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Biomedical subjects

X Marchand

Publications and source records attributed to X Marchand.

29 records · Page 2Linked to original sources
PubMed1987

[Prevalence of late potentials in ventricular tachycardias. Comparison with a control group].

High amplification electrocardiographic recording of ventricular late potentials was introduced a few years ago and seems to be a simple, reliable and reproducible method to identify patients at a high risk of sudden death and ventricular tachycardia, principally during the chronic phase of myocardial infarction. However, few authors have studied quantitatively the prevalence of late potentials in patients with ventricular tachycardia compared with a sufficiently large sample of healthy subjects. In this study 34 patients with sustained ventricular tachycardia (11 women, 23 men, mean age 58 years) and 131 healthy subjects (29 women, 102 men, mean age 29 years) underwent high amplification time-averaged ECG recording, and an algorithmic analysis of the tracings was conducted, using the Simson method. Three numeric parameters were used in the interpretation of the tracings: HFRMSA = mean RMS amplitude of the last 40 milliseconds of QRS; HFD40 = delay in signal decrease from amplitude 40 mu v to baseline, and delta QRS = difference in QRS duration with 0-250 Hz and 25-250 Hz filterings. Normal values, as determined from measurements in healthy subjects, were: HFRMSA above 27 mu v, HFD40 below 35 ms and delta QRS below 13 ms. Late potentials were present when at least one of these criteria was positive. When these norms were applied to patients with sustained ventricular tachycardia the prevalence of late potentials was 76%, rising to 90.4% in the subgroup of 21 patients with coronary disease. With the method thus defined the specificity for each criterion taken separately is 97.5%. According to the norms, only one control subject (0.8%) gave a false-positive result.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

[Rhythm disorders].

Explore the source record for details and available documents.

Anti-Arrhythmia Agents↗
PubMed1987

[The risk of cerebrovascular complications in the combination of pregnancy and mitral valve prolapse].

A case of left intraventricular thrombus, developed from a myxoid mitral valve and revealed by embolic cerebral vascular accidents at the end of a pregnancy, is reported. The links between a mitral valve prolapse and cerebral vascular accidents of embolic origin are studied during pre- and post-partum periods, where coagulation alterations are reviewed. It appears that, in pregnant women with a mitral valve prolapse, there is a maximum risk of developing an intra-cardiac thrombus in the last four weeks of pregnancy or immediately after delivery; this justifies, during that time, a thorough sonocardiographic monitoring.

Adult↗
PubMed1987

[Malignant pheochromocytomas. Apropos of a case with multiple metastatic localizations].

We are reporting a case of malignant pheochromocytoma surgically treated initially for an isolated left pararenal localization, and which recurred several years later accompanied with numerous metastases. Despite of a treatment with Iodine 131 MIBG, the evolution was rapidly fatal with a picture of cardiac failure. This cardiac involvement would be linked to a myocarditis directly secondary to the catecholamines and causing a marked increase of the free fatty acids concentration in the heart tissue. In reference to this case, all the data which may tend to suspect the malignant nature of a pheochromocytoma, present in 10 p. cent of the cases, are successively reviewed. There is no clinical specificity. The presence of a mixed secretion with marked urinary dopamine secretion, would not present, for all authors, the same criteria of specificity. Thoraco-abdominal scan and scintigraphy with iodine 131 MIBG are the two tests permitting to demonstrate, with a great sensitivity and specificity, an extra-adrenal localization, which is the best argument in favor of a malignancy since 30 to 40 p. cent of extra-adrenal pheochromocytomas are malignant, more especially as the metastases are located in areas where there are no embryonic remnants of tissues containing chromaffin cells. This permits to appreciate the difference between a non-malignant multicentric pheochromocytoma and a malignant pheochromocytoma. The ideal treatment of a malignant pheochromocytoma rests on surgery under the condition that there are ony one or two metastases. This procedure is preceded by a sodium nitroprusside preparation and followed with an alpha-blockers treatment. In case of multiple metastases, the therapeutic use of iodine 131 MIBG seems to be a tempting alternative.

Adrenal Gland Neoplasms↗
PubMed1986

[Ventricular extrasystole. Which should be treated and how?].

