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Biomedical subjects

S Effert

Publications and source records attributed to S Effert.

At least 163 records · Page 9Linked to original sources
PubMed1976

[Idiopathic hypertrophic subaortic stenosis in aortic valve disease-diagnosis using echocardiography].

In three patients with valvular aortic disease in addition isiopathic hypertrophic subaortic stenosis (IHSS) was proven by echocardiography. From the clinical standpoint the dynamic subvalvular stenosis was not supposed in all cases. IHSS was echocardiographically characterized by asymmetrical septum hypertrophy and systolic anterior movement of the anterior mitral leaflet. Isolated aortic valve insufficiency was found in two patients, and combined stenosis and insufficiency in one patient. Mitral leaflet fluttering - indicative of aortic valve insufficiency - was observed in two patients. The identification of the dynamic subvalvular stenosis in patients with valvular aortic disease is important for the therapeutical approach. Echocardiography is very suitable for the diagnosis of this combined heart disease.

Adult↗
PubMed1976

[Differentiation of infarct patterns in the computerized ECG and confirmation with clinical and coronarographic findings and cardiac catherization].

With a view to assessing the validity of ECG criteria for a personal computerization programme, definite external features have been introduced as controls to provide objective data on the patient's disease apart from the ECG picture. To analyse the reliability of this programme, the ECG infarction component of the following groups of patients was considered. 1) 84 ECGs of patients who have suffered myocardial infarction in the more or less distant past and the diagnosis of which was confirmed at the time by chemical and laboratory data. These patients were also submitted to angiocardiography. 2) 120 ECGs of patients who have suffered myocardial infarction in the comparatively recent past and diagnosis of which was confirmed by chemical and laboratory data. These patients were not submitted to angiocardiography. 3) 85 ECGs of definitely not coronaropathic patients in whom angiocardiography was performed. In these clinically well documented cases, computer diagnoses were well correlated with those of treating physicians. It should however be pointed out that in 18% of patients with myocardial infarction, the ECG did not confirm the lesion. In the control group also, ECG alterations were recorded in 18% cases. This is a high percentage because in numerous patients the presence of rheumatic or shunt valvulopathies or myocardiopathies was encountered.

Cardiac Catheterization↗
PubMed1976

[Intra-atrial conduction disorders of 2d degree].

Five patients with second degree intraatrial block are presented. The first three cases had a sick sinus syndrome with sinus bradycardia, broad P waves and episodes of atrial flutter or fibrillation. In these patients a Wenckebach phenomenon could bei elicited by atrial stimulation at a critical driving rate between the stimulated site and the recording electrode. In the first patient this conduction disturbance was obtained at several right atrial stimulation sites. The block could be elicited in the other two patients only in a limited area of the right atrium respectively only by left atrial pacing. In the remaining two patients an atrial tachycardia with block was observed. The intraatrial conduction disturbance was manifested as an exit block around the ectopic pacemaker. In one patient the tachycardia was induced by digitalis intoxication. In the other patient no etiologic factor of the tachycardia could be found. While the first three patients presented intraatrial conduction disturbances already in sinus rhythm, the last two cases showed after recovery from the atrial tachycardia P waves of normal duration and configuration.

Aged↗
PubMed1976

[Data processing system for laboratory and hemodynamic heart catheterization measurements].

In cooperation with the Department of Electronic Data Processing Systems we have developed a data processing unit for the analysis of hemodynamic data at the Department of Internal Medicine I. The aim was to design a computer-system for the daily routine in heart-catheterizations as well as for the solution of scientific problems during hemodynamic studies. In the on-line-mode besides the ECG up to four pressures can be analysed simultaneously. Analog and digital tapes can also be processed off-line on demand. The concept of the whole system and the individual steps of computer-handling are adjusted to the problems of data-analysis in praxis from the viewpoint of the examining cardiologist. Since the system is interactive after each measurement and each given command the computer-results are displayed on the video-scope. Because of the modular structure of the program new medical criteria can easily be implemented at any time. Since the computer-system is not effectively used with only one cath-lab other units possibly of different hard-ware configuration can be connected simultaneously to the computer. Each cath-lab shares 16 K out of the total 32 K core-memory. The results are displayed graphically and alpha-numerically on video-scope, x-y-plotter and line printer. The sampling-rate for fluid-filled catheters is 200 Hz and for catheter-tip-manometers 400 Hz. Smothing and differentiation-procedures are adapted to the respective catheter-material. The computer-program calibrates the different pressure amplifiers automatically. After defining the catheter-position the pressure-signals are sampled for 10 s and immediately afterwards analyzed by the computer. The ECG and the corresponding pressure-curves are displayed on the video-scope. The automatically selected representative beat as well as each of the identified and numerated other beats of the sampling-phase can be displayed selectively together with its numerical results. The computer marks the positions within the pressure-curves, where the individual measurements were taken. Besides the systolic and diastolic pressures in valvular stenosis the maximal and mean systolic or diastolic gradients, ejection- or filling-period, valve-flow and valve-area are calculated autonomously. The calculation of cardiac-output, different volume-indices and stroke-work-index are based on Fick-method, thermo- or indicator-dilution technique. The contractility-parameters max dp/dt, t-max dp/dt, max dp/dt/DP, max dp/dt/P, VPM, V40, min dp/dt and the stiffness are computed for the left and on demand also for the right ventricle. Data of the patient and the operating-team, catheter-technique, complications and free comments are transmitted to the computer via terminal together with the actual time. The computer-system was drafted for permanent use. Therefore possible technical defects have been anticipated in the design of hard- and soft-ware. In cases of failure suitable steps allow the immediate restart of the system without loosing information...

