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Biomedical subjects

Y Hasin

Publications and source records attributed to Y Hasin.

At least 127 records · Page 7Linked to original sources
PubMed1983

Survival after sudden obstruction of the left main coronary artery.

Left main coronary artery (LMCA) stenosis occurs in 10% of patients undergoing coronary arteriography, but total occlusion is rare. Goldberg et al reported 6 cases of complete obstruction of the LMCA among 2,200 patients studied arteriographically. Sudden obstruction of the LMCA should be lethal, and we found no report describing survival with sudden obstruction of the LMCA. The present report describes such a patient.

Coronary Angiography↗
PubMed1983

Prediction of in-hospital ventricular fibrillation from admission data in acute myocardial infarction.

We studied retrospectively 26 readily obtainable clinical and electrocardiographic variables in 22 consecutive patients who experienced primary ventricular fibrillation in association with an episode of acute myocardial infarction. Twenty-eight consecutive patients who had an uncomplicated course after acute myocardial infarction served as controls. The clinical profile of the two groups was similar except that patients who had primary ventricular fibrillation smoked more and had a higher peak creatinine phosphokinase level at the time of infarction. The data was evaluated using univariate and stepwise logistic regression analysis. This analysis demonstrated that patients who developed primary ventricular fibrillation had, on admission (1) more evidence of congestive heart failure (Killip classification), (2) a lower diastolic blood pressure, (3) greater ST-segment elevation, (4) a longer QTc interval, and (5) a less distinguishable J point on the electrocardiogram. This method of logistic analysis that utilizes easily obtainable hospital admission data serves as a preliminary model for prediction of the relative risk of primary ventricular fibrillation in a patient with acute myocardial infarction. The ability to identify patients at risk has important therapeutic implications.

Aged↗
PubMed1983

Intravenous verapamil therapy in imminent myocardial infarction.

We studied 16 patients with small myocardial infarction who had further episodes of chest pain with ST-segment elevation, a sign of transmural myocardial ischemia and imminent infarction extension. Coronary angiography in 14 showed a critical lesion in 13. Intravenous verapamil abolished chest pain and ST-segment elevation. It caused a fall in right atrial and left ventricular end-diastolic pressures (LVEDP) and cardiac output, reflex systemic vasoconstriction, and a rise in systemic vascular resistance. There was no reflex tachycardia. Volume expansion raised LVEDP and restored a normal cardiac output. Accelerated junctional rhythm with isorhythmic A-V dissociation occurred in 5 patients. Two patients sustained a transmural infarction, 10 underwent coronary artery bypass grafting, and 4 are symptom-free with oral treatment. Intravenous treatment was an effective method of treating acute episodes of transmural myocardial ischemia and preventing their recurrence in patients with critical coronary artery narrowing. Continuous verapamil infusion stabilized the patients' condition and enabled smooth coronary angiography and induction of anesthesia for surgery.

Aged↗
PubMed1983

The use of calcium with verapamil in the management of supraventricular tachyarrhythmias.

Verapamil, a calcium channel blocking drug, terminates supraventricular arrhythmias but may have a negative inotropic effect and produce peripheral vasodilatation and hypotension. We studied the efficacy of intravenous calcium gluconate in reversing or preventing the hypotensive effect of verapamil in 31 patients with atrial tachyarrhythmias. In 21 instances, verapamil was given first, and in 13 calcium was used as pretreatment before the administration of verapamil. Calcium gluconate, when given as pretreatment, prevented the fall in blood pressure induced by verapamil, and when given after verapamil restored blood pressure to control values. The administration of calcium did not alter the antiarrhythmic effect of verapamil.

Adult↗
PubMed1982

Verapamil in effort-induced angina pectoris in patients with normal coronary arteries.

Two patients with classical effort-induced angina pectoris associated with abnormal ST-segment depression on graded exercise testing and normal coronary arteriograms are described. Both patients deteriorated during treatment with propranolol, and became asymptomatic during treatment with verapamil with normal graded exercise tests. Verapamil may thus improve an inadequate vasodilatatory response of the coronary vascular bed to effort.

Angina Pectoris↗
PubMed1982

Long-term effect of verapamil in hypertrophic cardiomyopathy.

