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Biomedical subjects

R H Falk

Publications and source records attributed to R H Falk.

At least 109 records · Page 6Linked to original sources
PubMed1983

Sensitivity of technetium-99m-pyrophosphate scintigraphy in diagnosing cardiac amyloidosis.

To determine the value of technetium-99m-pyrophosphate myocardial scintigraphy in the diagnosis of amyloid heart disease this procedure was prospectively performed in 20 consecutive patients with biopsy-proven primary amyloidosis. Eleven patients had echocardiographic abnormalities compatible with amyloid cardiomyopathy, 9 of whom had congestive heart failure. Diffuse myocardial pyrophosphate uptake was of equal or greater intensity than that of the ribs in 9 of the 11 patients with echocardiograms suggestive of amyloidosis, but in only 2 of the 9 with normal echocardiograms, despite abnormal electrocardiograms (p less than 0.01). Increased wall thickness measured by M-mode echocardiography correlated with myocardial pyrophosphate uptake (r = 0.68, p less than 0.01). None of 10 control patients with nonamyloid, nonischemic heart disease had a strongly positive myocardial pyrophosphate uptake. Thus, myocardial technetium-99m-pyrophosphate scanning is a sensitive and specific test for the diagnosis of cardiac amyloidosis in patients with congestive heart failure of obscure origin. It does not appear to be of value for the early detection of cardiac involvement in patients with known primary amyloidosis without echocardiographic abnormalities.

Aged↗
PubMed1983

External noninvasive cardiac pacing in out-of-hospital cardiac arrest.

External noninvasive cardiac pacing was applied outside the hospital to 19 patients who had experienced cardiopulmonary arrest and 1 patient with life-threatening bradycardia. Seven patients developed electrocardiographic evidence of pacemaker capture, although only 2 had palpable pulses. The patient with bradycardia was successfully paced. This study demonstrates the feasibility of cardiac pacing in out-of-hospital cardiac arrest but confirms the poor prognosis of asystolic cardiac arrest even with the application of pacing.

Adult↗
PubMed1983

Amyloidosis of heart and liver: comparison of Tc-99m pyrophosphate and Tc-99m methylene diphosphonate for detection.

A prospective, comparative study was made of the efficacy of technetium-99m pyrophosphate (Tc PYP) and technetium-99m methylene diphosphonate (Tc MDP) in detecting soft-tissue amyloidosis. Tc PYP and Tc MDP scans were obtained within ten-day intervals in seven patients with histologically proven amyloidosis. Tc PYP was a better scanning agent for soft-tissue amyloidosis in all patients. Cardiac and hepatic involvement were proved by autopsy in one patient. Involvement of the heart was confirmed by echocardiography in five patients. The potential use of Tc PYP scanning as a screening test for soft-tissue amyloidosis is discussed.

Adult↗
PubMed1982

The heart in sickle cell anemia.

Sickle cell anemia is a lifelong debilitating disease often required multiple, frequent hospital admissions. Multiple organ systems become damaged, but the heart, although demonstrating abnormalities, is relatively spared. With increasing life span of these patients, cardiac dysfunction may become more prominent. Recent noninvasive and pathologic studies have given new information on the effect of this disease on the heart. This article reviews the current knowledge of cardiac involvement in sickle cell anemia.

Adolescent↗
PubMed1981

Reduction in vulnerability to ventricular fibrillation by bromocriptine, a dopamine agonist.

The effect of a dopamine agonist, bromocriptine, on ventricular fibrillation (VF) threshold was studied in anaesthetised dogs. Bromocriptine produced an increase of 50% in VFT. Pretreatment with the dopamine antagonist haloperidol abolished the effects of bromocriptine on VF threshold as did pretreatment with the peripheral dopamine antagonist, domperidone. It is concluded that bromocriptine reduces vulnerability of the nonischaemic canine ventricle to fibrillation. This effect is most probably mediated by peripheral presynaptic stimulation of dopaminergic receptors, thereby inhibiting noradrenaline release.

Animals↗
PubMed1979

Medication in acute myocardial infarction -- does it do as much harm as good?

Despite the apparent success of coronary care units in preventing death from ventricular fibrillation, the mortality from acute myocardial infarction is the same whether the patient is treated at home or in such a unit. No adequate explanation for this apparent paradox has been proposed. The evidence is therefore examined that there are detrimental effects of coronary care units and that these may balance the beneficial effects. In particular, it is suggested that antiarrhythmic medication, by virtue of its frequent side-effects, may increase mortality from non-arrhythmic causes.

Aged↗
PubMed1979

Prosthetic valve endocarditis resulting from Nocardia asteroides.

Nocardia asteroides was isolated from the prosthetic valve of a 64-year-old woman who had died of endocarditis after aortic valve replacement. Multiple blood cultures had all been negative. This organism is increasingly being recognised as a pathogen and is usually sensitive to sulphonamides. These should be tried in culture negative endocarditis unresponsive to standard therapy.

Aortic Valve↗
PubMed1979

Adverse reactions to medication on a coronary care unit.

In a prospective survey of treatment on a coronary care unit 23.6% of patients who received medication had one or more side effects. In several cases these were severe enough to cause marked deterioration of the patient's clinical status. Whilst antiarrhythmic therapy is an integral part of modern coronary care its potential hazards should be recognized, particularly in the elderly patient.

Adrenergic beta-Antagonists↗
PubMed1979

Intravascular haemolysis after valve replacement: comparative study between Starr-Edwards (ball valve) and Björk-Shiley (disc valve) prosthesis.

Seventy-four patients with single prosthetic valves (Björk-Shiley or Starr-Edwards) in the mitral or aortic position and 18 controls with rheumatic valvar heart disease were investigated for evidence of intravascular haemolysis. Serum lactate dehydrogenase (LDH) was used as the most sensitive indicator of haemolysis. Raised concentrations were found in a third of 39 patients with Björk-Shiley prostheses (mean 281 IU/l) and in all 35 patients with Starr-Edwards prostheses (mean 859 IU/l. Values were considerably higher in patients with Starr-Edwards prostheses and particularly in those with aortic prostheses (mean 927 IU/l). Eight out of 12 patients with haemosiderinuria had Starr-Edwards valves. Intravascular haemolysis was of little clinical significance in patients with Björk-Shiley prostheses, but some patients with Starr-Edwards prostheses became iron deficient as a result.

Aortic Valve↗