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Biomedical subjects

R J Hall

Publications and source records attributed to R J Hall.

282 records · Page 16Linked to original sources
PubMedDate not supplied

Severe mitral regurgitation caused by immobile posterior leaflet after radiotherapy.

Radiotherapy may affect the heart in several ways. We describe a child who had pulmonary edema caused by severe mitral regurgitation after thoracic radiotherapy for a Ewing sarcoma. Transesophageal echocardiography demonstrated this to be caused by an immobilized posterior leaflet, and valve replacement was necessary. This is the first reported patient with rapid progression to severe valvar disease after radiotherapy and in whom this novel mechanism has been demonstrated.

Bone Neoplasms↗
PubMedDate not supplied

Reversible angiography.

A 26 year old woman presented with a subacute onset of headache, hypertension, and neurologic impairment. Angiography revealed severe extracranial carotid and vertebral artery disease. Long segmental stenoses, lumen irregularities, and aneurysmal dilatations were noted. She improved with medical management and was followed for one year. Because recurrent neurologic symptoms developed, angiography was repeated and disclosed normal vasculature. "Spontaneous dissections" with recovery are the most probable explanation for this phenomenon.

Adult↗
PubMedDate not supplied

Surgical versus medical treatment of coronary artery disease: long-term survival.

In an attempt to answer the question as to whether or not aortocoronary bypass (ACB) does increase life expectancy of patients with coronary artery occlusive disease (CAOD), 4,766 consecutive patients undergoing ACB at the Texas Heart Institute from October, 1969 through June, 1975, were reviewed and followed for five and one half years. Overall early mortality was reduced from 9.7 percent during the first full year (1970) of the study to 3.3 percent during the last full year (1974). Early mortality in males (86.5 percent) was reduced to 3 percent during 1975, but in females only to 8.4 percent. However, late mortality in females was only 2.6 percent as compared to 3.4 percent in males. Long-term survival was similar for both males and females at five and one-half years when early mortality was considered. Males also experienced better symptomatic results than females with 90.3 percent of males remaining asymptomatic, while only 86.6 percent of females remained in this category. Early mortality increased as more vessels were bypassed, but late mortality decreased and symptomatic results improved as more complete revascularization was performed. Only 55 percent of late deaths were cardiac related. Actuarial comparison of this surgical series with the most comparable series in the literature of patients treated medically, demonstrated significant (P less than 0.001) increased survival in the surgical group as compared to medically treated patients at every year up to five and one-half years, for patients with double and triple vessel disease and for the entire series. In those patients with single vessel disease, the survival curves were similar to four years, following which survival was increased in the surgical patients at the end of the fifth and sixth reporting years. In summary, these data appear to suggest that surgical treatment of coronary artery occlusive disease does provide a favorable effect upon life expectancy.

Adult↗
PubMedDate not supplied

Valvular heart disease: recommendations for investigation and management. Summary of guidelines produced by a working group of the British Cardiac Society and the Research Unit of the Royal College of Physicians.

Despite the decline of rheumatic fever, valvular heart disease remains a common and important problem. The investigation and treatment of patients have been revolutionised by the widespread availability of echocardiography, which provides information about disease aetiology, accurate and non-invasive assessment of severity and a means of monitoring progression. These advances have facilitated progress in reconstructive valve surgery and the application of balloon valvuloplasty. Improved valve prostheses and reduction in peri-operative mortality have also broadened the indications for valve replacement surgery. A working party convened by the British Cardiac Society and the Royal College of Physicians of London have reviewed current practice and provided guidelines, summarised in this article, for the investigation and management of adults with valvular heart disease in primary care, district general hospitals and tertiary referral centres.

Adult↗
PubMedDate not supplied

Myocardial stunning and hibernation.

Hibernating myocardium is a potentially reversible form of left ventricular (LV) dysfunction the treatment of which improves function and prognosis. The identification of viable myocardium is critical in deciding which patients undergo revascularisation. Stunning is a clinically relevant phenomenon and it has been suggested that repeated episodes of stunning may cause chronic LV dysfunction. If this is the case then pharmacological agents which prevent stunning could represent a potential treatment of chronic LV dysfunction in patients with CAD.

Animals↗