We studied the long-term effects of oral verapamil (240-720 mg) daily on 10 patients with hypertrophic cardiomyopathy. Symptomatic improvement of chest pain or shortness of breath occurred in all the patients although 4 deteriorated after 1 year. Side effects occurred in 3 patients. The electrocardiogram improved in 4 subjects. Quantitative echocardiography showed a significant (P less than 0.05) decrease in left ventricular contractility (% delta S decreased from 44 +/- 9 to 38 +/- 9, mean +/- SD), septal hypertrophy (1.6 +/- 0.5 to 1.4 +/- 0.5 cm) and % thickening of the left ventricular free wall (79 +/- 29 to 57 +/- 22). There was also moderate evidence of improvement in left ventricular compliance; mitral valve EF slope increased from 38 to 55 mm/sec and left atrial diameter decreased.

Adult↗
PubMed1982

Intraaortic balloon counterpulsation in acute myocardial infarction.

Intraaortic balloon counterpulsation was undertaken in 24 patients with acute myocardial infarction. The patients were divided into four groups: severe left ventricular dysfunction (11 patients), mechanical lesions (6), intractable angina pectoris (6) and refractory ventricular tachycardia (1). The clinical condition and the hemodynamic measurements improved dramatically in 21 patients, but there were only 9 long-term survivors. Intraaortic balloon counterpulsation gave the best results in patients with preinfarction angina pectoris or patients with left ventricular dysfunction where the hemodynamic status deteriorated after an acute but reversible cardiovascular event. Numerous local complications were observed.

Adult↗
PubMed1982

Verapamil responsive reentrant ventricular tachycardia: a case report with electrophysiological investigation.

A patient with left ventricular aneurysm had recurrent ventricular tachycardia. His arrhythmia could be induced and interrupted by programmed ventricular stimulation. Quinidine and procainamide facilitated the induction of the tachycardia by widening the tachycardia induction zone. Ajmaline slowed the rate of the induced tachycardia and verapamil abolished the arrhythmia. The possible mechanism underlying these phenomena is discussed.

Electrophysiology↗
PubMed1981

Myocardial conduction time and antiarrhythmic drugs.

Complete a-v block was induced in anesthetized mongrel dogs by direct electrocoagulation of the a-v node. The ventricles were paced by steady stimulation (S1) at a rate of 100/min. and by test stimuli (S2) with varying post S1 delay. Right ventricular myocardial tension was measured from the S2 stimulation site of a specially designed miniature strain gage and from a different site by a Walton-Brodie strain gage. A reproducible time lag between the two sites could be measured by comparing the differences in mechanical response to S2 stimuli. This time difference was called delta IT. delta IT varied markedly (from 10-60 msec) when measured at different sites but no linear relationship between delta IT and the inter-gage distance could be observed. Increasing the S2 current intensity induced shortening of delta IT from 37 +/- 13 msec (mean +/- S.D.) at the threshold current to 16 +/- 10 msec (mean +/- S.D.) with 10 mA. A strength-delta IT curve could be constructed and was found to be remarkably reproducible during the experiment. Quinidine and disopyramide induced upward displacement of the curve, lidocaine did not change it while verapamil lowered the delta IT values. We suggest that delta IT can be used as a reliable indicator of myocardial conduction rate. The possible reasoning for this suggestion has been discussed.

Animals↗
PubMed1979

Relationship between extent of coronary artery disease and correlative risk factors.

An analysis was made of correlative factors which might be related to the angiographically measured extent of coronary artery disease in 140 patients. All patients presented with clinically important chest pain. Thirty-three had a normal coronary arteriogram. The extent of the atheromatous process was measured precisely at angiography by three different techniques. A coronary score, based on the percentage of luminal narrowing, was found to be best suited for the analysis. The most important contributory factors to the severity of atherosclerosis was duration of clinical history, number of previous myocardial infarctions, and male sex, but more specifically elevation of serum cholesterol and diabetes mellitus. Cigarette smoking, obesity, hypertension, a family history of atherosclerosis, and elevated serum triglycerides had a positive influence but this was not statistically significant.

Angina Pectoris↗