Biomedical subjects
Publications and source records attributed to N Coulshed.
A large abscess of the interatrial septum developed during the course of acute bacterial endocarditis affecting the aortic valve. Septic involvement of the cardiac conducting system produced atrioventricular dissociation, and subsequent abscess rupture resulted in an aorto-right atrial communication. The clinical presentation of this rare complication of acute bacterial endocarditis is correlated with the post-mortem findings.
The clinical features of four adult patients with Noonan's syndrome and cyanotic congenital heart disease are presented. These findings, together with those of previously reported cases, illustrate the wide spectrum of cardiac anomalies that may be associated with the multiple somatic abnormalities of Noonan's syndrome.
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Plasma catecholamine concentrations were estimated in a group of 17 fasting patients immediately before and 3 days after cardiac catheterisation. At both times electrocardiograms were recorded and blood pressures, heart rates, and respiration rates measured. Control catecholamine values were established in a group of 10 male and 10 female volunteers, bled at the same time of day under the same conditions of nutrition and posture. Levels of adrenaline and noradrenaline were increased substantially before catheterisation; 3 days later, the values were comparable to those of the control group, though still marginally higher. The increments in catecholamine levels were independent of sex and of the presence or otherwise of persistent supraventricular arrhythmias. In spite of the considerably raised catecholamine levels, electrocardiographic patterns remained unchanged, as did the other physiological values. The absence of any relation between enhanced catecholamine secretion and physiological effects is considered to be the result either of enhanced parasympathetic activity or of adaptation to a prolonged period of stress.
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