1,720,977 research outputs found
Electrocardiographic diagnosis of left ventricular hypertrophy in the presence of left bundle branch block: a wasted effort.
Full text link[The problem of ventricular tachycardia with torsade de pointes and its rational therapy].
No full text[Phono-echocardiographic analysis of variations in tone I during atrioventricular block].
No full text[Cardiomyopathies with arrhythmic signs. A contribution to the clinical nosography of cardiomyopathies].
No full textElementi di valutazione fisiopatologica degli effetti emodinamici delle aritmie cardiache
No full textConsiderati i meccanismi fisiopatologici elementari degli effetti emodinamici delle aritmie cardiache, viene sottolineata l'importanza, ai fini del giudizio prognostico e terapeutico, della loro valutazione nel contesto clinico individuale.Elements of pathophysiological evaluation of the hemodynamic effects of cardiac arrhythmias.
The hemodynamic effects ot cardiac arrhythmias are discussed. The prognosis and treatment are, obviously, related to an individual clinical evaluation
Le miocarditi: attuali concetti eziopatogenetici e nosografici
No full textAffermata l'opportunità di conservare il termine di miocardite per le miocardiopatie caratterizzate dalla preminente flogosi essudativo-infìltrativa o granulomatosa, ne vengono presi in considerazione i vari aspetti eziopatogenetici, con speciale attenzione alle moderne concezioni sui meccanismi mediati di tipo immuno-allergico. La sostanziale univocità dei reperti istologici dovuti a noxae diverse, particolarmente per quanto riguarda la miocardite interstiziale aspecifica, secondo
recenti vedute sarebbe appunto l’espressione di un comune meccanismo di azione dei vari fattori patogeni in quanto capaci di attivare una reazione autoimmunitaria.
Le ripercussioni del danno anatomico sulla funzione cardiaca e le relative manifestazioni cliniche, dal quadro di cardiopatia dilatativa evolvente verso lo scompenso congestizio alle semplici turbe del ritmo disgiunte da segni clinico-funzionali di cardiopatia organica, vengono riferite alla severità, rapidità ed estensione delle lesioni a carico del miocardio comune e del tessuto specifico, indipendentemente dalla loro eziologia.
Una speciale trattazione è riservata alle miocarditi virali ed alle miocardiopatie idiopatiche ad impronta flogistica più o meno pronunziata, per la pressante attualità della loro epidemiologia e per i complessi problemi eziopatogenetici e diagnostici che esse propongono.Myocarditis: current etiopathogenetic and nosographic concepts.
The authors consider that the term myocarditis should be retained for myocardial disease characterized by predominance of exudative-infiltrating or granulomatous inflammation. The various etiopathogenetic aspects are discussed with special reference to current views on immuno-allergically mediated mechanisms. According to current opinion, the substantial uniformity of histologic findings due to a variety of noxae, especially where non specific interstitial myocarditis is concerned, is believed to be the expression of a common mechanism of action of a variety of pathogenetic factors capable of triggering an autoimmune reaction.
