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Biomedical subjects

O Edhag

Publications and source records attributed to O Edhag.

At least 109 records · Page 6Linked to original sources
PubMed1977

A case of severe compression of the coeliac artery.

A man, aged 42 years, presented as an emergency with a history of stabbing upper abdominal pain, nausea and diarrhoea of two weeks' duration. Apart from abnormal transaminase and alkaline phosphatase values, the routine clinical and laboratory examinations did not reveal any abnormality. As the abdominal pain increased in severity, particularly in association with eating, and projectile vomiting supervened, aortography was carried out and showed severe stenosis of the coeliac axis, involving about 1 cm of the artery. At operation a thick fibrous band, which originated from the median arcuate diaphragm, was seen to constrict the point of origin of the artery and to compress the vessel against the aorta. The band was divided, whereupon the coeliac artery immediately showed strong pulsations and adequate filling. Microscopic examination of the fibrous band revealed, among other structures, those characteristic of a ganglion. The symptoms disappeared after operation.

Adult↗
PubMed1977

Deleterious effects of cardiac pacing in a patient with mitral insufficiency.

A 70-year-old, artificially paced women with dizziness and extremely low physical capacity exhibited a systolic BP varying from one moment to another; in standing position it was not measurable. With the aid of a strain gauge technique, the amplitude of the pulse wave of her left thumb was recorded and shown to vary widely. The variations were correlated to synchrony or asynchrony between atrial and ventricular activity. Pronounced decreases in stroke volume and peripheral pulse volume were recorded with pacemaker-induced beats compared with idioventricular beats. With artifical stimulation at a rate of 45/min, thus avoiding competition but still protecting her from syncopes, she was free from symptoms.

Aged↗
PubMed1977

Low threshold endocaridal electrodes for permanent cardiac pacing. Comparison between one large and two small surface electrodes.

Three different electrodes, i.e. conventional large and small surface endocardial electrodes and a new large contact area-small active surface electrode, have been compared with respect to their stimulation thresholds for cardiac pacing in 94 patients with 96 electrodes. Both capacitor discharge and constant current pulses were used for the measurements. The average 2 msec impulse threshold for the 47 mm(2) electrode reached its maximum on the 14th postoperative day and was 3.6+/-1.4 V and 4.4+/-1.8 mA. One month after insertion, the threshold was 3.2+/-1.4 V and 3.9+/-1.7 mA. Corresponding values after one month for the 6 mm(2) electrode were 2.0+/-1.0 V and 1.7+/-0.9 mA and for the new electrode 1.7+/-0.9 V and 1.4+/-0.8 mA. Thresholds increased by about 20% when the impulse duration was diminished from 2 to 0.5 msec. The new large area-small active surface electrode offers advantages of significantly smaller increases in stimulation thresholds during the first month after insertion and good attachment to the endocardium.

Adult↗
PubMed1976

Extreme elevation of transaminase levels in acute heart disease-a problem in differential diagnosis?

Five patients admitted to the Coronary Care Unit at the Department of Medicine, Serafimerlasarettet, who developed extreme elevation of transaminase levels, are discussed in terms of problems in differential diagnosis. All five had manifest right ventricular failure on admission and four also had hypotension. Three of the patients died, two survived. The three post-mortem examinations showed extensive infarctions of the left ventricle and septum. The two survivors had had a prolonged ventricular tachycardia and a probable silent infarct, respectively. It is concluded that the extremely high transaminase levels sometimes seen in acute cardiac disease are predominantly due to sizeable amounts released by the liver as a result of central necrosis of the liver cells. The probable prerequisite for the development of central necrosis of the liver in acute cardiac disease is usually the combination of right ventricular failure and hypotension, which in turn are most often due to extensive left ventricular infarcts.

Acute Disease↗
PubMed1976

The value of an oscilloscope in routine checking of pacemakers.

