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At least 361 records · Page 20Linked to original sources
PubMed1988

The role of histamine in the cardiovascular system.

This article reviews briefly the role of histamine through its H1 and H2 receptors on the cardiovascular system and its action on calcium and catecholamines. The analogy between the adrenergic and the histaminergic systems is well demonstrated and there is evidence that histamine participates in myocardial damage and arrythmias, but the question of its exact role in the early stages of cardiovascular diseases, such as myocardial ischaemia and atherosclerosis, requires further study.

Animals↗
PubMedDate not supplied

Comparison of incidence and prevalence of arrhythmias in acute myocardial infarction.

Current methods of handling quantitative arrhythmia data deal primarily with the incidence (I) of arrhythmias and the relation of incidence to morbidity and mortality in patients with acute myocardial infarction (MI). To evaluate a new parameter, prevalence (P), and compare it with I, data from 345 patients with MI were analyzed from a computerized data base. I was defined as the number of patients in whom an arrhythmia had occurred and P as the number of days the arrythmia persisted. A high I/P ratio is generally associated with a low prevalence and a low I/P ratio with a high prevalence. Incidence, prevalence, and I/P ratios are shown for supraventricular, junctional, and ventricular arrhythmias, and AV block. Further analysis of the data from 98 patients showed that when inferior MI was compared to anteroseptal MI there was an increased incidence of AV block, and an increased incidence of ventricular tachycardia. A high I/P ratio is shown for arrhythmias associated with a high mortality in our previous studies. The data suggest the need for newer techniques for handling quantative arrhythmia data.

Arrhythmias, Cardiac↗
PubMedDate not supplied

[Postero'inferior aneurysm of the left ventricle following myocardial infarction. Diagnosis and surgical treatment].

This is a report of the first four cases of left ventricle aneurysm of the posterior and inferior segments successfully treated surgically in the Hospital de Cardiología y Neumología del Centro Médico Nacional, México D. F., and represent the twelve per cent of all realized aneurysmectomies. The patients were all men with 57 years mean age, and a previous history of posteroinferior myocardial infarction, complicated in three of them with angor and severe ventricle arrythmias; chest X ray in lateral view showed a bump of the posteroinferior border of the cardiac silhouette; the echocardiography increase in the ventricular diameter below the mitral valve; the ventriculography made evident a diastolic bulging with systolic expansion of posterior and inferior segments of the left ventricle and no mitral regurgitation; selective coronary arteriography showed a dominant right pattern with 100 per cent proximal occlusion. Aneurysmectomy was done in all four cases and aortocoronary by-pass in two. The posteromedial papilar muscle was found respected in all cases and in two cases a mural thrombus was detected.

Coronary Angiography↗
PubMed1987

Mefloquine, sulfadoxine, and pyrimethamine in the treatment of symptomatic falciparum malaria: a double-blind trial for determining the most effective dose.

A total of 89 adult male Thai patients who had acute, uncomplicated falciparum malaria were treated in a double-blind randomized trial with a single oral dose of two or three tablets, each consisting of 250 mg mefloquine, 500 mg sulfadoxine, and 25 mg pyrimethamine (MSP). The two-tablet regimen produced a cure rate (S response) of 93%, the three-tablet regimen a cure rate of 98%. The mean duration of parasitaemia for the two- and three-tablet groups was 50 and 29 hours, respectively, while the mean duration of fever was 43 and 40 hours, respectively. Differences between the groups were not statistically significant. Tolerance was good at both dose levels. The main side-effects were abdominal discomfort, nausea, vomiting, dizziness, and diarrhoea, but these were mild, transient, and required no specific treatment. The results of haematological and biochemical investigations and of urinalysis revealed no drug-related changes following administration of MSP. The electrocardiograms of some patients revealed sinus bradycardia or sinus arrythmia, but these conditions were transient, symptomless, and clinically not significant.

Administration, Oral↗
PubMed1986

Maternal and neonatal death associated with Eisenmenger's syndrome.

Pregnancy in patients with Eisenmenger's syndrome is known to be associated with a high incidence of maternal and perinatal death. Complications can occur before and during parturition but are most hazardous in the early postpartum period. If the exact causes of maternal death remain in most instances unknown, hypovolemia with augmented pulmonary to systemic shunt, thromboembolism and cardiac arrythmias are often mentioned as the primary causes of mortality. We report the unsuccessful management of a pregnant patient with Eisenmenger's disease despite all possible precautions as reported in the literature had been taken. We discuss these precautions and more specifically the type of anesthesia that is best given, the prophylactic methods of anticoagulation and the benefit of monitoring techniques in the management of such complex pathologies.

