efficacy by reducing myocardial oxygen demand, and increases exercise tolerance in effort angina patients.

Adult↗

Changes in cardiovascular function induced by verapamil in healthy subjects and in patients with ischemic heart disease.

Alterations in cardiovascular function induced by the acute intravenous administration of verapamil (5 or 10 mg) in 52 patients (29 with ischemic heart disease and 23 without heart disease) were evaluated with use of invasive techniques (right and left heart catheterization, left ventricular cineangiography, and coronary arteriography). The most significant changes were represented by a decrease in systemic vascular resistance and systemic arterial pressure, and an increase in heart rate and cardiac output. Contractility indexes were not depressed in either group, and altered ventricular wall motion tended to improve to a slightly smaller degree than in patients treated with nitroglycerin. The use of verapamil in patients with ischemic heart disease appears to be safe, and concern about the negative inotropic influences in humans no longer seems justified.

Adult↗

[Behaviour of serum CPK curves in acute myocardial infarction treated with digitalis, verapamil and combined verapamil-digitalis (author's transl)].

In order to compare the effectiveness of different therapeutic regimens in reducing infarct size serial determinations of CPK activity (at 4 hourly intervals in the first 48 hours from the admission to CCU, at the 72th and at 120th hours) were performed in 100 patients with transmural AMI (53 anterior and 47 inferior) with no obvious evidence of LV failure and basal CPK levels lower than 50 U/L. 20 patients (control group) have been treated with glucose-insulin-potassium (GIK). 20 patients have been treated with GIK plus Verapamil (GIK + V). Verapamil was administered at the dose of 50 mg in continuous drip. 20 patients received GIK plus digoxin at the dose of 0.25 mg b.i.d. (GIK + D). 40 patients received GIK, Verapamil and digoxin at the above doses (GIK + V + D). Different values of CKr and infarct size (IS.) show a statistically significant difference between the various regimens, which is more evident if we consider the whole series. Infarct size was greater in patients treated with digoxin with respect to controls, while it was smaller in patients treated with Verapamil. Combined Verapamil-digoxin therapy is associated to an enzymatic behaviour not different from controls. Authors emphasize that in uncomplicated AMI digoxin causes an increase in infarct size while Verapamil reduces significantly it. Association of Verapamil allows the use of digoxin, if clinically justified, without increase in infarct size.

Adult↗

[Changes in left ventricular regional wall motion induced by Verapamil (author's transl)].

28 subjects with atherosclerotic lesions of coronary arteries were studied by means of cineventriculography both before and after IV administration of verapamil Regional wall motion has been analyzed by means of two different methods. Imporvement of regional wall motion has been demonstrated in about 65% of cases. No significant result has been achieved in segments corresponding to previous infarctions. Such a response does not differ substantially from that evoked by nitroglycerin or other calcium antagonist drugs.

Arteriosclerosis↗