An evaluation has been made of the usefulness of the oscilloscope at routine check-ups of cardiac pacemakers. Measurements of 100 consecutive implanted pacemakers, obtained after their removal have been compared with changes in rate and changes in impulse duration and amplitude obtained at previous routine controls. Other changes in pacemaker characteristics have also been evaluated. Eight faulty pacemakers were found. Six had a decreased voltage, none however, less than 3.5 volts. Five of them had shown a decrease in rate by at least 7 impulses per minute, while in one QRS-synchronized pacemaker the synchronizing circuit did not function. In one pacemaker the stimulating rate had increased with 20 impulses while in one P-synchronized pacemaker the delay time had decreased. In 6 patients a significant decrease of the impulse amplitude was noticed without fall in voltage or electronic failure and in 3 others no decrease of the impulse duration was noticed in spite of decreased voltage at check after explantation. The present study therefore indicates that, at routine check-ups of the presently analyzed pacemakers with voltage depending stimulation rate, an analysis of the latter gives satisfactory information of pacemaker function and can be used instead of oscilloscope test, eventually in combination with electronic measurements of impulse duration.

Evaluation Studies as Topic↗
PubMed1976

Prognosis of patients with complete heart block or arrhythmic syncope who were not treated with artificial pacemakers. A long-term follow-up study of 101 patients.

This paper reports the results of a retrospective study carried out with special reference to the survival rate in a series of 101 selected cases including patients with complete heart block (CHB) combined or not combined with Adams-Stokes attacks and patients with arrhythmic syncope without ECG evidence of CHB. All these patients were treated in our Department during 1958-68, none being artificially paced. Twenty-seven patients were alive at the end of the follow-up, i,e 6-15 years after admission to this Department on account of syncopal episodes or CHB. The survival rate--higher in females than males--was lower in the cases of CHB combined with Adams-Stokes attacks than in the cases of asymptomatic CHB. This applied also to the instances in which a complicating disease such as ischaemic heart disease (IHD), hypertension, diabetes, digitalis intoxication or cardiac enlargement coexisted. The survival rate in the 68 cases of CHB was higher at one year (68%) as well as at 5 years (37%) than that reported by other investigators. When assessing the survival rate in cases treated with artificial pacemakers, it is important to study the individual case histories with special reference to a previous or coexisting condition such as IHD, hypertension, diabetes or the presence of cardiac enlargement. The present results support the view that the indications for treatment with artificial pacing should be wide, albeit that the prognosis in this series was more favourable than might have been anticipated from observations by others.

Adams-Stokes Syndrome↗
PubMed1976

A low-threshold, non-dislocating endocardial electrode.

Threshold curves with large and small surface intracardiac pacemaker electrodes are compared. The 2 msec. impulse threshold with a 47 sq. mm. electrode was 3.6 v. (4.3 mA.) on the fourteenth postoperative day, when it reached its maximum, and 2.8 v. (3.1 mA.) one month after the operation. These values were 45 and 30 per cent lower with a 6 sq. mm. electrode. Thresholds increased by about 20 per cent when the impulse duration was shortened from 2 to 0.5 msec. The small surface electrode consumed about 35 per cent less current than the 47 sq. mm. one. A newly designed large area-small surface electrode with the shape of an open cage, seems to have the advantages of less increase in postoperative thresholds and good attachment to the endocardial wall.

Arrhythmias, Cardiac↗
PubMed1975

Effect of quinidine on maintaining sinus rhythm after conversion of atrial fibrillation or flutter. A multicentre study from Stockholm.

In a controlled study comprising 176 patients, quinidine in the form of Kinidin Durules was found to reduced significantly the recurrence of the atrial fibrillation during a 1-year follow-up period after successful electric shock conversion. After one year, 51 per cent (52/101) of the patients in the quinidine group, and 28 per cent (21/75) in the control group remained in sinus rhythm (P smaller than 0.001). No less than 43 per cent of the patients converted to sinus rhythm during treatment with maintenance doses of quinidine sulphate before intended DC conversion. Gastrointestinal side-effects were not uncommon, and caused interruption of quinidine treatment in some cases.

Adult↗
PubMed1975

Advanced heart block aggravated by carbamazepine.

This report presents a serious adverse reaction to the anticonvulsant compound carbamazepine. A woman was admitted to hospital for recurrent attacks of syncope. She suffered from atrioventricular block of the Mobitz type II. Carbamazepine suppressed the conduction in her already defective Purkinje fibres and induced ventricular stand-still with subsequent Adams-Stokes attacks.

Adams-Stokes Syndrome↗