Adult↗
PubMed1985

[Deep accidental hypothermia without cardiorespiratory arrest].

A case is reported of profound accidental hypothermia with spontaneous cardiac activity in a patient presenting several risk factors. The rewarming from 23.5 degrees C to 36.5 degrees C by partial cardio-pulmonary bypass was carried out without complications and in particular without cardiac arrythmia. As far as we are aware this is the twelfth case of profound accidental hypothermia reported in the literature in which rewarming was carried out by this method and the fourth case not involving cardiac arrest. Rapid rewarming by partial cardio-pulmonary bypass could be useful in patients with profound accidental hypothermia without cardiac arrest, the most serious complication being, precisely, cardiac arrest during rewarming.

Adult↗
PubMedDate not supplied

[Endocardial monophasic action potentials obtained by means of suction catheters].

Endocardial monophasic active potentials (M.A.P.) recorded by suction --tip intracardiac catheters constitute a new research-- method in cardiac arrythmias, electrophysiology and pharmacology. The characteristics of MAP at auricular and ventricular levels are analyzed. The limitations of the method in its incapacity to record the MAP of conduction tissues is discussed. This method of recording MAP is evaluated with antiarrythmic drugs of tipes I, II, III and IV. The results are identical to recordings performed with intracellular microelectrodes.

Action Potentials↗
PubMed1975

[Clinical evaluation of the new anesthetic "Ethrane"].

Seventy-four patients aged 14 months to 71 years, classified as ASA I and II were anesthetised with Ethrane for surgical interventions of mean duration 117 minutes. With the exception of 5 patients who were directly anesthetised with Ethrane, the others received Ethrane after induction with Penthiobarbitone. Maintenance of anesthesia was ensured with 1 to 4p. 100 concentrations of Ethrane and 33p. 100 oxygen and 66p. 100 nitrous oxide. Tracheal intubation was facilitated by injection of 1 mg/kg of succinylcholine. Induction with enflurane is rapid with no phenomena of excitation or irritation of the ear passages. The cardiovascular apparatus is stable with no arrythmia but an increase in heart rate of 11 to 50p. 100 is noted and in 41p. 100 of the cases hypotension of 35p. 100 of the intitial value. During spontaneous ventilation, a type of rapid and superficial respiration is observed with a flow volume of 5.3 ml/kg for an average frequency of 25/min. The arterial blood gases show slight hypercapnia. Myorelaxation is significant and better than that obtained with halothane. Coming round poses few problems apart from agitation in adolescents. Response to simple orders appears at 13 minutes. Trembling and rigidity occur in 41p. 100 of the cases for 5 to 30 minutes. From the hepatic point of view, no lastin enzyme changes were noted and no renal toxicity was demonstrated. Ethrane appears to be a good anesthetic agent but the few advantages mentioned means that it does not fulfil ideal conditions.

Adolescent↗
PubMed1978

[Hyperthyroidism in older patients].

This study comprises 81 thyrotoxic patients with onset after the age of 60. In elderly persons, toxic multinodular goiter is the most common cause (68%) of hyperthyroidism, followed by solitary thyroid nodules (16%) and Graves' disease (16%). Cardiovascular disorders (cardiac failure, arrythmias etc.) constitute the first and often the only symptom in 62% of the cases. The other forms of appearance are both various and deceptive: depression, slight fever, asthenia or nausea. Separate analysis of the three forms of hyperthyroidism did not reveal clinical, biological or therapeutic differences between them, except an inferior rate of captation for the toxic nodules. Isolated measurement of T3 or T4 is often insufficient to confirm the diagnosis because either of these hormones may appear at a normal rate. In three cases only the free thyroxin index was pathological on first determination. The authors have established that the autonomous nodules are larger and more active after, rather than before, 60 years of age, and have attempted to define their morphological identity. The results of the treatment are analyzed and preference is expressed for radioactive iodine in every form of hyperthyroidism.

Aged↗
PubMed1980

[Use of fazadinium in heart surgery. Clinical contribution].

