[Show abstract][Hide abstract] ABSTRACT: Twenty patients with pulmonary artery thrombosis presenting as dyspnoea of more than two weeks' duration (15 days up to 46 months) were treated by thrombolysis. The results were monitored during treatment in most cases by angiography, catheterisation and scintigraphic studies. One death due to heamorrhage is to be regretted. There were 5 good results, showing that it is sometimes possible to lyse the thrombus some way from the site of the embolus. In these 5 cases, the time elapsed since the last embolic episode varied from 5 days to 14 weeks. When allowance has been made for the difficuties in establishing the age of the embolus, these results do appear to show that thrombolytic treatment should be undertaken in subacute cases when the symptoms have been present for less than three months. In the chronic cases with a longer history, the chances of a successful result are very small. Thrombolytic treatment should also be advised when, although the symptoms are of longstanding, the history suggests a relapse, with renewed dyspnoea.
No preview · Article · Jan 1977 · Coeur et médecine interne
[Show abstract][Hide abstract] ABSTRACT: The effects of amiodarone by injection have been studied in 100 patients. 50% of these patients were in cardiac failure. Amiodarone was given intravenously over 30 seconds in a dose of 300 mg; in 15 of the patients a further dose of 150 mg was given after ten minutes. Amiodarone was found to be particularly effective in the tachy-arrhythmias (90% successful) in which it brought about slowing (18 cases out of 30) or conversion (17 cases out of 30). Just as good results were obtained for the atrial tachycardias (90% success rate) and in the junctional tachycardias. This treatment is less effective for atrial flutter (50% successful) and for ventricular arrhyrthmia, in which the success rate was only 60%. It is possible to use the defibrillator after amiodarone has been administered. This drug is well tolerated, and no increase in cardiac failure has been noted in these patients. There does remain, however, the possibility of hypotension and perhaps of circulatory collapse, which is rapidly reversable; this is probably due to vasodilator activity. Intracavitary studies in 8 patients have shown that amiodarone causes slowing of sino-atrial and of atrio-ventricular conduction. Amiodarone may equally worsen a distal conduction defect. The uses for this anti-arrhythmic drug, which is particularly effective at the atrial level, are discussed in this paper.
No preview · Article · Jun 1976 · Archives des maladies du coeur et des vaisseaux
[Show abstract][Hide abstract] ABSTRACT: Report of one case of Prinzmetal variant of angina pectoris with a typical clinical and electrocardiographic picture in a man aged 87. Severe arrhythmias resulted in death of the patient. On autopsy a moderate narrowing of the anterior interventricular artery was demonstrated. In that relation, a review of the literature on the anatomical lesions and coronary arteriographic data of Prinzmetal angina was performed. It showed that in some cases Prinzmetal angina could be observed while the coronary artery lesions were very moderate. The pathogenesis of these facts was discussed.
No preview · Article · Mar 1975 · Archives des maladies du coeur et des vaisseaux
[Show abstract][Hide abstract] ABSTRACT: A report is given of ultrasonic studies performed on 22 patients with myocardial infarction, within 72 hr after the onset of pain. The results were compared with those of thirteen normal subjects explored with the same technique and device. Eleven of the 22 cases of myocardial infarction were completely catheterized as well, with measurement of the pulmonary artery pressure, of the cardiac output by dye dilution and of systolic time intervals by phonocardiography. On the ultrasonic recording the mean speed of circumferential shortening (SCS), the maximal displacement speed of the posterior wall (MDSPW) and the diameter of the ventricular chamber in systole and in diastole (DS and DD) were measured. There was no correlation between these measurements and the data of the conventional catheterization. On the contrary, the prognosis of myocardial infarction seemed to be severe when SCS and the output per beat decreased simultaneously, as 4 of 5 of these patients with these criteria died. Lanatoside C injection during the acute stage of myocardial infarction should be considered only when the SCS decreased : indeed, the mode of adaptation of the heart to infarction is usually by increasing the SCS with the help of the unaffected fibers; this spontaneous increase of the SCS makes the digitalis action useless and inefficient. In the patients with a diminished SCS, Lanatoside C never made it possible to resume a normal ventricular performance.
No preview · Article · Jan 1974 · Coeur et médecine interne
[Show abstract][Hide abstract] ABSTRACT: The negative dromotropic effect of 0.4 mg of pindolol and of 5 mg of propranolol was examined in 30 patients by recording His bundle potentials under atrial pacing. The effects of vagal tone were eliminated in 17 cases be preliminary injection of 1 mg of atropine. These two beta blocking agents act on intra nodal conduction and are without effect on intraventricular conduction.
No preview · Article · Feb 1973 · Acta cardiologica