The decision of whether or not to treat a ventricular extrasystole depends in the first instance on the benign or severe nature of the disorder, and on whether there is subjacent cardiopathy. The results of 24-hour Holter monitoring, exercise tolerance tests and clinical and echographic examinations will define the pathological character of a ventricular extrasystole and will indicate any subjacent cardiopathy. Electrophysiological exploration with programmed stimulation should be reserved for so-called lethal cases of arrhythmia, such as attacks of sustained ventricular tachycardia. Ischemic cardiopathy is by far the most frequent cause of ventricular extrasystoles. The two major risks of sudden death after myocardial infarction are due to left ventricular dysfunction and repetitive and/or complex ventricular extrasystoles, as well as to attacks of ventricular tachycardia. Heart patients presenting these disorders must receive urgent treatment with antiarrhythmics. Isolated, monomorphic ventricular extrasystoles are also treated in heart patients at risk if their frequency is greater than 10 per hour, measured by 24-hour Holter monitoring. In the absence of subjacent cardiopathies, the therapeutic indications are much less well defined. Approximately five per cent of subjects in a normal population present ventricular extrasystoles, the frequency of which, however, rarely exceeds 100 per 24 hours. Repetitive phenomena are only seen in 10 per cent of cases. Attacks of ventricular tachycardia are almost never seen. Ventricular extrasystoles that develop in apparently normal hearts, but which do not fulfill the above criteria, can be considered abnormal. Nevertheless, there is no categorical proof that these ventricular extrasystoles represent any risk, notably of sudden death.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Arrhythmia Agents↗
PubMed1986

[Aneurysm of the sinus of Valsalva in children and young adults. Apropos of 9 cases].

Nine cases (7 boys and 2 girls) of aneurysm of the sinus of Valsalva (SVA) diagnosed before 19 years of age are reported. Group 1 comprised 5 children aged 5 to 14 years without rupture of the aneurysm; 3 had an associated ventricular septal defect (VSD). The diseased sinus was the right anterior sinus in 4 cases and the posterior sinus in one case. The diagnosis was made by 2D echocardiography, performed in 3 patients for follow-up of a VSD and in 2 patients to investigate a systolic murmur. Group 2 comprised 4 patients under 19 years of age with SVA which ruptured into in the right heart cavities. One of these patients had a known right anterior SVA diagnosed at angiography performed to investigate a VSD when the child was 4 years old. The rupture occurred suddenly when the child was 14. These cases of SVA involved the right anterior sinus with rupture into the right ventricle (3 cases) and the posterior non-coronary sinus with rupture into the right atrium (1 case). A rupture syndrome was observed in 3 of the 4 patients with pulmonary oedema in 2 cases. The authors emphasise the rarity of SVA diagnosed before rupture and the low frequency of rupture before adulthood. Echocardiography is certainly the best method for diagnosing the condition and for following up these patients.

Adolescent↗
PubMed1986

[Malignant pheochromocytoma associated with Recklinghausen's disease. Apropos of a case. Value of new methods in the diagnosis of pheochromocytoma].

After having reported the case of a pheochromocytoma associated to Recklinghausen's disease, the authors define the best criteria of detection and localization of the pheochromocytoma and study its association to phacomatoses. Headaches, bouts of tachycardia and excessive inappropriate diuresis are the most evocative clinical signs of a pheochromocytoma. The different hormones and their urinary metabolites must be titrated separately and repeatedly. Two other examinations, scanner and scintigraphy with MIBG, visualize quite reliably the tumor foci. Calcium inhibitors are quite effective in sudden blood pressure rises. The association described here, may be explained by the fact that the two pathologies belong to the group of neurocristopathies.

Adrenal Gland Neoplasms↗
PubMed1985

[Cardiovascular complications due to naftidrofuryl].

The authors report the case of a serious cardiovascular complication due to naftidrofuryl overdosage following its intravenous administration. Other similar complications have already been reported in the literature and in experimental animal studies (particularly involving the conduction system of the heart). Since naftidrofuryl belongs to the class of local anesthetics and is pharmacologically related to procainamide, certain precautions must be closely followed if it is administered intravenously: avoidance of rapid injection directly into the vein, limiting the infusion to 200 to 400 mg given over a 3 hour period using preferably a constant infusion syringe pump or an infusion pump, and using caution when associated with other medications, particularly antiarrhythmic agents which could affect atrioventricular or intraventricular conduction.

Adolescent↗