Late pacemaker twiddler syndrome.
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Electric Power Supplies↗
Biomedical subjects
Osman Yesildag
Publications and source records attributed to Osman Yesildag.
Hypotension, bradycardia and syncope caused by honey poisoning.
Honey intoxication, a kind of food poisoning, can be seen in the Black Sea region of Turkey and in various other parts of the world as well. In this study, 66 patients were hospitalized with a variety of symptoms including nausea, vomiting, salivation, dizziness, weakness, hypotension, bradycardia and syncope several hours after the ingestion of small amounts of honey. All patients had hypotension, and majority had bradycardia. These features resolved completely in 24 h with i.v. fluids and atropine, and none died. In conclusion, honey poisoning should be taken into consideration in the differential diagnosis of acute myocardial infarction and in the patients with vomiting, hypotension and bradycardia.
Adolescent↗
The relationship between T-wave polarity and clinical as well as angiographic findings in the early stage of acute myocardial infarction.
BACKGROUND: Restoration of a positive T-wave in the chronic stage of myocardial infarction (MI) is usually seen in patients with a non-Q-wave (non-transmural) MI, where a viable tissue is present. The causes and significance of a positive T-wave in the early phase of acute MI are not clear. AIM: To investigate angiographic and clinical characteristics of patients with a positive T-wave in the early stage of acute MI. METHODS: We evaluated the clinical and angiographic data in relation to T-wave polarity in 188 patients with acute MI. Coronary risk factors, pre-infarction angina, CK-MB level, left ventricular ejection fraction and angiographic findings were analysed. Death, cardiogenic shock, ventricular tachycardia/fibrillation and high-degree atrioventricular block were regarded as in-hospital complications. All electrocardiograms were divided into two groups, according to the shape of the T-wave, as exhibiting a positive T-wave or negative T-wave. RESULTS: A positive T-wave was present in 30 (15.9%) patients. None of the patients with a positive T-wave had three-vessel disease compared with 21.5% of patients with a negative T-wave (p <0.04). In-hospital complication rates were similar in both groups. CONCLUSIONS: Patients with a positive T-wave in the early phase of acute MI have significantly less frequently three-vessel disease than patients with a negative T-wave.
Atrioventricular Node↗
The influence of ambulatory blood pressure profile on left ventricular geometry.
Besides causing a hypertrophy in the left ventricle, hypertension results in a change in the geometry of the left ventricle. The blood pressure, which does not decrease enough during the night, leads to structural changes in the left ventricle. In this study, the influence of 24-hour blood pressure profile on the left ventricular geometry was examined. Ambulatory blood pressure monitoring was applied to 60 patients with mild to moderate hypertension who had never been treated and standard echocardiographic evaluation was conducted thereafter. The patients were divided into two groups with respect to the ambulatory blood pressure profiles: the patients whose night blood pressure levels decreased by more than 10% compared to their daytime blood pressure levels (dipper) and those whose levels did not decrease that much (nondipper). The left ventricle mass index and the relative wall thickness of the patients were calculated. With respect to the left ventricle geometry, mass index and relative wall thickness of the patients were determined as: having normal geometry, concentric remodeling, eccentric hypertrophy, and concentric hypertrophy. Age, gender, systolic, and diastolic blood pressure were similar within the dipper and nondipper groups. Normal geometry, concentric remodeling, and concentric hypertrophy ratios were similar in both groups. Eccentric hypertrophy was higher in the nondipper group compared to the dipper group (42.9% vs 6.3%, P < 0.03). Patients with mild to moderate hypertension, whose blood pressure does not decrease enough, develop eccentric hypertrophy.
Blood Pressure Monitoring, Ambulatory↗
Correlation between clinical findings and the "tombstoning" electrocardiographic pattern in patients with anterior wall acute myocardial infarction.
The tombstoning electrocardiographic pattern of a particular kind of ST-segment change, as observed in some patients during the early stages of acute myocardial infarction, is well known to be of prognostic value. However, little is understood of the causes and the relations of these changes. This study of 106 patients showed that in patients with tombstoning electrocardiographic patterns, infarction size is larger; left ventricular ejection fraction and preinfact angina are lower, and in-hospital complications are higher.
Chi-Square Distribution↗
Effect of O2-enriched breathing on myocardial uptake of 99mTc-sestamibi.
Oxygen (O(2)) inhalation after acute myocardial ischaemia has long been a part of standard therapy in cardiology. It has also been demonstrated that therapeutic hyperoxia diminishes myocardial stunning. The aim of this pilot study was to investigate whether the uptake kinetics of the myocardial perfusion agent technetium-99m sestamibi (MIBI) during O(2)-enriched breathing is modified in comparison with the kinetics observed under conventional rest imaging performed after injection during inhalation of room air. Nine patients scheduled for coronary intervention (CI) with a documented significant stenosis (> or =50%) of at least one epicardial coronary vessel and one patient with slow flow on coronary angiography were investigated. First, rest MIBI electrocardiogram-gated single-photon emission tomography (G-SPET) with 740 MBq was performed. Two days later, the tracer was injected following a 5-min period of 100% O(2)-supported (nasal catheter) breathing at rest (6 l/min) and a second G-SPET acquisition (O(2)+MIBI G-SPET) was carried out. Patients' medication was not withdrawn and was matched throughout the study. The mean elevation of arterial oxygen saturation achieved was 2.95%. No significant changes in arterial blood pressure or heart rate could be detected at any time during the procedure. Compared with the results of baseline G-SPET, on O(2)+MIBI G-SPET five patients scheduled for CI and the patient with slow flow showed increased tracer uptake in initially ischaemic regions without any alterations in other myocardial regions. In three of these five patients, post-CI imaging could be performed and showed increased tracer uptake in all additional areas detected previously by O(2)+MIBI imaging. In three patients, besides improvement in ischaemic regions, a mild reduction in tracer uptake was observed in myocardium that initially appeared normal. In one of these patients, thallium-201 rest-redistribution SPET was performed and showed an uptake pattern more similar to that seen on O(2)+MIBI images than that on baseline MIBI G-SPET. In one patient, no difference in tracer uptake was observed in pre- and post-CI studies. Improvement was detected in the wall thickening images of the O(2)+MIBI study in seven of the ten patients. Four of these patients showed improvement in the same regions after CI. In this pilot study, it was demonstrated that MIBI injection during O(2)-enriched breathing can be a useful technique for enhancing the detection of viable myocardial tissue. The possible mechanisms of altered tracer kinetics are discussed.
Aged↗