The repercussions of anatomical injury on cardiac function and the corresponding clinical manifestations - from cardiac disease with heart dilatation leading to congestive heart failure to simpIe arrhythmias not accompanied by clinical or
functional signs of organic heart disease - are related to the severity, speed and extension of damage to the myocardium and to specialized myocardial tissue regardless of their etiology. Viral myocarditis and idiopathic myocardial diseases with more or less marked phlogistic character are considered apart in view of the eminently topical character of theìr epidemiology and of the complex etiopathogenetic and diagnostic problems they present
Signal-averaged electrocardiography in myotonic dystrophy
No full textWe performed signal-averaged electrocardiography and 24-h ambulatory electrocardiographic monitoring in 53 patients with myotonic dystrophy to determine the incidence and clinical significance of ventricular late potentials. Patients were followed up for a mean period of 31 ± 17 months (range 11–68 months). At entry, none of the patients had bundle branch block on 12-lead electrocardiogram and none had wall motion abnormalities on routine echocardiogram. Also, no patient had history of syncope or clinical evidence of ischemic heart disease or a documented sustained ventricular tachycardia. A group of 47 healthy subjects matched for age and sex also underwent signal-averaged electrocardiography for comparison with the patient group. Late potentials were diagnosed in the presence of at least two of the following measures: duration of the filtered QRS > 114 ms, root-mean-square voltage of the terminal 40 ms of the filtered QRS 38 ms. Late potentials were more frequent in patients than in controls: 18 of the 53 patients (34%) showed late potentials compared with four of the 47 controls (8.5%) (P < 0.01). In 45 patients (85%) no ventricular ectopy (40 cases) or infrequent premature ventricular complexes (five cases) were detected on Holter monitoring. Complex ventricular arrhythmias were traced in the remaining eight patients. These were six of the 18 patients with, and two of the 45 patients without late potentials (33% vs. 6%, respectively; P < 0.01). Only two of the eight patients with complex ventricular arrhythmias were documented to have repeated three-beat runs of ventricular tachycardia; both patients also had late potentials. During the period of observation there were no sudden deaths. Two patients required permanent pacemakers for appearance of serious conduction defects and recurrent syncope. Therefore, ventricular late potentials are a frequent finding in patients with myotonic dystrophy. In our series they were sensitive in predicting complex ventricular arrhythmias being present in 75% of cases and correctly identifying the patients with ventricular tachycardia. However, specificity and positive predictive value were unacceptable due to the high false-positive rate. Also, the absence of cardiac catastrophic events during follow-up calls in question the prognostic value of ventricular late potentials in myotonic dystroph
Clinical relevance of the electrocardiogram in relatives of patients with hypertrophic cardiomyopathy.
No full textEighty-nine first-degree relatives of 22 patients with an established diagnosis of hypertrophic cardiomyopathy underwent electrocardiographic and echocardiographic screening. Scalar electrocardiogram was abnormal in 30/89 (33.7%) relatives. Of these thirty, eleven had definite evidence of hypertrophic cardiomyopathy at echo; one had borderline hypertrophy and was considered neither affected nor unaffected; four had questionable signs of hypertrophy. The remaining 14 relatives had normal echo-cardiograms. Fifty-nine relatives (66.3%) had normal electrocardiograms; at echo 3 were considered to have borderline hypertrophy, 16 had questionable signs of hypertrophy and 40 were normal. In relatives of patients with hypertrophic cardiomyopathy an abnormal electrocardiogram may reflect different morphologic conditions: a real hypertrophic cardiomyopathy or a myocardial hypertrophy of uncertain significance. Furthermore, in these categories of subjects, an abnormal electrocardiogram with normal echo must be considered with caution
Left ventricular myocardial function in myotonic dystrophy
No full textMyotonic dystrophy is an autosomal dominant disease affecting many organ systems, including the heart. Abnormalities of the cardiac conduction system are a frequent and well-documented finding in this neuromuscular disease, whereas overt signs of heart failure are rarely reported. However, controversy exists about the prevalence of preclinical left ventricular (LV) dysfunction in patients with myotonic dystrophy who have no symptoms of heart failure. To address this issue, load-independent LV function indexes were compared in patients with myotonic dystrophy and in normal subjects. LV measurements were obtained with M-mode echocardiography in 43 consecutive patients with myotonic dystrophy (mean age 35 +/- 14 years) who had no clinical evidence of heart failure, and in 35 sex- and age-matched controls. A cuff sphygmomanometer was used to determine blood pressure. No difference was found between patients and control subjects in the percentage of LV ejection fraction predicted for end-systolic stress (103 +/- 7 vs 103 +/- 7%; p = 0.97) or in the end-systolic stress/volume index ratio (2.9 +/- 0.5 vs 2.7 +/- 0.4 dyne7/cm3; p = 0.09). Similarly, no significant difference in LV myocardial function was detected between the 19 patients with a mild degree of the neuromuscular disease and in the 24 with a moderate or severe degree of the disease. Finally, LV myocardial function was compared between patients with myotonic dystrophy and atrioventricular or intraventricular conduction disturbances (n = 8) and those without these disturbances (n = 35), but no significant difference in the percentage of LV ejection fraction predicted for end-systolic stress or in the end-systolic stress/volume index ratio could be detecte
- …