A new muscle relaxant, fazadinio bromide, has been administered to 10 heart patients awaiting surgery and its induction utility assessed. A constant though non-significant increase in heart frequency, a significant reduction in maximum and a non-significant reduction in minimum arterial pressure were recorded. No arrythmia or changes in effort-induced cardiac index were seen. The short latency period and myoresolution characteristics permitted speedy, atraumatic intubation. While these features and the absence of arrhythmia suggest the drug might have some clinical utility, tachycardia and arterial hypotension limit its use in heart patients.

Adult↗
PubMed1982

Clofibrate, calcium and cardiac muscle.

The anti-hyperlipidemic drug clofibrate produces negative inotropic effects and arrythmias in isolated perfused rabbit heart Langendorff preparations. In electrically stimulated rat left atria, clofibrate produces negative inotropic effects, the speed of onset and extent of which are decreased by raising the Ca concentration of the bathing medium. Sensitivity of isolated rat atria to clofibrate is not increased when the tissues are stimulated under slow Ca channel conditions, in which the tissues are activated by either isoproterenol or dibutyryl cyclic AMP, although sensitivity to clofibrate is decreased when atria are exposed to increasing concentrations of norepinephrine. Increasing the stimulation frequency of isolated guinea-pig atria to produce a positive treppe also decreases the inhibitory effect of clofibrate, while in rat atria the typical negative treppe is altered towards a positive treppe in presence of clofibrate. The effects of paired electrical stimulation are not diminished by the drug, suggesting that Ca release from the sarcoplasmic reticulum is not affected by clofibrate, although the drug inhibits the rate of Ca uptake by isolated cardiac sarcoplasmic reticulum and mitochondria. These results suggest that clofibrate has multiple effects on Ca functions in cardiac muscle.

Animals↗
PubMed1982

[Fabry's disease. Light and electron microscopic cardiac findings 12 years after successful kidney transplantation].

Fabry's disease (angiokeratoma corporis diffusum universale) is a disorder of sphingolipid metabolism affecting predominantly male patients. Renal damage is usually the cause of death in the fourth or fifth decade. Renal transplantation represents a new approach to correction of uremia and perhaps even of the basic congenital metabolic anomaly. In this case the patient, a 57-year-old man, developed renal failure at the age of 45 and received a renal allograft at that age. The transplantation was followed by complete remission of uremia and concomitant symptoms, but later complicated by progressive cardiac failure, anginal chest pain and arrythmia. Necropsy findings showed persistent deposition of ceramide in the myocardium and especially in the conduction system. This was documented, for the first time to the author's knowledge, by electron microscopic investigations. Cardiac manifestations of Fabry's disease are discussed in relation to patients with renal transplants.

Cardiomyopathies↗
PubMed1984

[Coronary spasm as a mechanism of ischemia or myocardial necrosis immediately after coronary surgery. Considerations on 5 cases and review of the literature].

Several recent reports suggest that coronary artery spasm may represent a major complication of coronary artery bypass surgery, and that it may have gone unrecognized in the past. During a three-year interval ending July 1983 we have encountered 5 cases in whom reversible S-T changes, angina, arterial hypotension, major arrythmias and/or angiography prompted the diagnosis of coronary arterial spasm early after aorto-coronary bypass surgery. Our experience and the review of 15 previously reported cases reveals that in most cases the clinical presentation was that of an acute, severe, ischemic cardiac event that occurred few hours after termination of cardiopulmonary bypass. A more benign course took place in a minority of cases, although some of them showed evidence of myocardial necrosis on ECG and/or left ventriculography. The mortality rate in the collective series was 20%, and the rate of perioperative non fatal myocardial infarction was 25%. Glyceryl trinitrate administration into the ascending aorta or into the spastic coronary artery appeared to be the most effective way of treating this condition, while the same drug was seemingly uneffective when administered intravenously. The use of calcium antagonists was associated with a favourable outcome in some patients, but on the whole the results were unpredictable. Prompt consideration of the possibility of coronary artery spasm and aggressive treatment are required in order to minimize its impact on perioperative mortality and morbidity rates.

Adult↗
PubMedDate not supplied

[Changes in plasma nonesterified fatty acids and blood glucose in the newborn infant in therapy with aminophylline].

