[Results of roentgenologic thorax diagnosis on the 1st day of life of newborn infants in an intensive care unit].
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A patient presented with rupture of right bronchus associated with rupture of the homolateral subclavian artery (diagnosed secondarily at the false aneurysm stage) and bilateral fracture of the 1st rib. Two stage repair operation provided lasting recovery. This case is used as a basis for emphasizing the diagnostic problems raised by combined endothoracic lesions, the need for systematic investigation of possible presence of a lesion of subclavian artery in patients with fracture of 1st rib, and finally various operative tactics (in the framework of false aneurysms of proximal subclavian vessels).
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The authors give a review of 74 patients with radiation-induced heart disease which could be easily detected by echocardiography. In almost all of the patients a pericardial effusion (P.E.), with relative sinus tachycardia was found 3 to 4 weeks after onset of radiation and this was transient in some cases. This phenomenon was interpreted as an early radiation-induced reaction of the heart. 6 to 12 months after radiation, late damage of the heart occurred depending on field and total radiation dose. This manifested as massive P.E. with changes in ECG. Later there was damage to the myocardium caused by coronary sclerosis. The tendency to constrictive pericarditis was manifested not earlier than 3 years or later after radiation. The authors advise follow up of the irradiated patients case by case, checked by echocardiography, especially those who received more than 5000 rad to the heart area and therefore have high risk of late heart damage.
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