[Electrocardiographic signs of pulmonary artery thromboembolism].
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Biomedical subjects
Publications and source records attributed to N Iu Antonova.
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The use of electro- and echo-graphic examinations in patients with chronic post-embolic pulmonary hypertension allowed the identification of the most sensitive signs of right ventricle hypertrophy which made it possible to assess objectively the state of the cardiac muscle.
Variations in coronary blood flow and cardiac output were studied using dopplerography throughout rationed exercise in 16 patients with chronic postembolic pulmonary hypertension. All patients showed reduced coronary flow during exercise, an evidence of early signs of coronary insufficiency. A correlation was demonstrated between coronary flow disorders and the severity of pulmonary hypertension, the extent of pulmonary vascular bed lesion and right-ventricular hypertrophy.
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Characteristic hemodynamic manifestations of pulmonary artery thromboembolism include a decrease in both the volume and the time of pulmonary blood flow. The reaction of the cardiac output in response to pulmonary artery thromboembolism may assume the form of three types of circulation attended by volumetric alterations.
Indices of the central hemodynamics were studied in 39 patients operated on the organs of the abdominal cavity. It was shown that acute direct hemodilution improved the functional state of the cardio-vascular system of the patient. The authors recommend to maintain the state of hemodilution in the nearest postoperative period.
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The article deals with chronic pulmonary hypertension consequent upon thromboembolism of the pulmonary artery. From experience gained in the treatment of 15 patients 4 of whom underwent operation, the authors discuss the pathogenesis, clinical picture, diagnosis, and treatment of chronic postembolic pulmonary hypertension.
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The effect of myotropic spasmolytic drugs--papaverine and trental was studied in 54 patients with acute arterial obstruction. After intravenous injections of papaverine 55.8% of the patients developed impairment of peripheral macrohemodynamics and 52.9%--of microcirculation. The injection of trental was followed by an improvement of peripheral macro-and microcirculation in 75% of cases.
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The article is concerned with the methods used in the diagnosis of thromboembolism of the pulmonary artery. It is based on the experience in the examination of 160 patients admitted to the clinic with suspected pulmonary embolism, in 134 of whom the diagnosis was confirmed. The diagnostic possibilities of noncontrast X-ray examination of the lungs, electrocardio- and rheopneumography, catheterization of the heart and angiopneumography, and perfusion scan of the lungs are appraised.
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