We investigated the effect of intravenous infusions of aminophylline on plasma glucose and nonesterified fatty acid (NEFA) levels in 14 newborns with apnea (mean birthweight: 2.514 +/- 866 g; mean gestational age: 34.8 +/- 3.94 weeks). Theophylline apparent volume of distribution was 0.55 liters per Kilogram and the half-life was major than 12 hours. It was found that theophylline caused pronounced and prolonged lipid mobilization, as measured by the plasma NEFA. The ability of theophylline to induce a rapid rise in blood glucose was confirmed. Elevation in plasma NEFA might be an important factor in facilitating the competition with bilirubin for binding sites of albumin and the development of arrythmias in newborns with acute myocardial injury.

Aminophylline↗
PubMed1984

[Clinical characteristics of patients with coronary spasm demonstrated angiographically].

We studied a group of 112 patients with angiographically documented coronary artery spasm (CAS). In 102 of them (91%) was methylergonovine-induced. Mean age was 51,25 +/- 8,5, ranging from 28 to 76 years. Only 6 were females. We analized the prevalence of coronary risk factors; among them, heavy smoking was prominent. Clinical manifestations were: angina at rest 62%, effort angina 9%, mixed angina 24%, acute myocardial infarction 2%, asymptomatic with previous infarction 3%. Basal ECG was not a useful diagnostic tool, because in more than 50% of patients it was normal. Conversely, ECG during chest pain episodes was very useful, because only in 9% of patients it showed no changes. The most frequent alteration was ST segment elevation, observed in 53% of cases. Arrythmias during angina episodes were documented in 25% of cases. Stress test was negative in 50% of patients. Moreover, ST-segment depression was observed in 34% of patients.

Adult↗
PubMed1978

[Effects of dopamine and orciprenalin on human metabolism (author's transl)].

10 healthy probands were given on several subsequent days by intravenous infusion lasting 20' only orciprenalin and dopamine in therapeutic doses of 0.1 mg/kg bodyweight and 0.5 mg, respectively. In all cases application of orciprenalin resulted in a significant rise of glucose, insuline, lactate and free fatty acids. By contrast, no such changes were observed after infusion of dopamine. This suggests that a rise of free fatty acids in the serum may be important for the occurrence of cardiac arrythmia.

Adult↗
PubMedDate not supplied

Positive and negative effects of anticoagulant treatment during and after arterial embolectomy.

Eighty-four consecutive patients subjected to arterial embolectomy were studied. Cardiac arrythmia was found in 64% of the cases. The incidence of upper limb embolus was 15%, and lower limb 85%. Our total results are in agreement with most reports--the limb salvage rate of survivors was 84%, and the amputation rate was 16%. The primary mortality, 18%, is a rather low figure considering the high mean age (72 years) of the material. The prognosis after embolectomy was dependent on time from onset of symptoms and on the age of the patient. In the group of patients treated with anticoagulants the primary mortality was 7%, and in the untreated group 26%. The results of this investigation of patients treated with arterial embolectomy indicate: Adequate anticoagulant treatment during the per- and postoperative period decreased the primary mortality significantly, possibly as a result of fewer thromboembolic complications. The anticoagulant treatment was associated with a higher frequency of local complications as postoperative hemorrhage and reocclusions, which increased the frequency of reoperations and amputations. These drawbacks of anticoagulant treatment could possibly be counteracted by proper measures during the operation.

Adolescent↗
PubMed1982

[Urea and potassium losses and changes in amino acid concentration after aortocoronary bypass operations].

Changes in urea nitrogen excretion, renal potassium losses, and changes of amino acid concentrations in plasma following aortocoronary bypass operations were observed in 10 patients. The observation time included the preoperative day, the day of operation, and 4 postoperative days. The patients were treated with a 5% glucose solution (800-1000 ml/m2). The additional spontaneous oral intake was estimated and reached approximately 600-800 kcal and 25-30 g protein on the 3rd and 4th postoperative day. The calculated urea nitrogen loss was between -8.2 g (operation day) and -11.2 g (4th postoperative day). The concentrations of serum amino acids in plasma were below normal preoperatively. It seems possible that this is due to longer preoperative fasting because only patients with normal body weight were admitted to operation. The amino acid concentrations fell significantly to lower than normal values during the postoperative period. There were massive renal losses of potassium of about 140 mEq/day on the day of operation and on the 1st postoperative day. High parenteral substitution was necessary to avoid severe falls in serum potassium levels and possible cardiac arrythmias.

Amino Acids↗