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Biomedical subjects

R K Mautner

Publications and source records attributed to R K Mautner.

30 records · Page 2Linked to original sources
PubMed1980

Chronic ventricular dysrhythmia in the mitral valve prolapse syndrome: frequency and clinical significance of ventricular site of origin.

Twenty-two patients with the mitral valve prolapse-click syndrome and chronic ventricular dysrhythmia were judged to have either right or left ventricular premature contractions on the basis of electrocardiographic QRS configuration of the premature beats. The 11 patients with right-sided premature ventricular contractions (PVCs) were younger (P < .01), and had less abnormal electrocardiograms (NS) and fewer complications (NS) than those with left-sided PVCs. Coronary arteriograms performed on four in the latter group were normal, supporting a noncoronary etiology for the arrhythmia. Thus, patients with mitral valve prolapse and chronic ventricular dysrhythmia appear to have an equal prevalence of right- and left-sided premature complexes and, though not statistically significant, there was a consistent trend toward a more malignant course in the group with left ventricular premature complexes.

Adolescent↗
PubMed1980

Coronary ostial stenosis.

Coronary ostial stenosis as a complication of atherosclerosis is a rarely emphasized angiographic finding. Its recognition is important because of the adverse prognosis of left main stenosis and the inherent risks during catheterization of these patients. Recently 3 patients were identified with left coronary ostial stenosis. A clinical picture emerged during coronary angiography characterized by an abrupt fall in catheter tip pressure associated with symptoms of dyspnea and chest pain. Contrast media injections into the sinus of Valsalva, in right anterior oblique and left anterior oblique projections, revealed characteristic angiographic changes.

Constriction, Pathologic↗
PubMed1979

Left main coronary artery disease.

Eighteen patients with significant stenosis of the left main coronary artery are reported and compared with 1,040 patients described in the ten largest published series. In comparison to previous reports, our patients have a higher incidence of congestive heart failure, previous myocardial infarction (especially inferior wall), poorer left ventricular function, and more advanced coronary artery disease. Despite this, there was no increased risk during catheterization and bypass surgery. This small group of patients reflects the modern experience that, with increasing awareness of this lesion, there need not necessarily be a higher risk during diagnostic studies and therapeutic intervention.

Adult↗
PubMed1979

Rate-related left bundle branch block secondary to intra-his block.

A 67-year-old man who had chronic aortic valvular disease with first degree AV block and rate-related left bundle branch block on the surface electrocardiogram was studied by His bundle electrography. During conduction with narrow QRS complexes, the first degree block was AV nodal in origin. With spontaneous heart rate acceleration a QRS pattern of left bundle branch block emerged, and the His electrogram revealed split His potentials. This report adds strong support to the evolving concept that left bundle branch block, in some cases, actually may be secondary to block anatomically localized to the His bundle.

Aortic Valve Insufficiency↗
PubMed1979

Hypertrophic obstructive cardiomyopathy and coronary artery spasm.

Three patients had hypertrophic obstructive cardiomyopathy and coronary artery spasm. The clinical diagnosis of hypertrophic obstructive cardiomyopathy, in all patients, was confirmed by echocardiography and angiography. Significant spasm of the right coronary artery was demonstrated in each patient by selective coronary arteriography. One patient had atherosclerotic obstructive three vessel disease, while the other two showed no evidence of any fixed organic narrowing of the coronary arteries. ST segment elevation in the inferior ECG leads was documented in two of the patients in association with coronary spasm.

Cardiomegaly↗
PubMed1977

The antiarrhythmic efficacy of intravenous therapy with disopyramide phosphate.

Disopyramide phosphate was administered intravenously to 57 patients with 60 episodes of arrhythmia (21 supraventricular and 39 ventricular) as a 2 mg/kg bolus. Conversion to sinus rhythm was achieved in three (38 percent) of eight patients with atrial flutter, two (20 percent) of ten patients with atrial fibrillation, one (33 percent) of three patients with paroxysmal atrial tachycardia, and two (50 percent) of four patients with sustained ventricular tachycardia. In nine (75 percent) of 12 patients with nonsustained ventricular tachycardia, suppression of the arrhythmia was accomplished following the intravenous bolus of disopyramide. In 18 (78 percent) of 23 patients with frequent ventricular premature contractions, greater than 50 percent suppression of the ventricular premature contractions was achieved. These effects were satisfactorily maintained in six (86 percent) of seven patients with nonsustained ventricular tachycardia and in 14 (88 percent) of 16 patients with frequent ventricular premature contractions in whom therapy with disopyramide phosphate was continued as a 20 mg/hour intravenous drip infusion for up to 24 hours. Side effects were observed in only eight patients (14 percent) and were primarily anticholinergic in nature. Transient hypotension, not necessitating treatment with pressor agents, was observed in three patients (5 percent), in two of whom discontinuance of therapy with disopyramide was deemed necessary. Intravenous therapy with disopyramide in the dosage regimen employed appears to be moderately effective against supraventricular arrhythmia and particularly effective against ventricular arrhythmia with minimal toxicity. It appears to be a suitable alternative to intravenous therapy with lidocaine and has the additional advantage of availability for oral administration.

Administration, Oral↗
PubMed1976

Electrophysiological studies in patients with chronic recurrent ventricular tachycardia.

Seventeen consecutive patients with chronic recurrent ventricular tachycardia (VT) were studied in an attempt to delineate the reproducibility and mechanism of this arrhythmia. Six patients had nonsustained and 11 had sustained VT. The following electrophysiological techniques were utilized in an attempt to reproduce VT: 1) rapid atrial and ventricular pacing (17 pts); 2) atrial extrastimulus technique (17 pts); 3) ventricular extrastimulus technique (17 pts); 4) V1V2V3 stimulation technique (5 pts); 5) ventricular pacing from two or more sites (5 pts). Ventricular tachycardia was induced in six of 11 (54%) patients with sustained VT. However, in four there was only a single induction and only in the remaining two patients could VT be repetitively induced. In the latter two patients ventricular tachycardia was induced with both atrial and ventricular stimulation. Ventricular tachycardia could not be induced in any patient with nonsustained VT, although three had spontaneous episodes of ventricular tachycardia during study. In conclusion, in the present series of patients with chronic recurrent VT, this rhythm could not be reproducibly induced in the majority of patients in the cardiac catheterization laboratory utilizing catheter stimulation techniques.

Action Potentials↗
PubMedDate not supplied

Racial differences in platelet survival time in patients with symptomatic coronary atherosclerosis.

Platelet survival times were studied in 40 patients (21 white and 19 black) with coronary artery disease and stable effort induced angina pectoris. The platelet survival times of 19 white controls (9.27 +/- 0.49 days; mean +/- SD) were not significantly different from those of 12 black controls (8.88 +/- 0.81 days), and the platelet survival times for 21 white patients with coronary artery disease (8.46 +/- 0.65 days) were lower than the times for both the white controls (p less than 0.01) and the combined control group (p less than 0.01). However, the difference between the mean platelet survival times of 19 black patients (9.22 +/- 0.68) and the control groups was not significant, and the difference between the mean platelet survival times of the 21 white patients and the 19 black patients was significant (p less than 0.01). Stepwise multiple linear regression analysis indicated that race was the most significant factor in predicting shortened platelet survival (r = 0.4783; p less than 0.01). It is concluded that racial background should be considered in the interpretation of platelet studies and that reported racial differences in the rate and extent of atherosclerotic lesions may be related to racial differences in platelet consumption.

Black People↗