Angiocardiography↗
PubMed1975

[Echocardiographic criteria of asymmetrical hypertrophy of the ventricular septum without outflow tract obstruction (author's transl)].

Asymmetrical septal hypertrophy (ASH) without outflow tract obstruction is a genetic variant of idiopathic hypertrophic subaortic stenosis (IHSS). Without difficulty and risk echocardiography can distinguish both diseases. Comparison in 33 patients with ASH but no outflow tract obstruction and in 29 with IHSS revealed following identical findings: (1) excessive hypertrophy of the ventricular septum when compared with the posterior wall of the left ventricle (asymmetrical septal hypertrophy); (2) decreased systolic motion of the septum; (3) slowed early diastolic closure of the anterior mitral leaflet; (4) relatively small end-diastolic and systolic diameter of the left ventricle. But the important distinction was that, while in IHSS there was a systolic forward movement of the anterior or both mitral leaflets, this not recorded in patients with ASH without outflow tract obstruction. The posterobasal portion of the left ventricle is thickened in patients with IHSS, due to the outflow tract obstruction.

Adolescent↗
PubMed1975

[Diagnostic criteria of idiopathic hypertrophic subaortic stenosis in the echocardiogram(author's transl)].

Idiopathic hypertrophic subaortic stenosis (IHSS) is morphologically characterized by ventricular septal hypertrophy. It is asymmetrical because there is no corresponding hypertrophy of the posterior wall of the ventricle. The proportion between septal thickness and posterior wall thickness is more than 1.2. In addition, the anterior mitral leaflet moves towards the ventricular septum during the ventricular systole. Finally, the aortic cusps may close prematurely, even during ventricular systole, if there is a marked outflow-tract obstruction. The thickness of the septum and posterior wall, as well as the movement of the mitral and the aortic valves, can be easily registered by the echocardiograph. IHSS is, therefore, more easily diagnosed by this non-invasive method than by any other method. The echocardiogram demonstrates (1) asymmetrical septal hypertrophy, (2) anterior movement of the anterior and frequently also the posterior mitral leaflet in midsystole, (3) partial or complete closure of the aortic valve in mid-systole, (4) relatively small end-diastolic and systolic diameters of the left ventricle, (5) delayed early-systolic closure movement of the anterior mitral leaflet in the sense of a functional mitral stenosis, (6) decreased systolic septal movement.

Adult↗
PubMed1975

[Localization of the conduction defect in complete A-V block by means of His bundle electrograms (author's transl)].

The localization of the conduction defect in so-called complete A-V block can be established by electrocardiography only indirectly and unreliably. In principle the region of the atrio-ventricular junction, i.e. the A-V node and the bundle of His, may be involved just as well as the two branches. Analysis of the configuration of the QRS complex in the electrocardiogram is unreliable, particularly in cases with bundle branch block, because any pattern can arise from the appropriate site of a tertiary focus of stimulation in one of the two ventricles. Recording His bundle potentials (His bundle electrogram) enables differentiation. In eleven personal observations and 151 cases collected from the literature of complete A-V block the analysis with this method showed that the so-called A-V block in the majority of cases (63%) is actually due to bilateral bundle branch block. In the other 37% an A-V junctional block was present. This type of block could be differentiated by means of His bundle electrograms into an A-V nodal block and His bundle block.

Adult↗