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Biomedical subjects

A Agapito

Publications and source records attributed to A Agapito.

5 recordsLinked to original sources

[Persistent ductus arteriosus in the adult--report of a case].

The authors describe a case of congenital heart disease no longer frequent in adults, due to an early diagnosis and surgical treatment. The patent ductus arteriosus in adults who received no therapy can present several forms of evolution, depending on its own hemodynamic profile. The present case is an example of a congenital heart disease not diagnosed during the childhood, that developed pulmonary hypertension and congestive heart failure. These clinical situations have a bad prognosis and place this patient in a group of high surgical risk. Thus, surgery is not advisable considering the bad prognosis and early high mortality rate.

Age Factors

[Myxedema coma].

Five patients, 4 female and 1 male, aged 45 to 73, were observed in myxedema coma between 1984 and 1992. In three patients hypothyroidism was not known. Depressed consciousness, hypothermia, bradycardia and no goiter were common to all and a precipitating factor could be identified in 3 of them. Therapy included L-thyroxine and/or triiodothyronine by nasogastric tube, hydrocortisone and supportive measures. Outcome was good in the 2 patients with known precipitating event, less impaired consciousness and normalization of body temperature by the third day of treatment.

Aged

[Hyperthyroidism caused by non-neoplastic inappropriate TSH secretion].

We report a case of hyperthyroidism due to non-neoplastic inappropriate thyrotrophin secretion in a 31 year old woman. Increased T3 and THS levels after thyroidectomy led us to suspect the diagnose. Serum levels were further increased by TRH and only partially suppressed by triiodothyronine and computerised axial tomography showed a normal sellar region. These features are characteristic of inappropriate TSH secretion due to thyrotroph resistance to thyroid hormones. Bromocriptine and octreotide were ineffective in lowering TSH levels. Pregnancy and breastfeeding postponed 3,5,3'-triiodothyroacetic acid therapy.

Adult

[Pulmonary stenosis in adults. Report of a clinical case].

The authors report a case of valvular pulmonary stenosis in a 60 years old patient, admitted to hospital with heart failure and angor pectoris. Four years previously a VVI pacemaker had been implanted for complete heart block. At the time of the admission he had two pacemakers leads in the right ventricle; one of them was retained and functionless since the changing of the generator which occurred 1 year before. The usual complications of endocardial pacemakers are discussed, as well as the natural course and surgery indications for valvular pulmonary stenosis in adults.

Humans

[Value of two-dimensional echocardiography in the prognosis of patients after acute myocardial infarction].

OBJECTIVES: To evaluate the prognostic importance of two-dimensional echocardiography in patients (pts) with acute myocardial infarction. SETTING: Department of Cardiology in a Central Hospital. METHODS: In 71 pts (63 men and 8 women) aged 35 to 75 years interned with a proved myocardial infarction, a score of left ventricular segmental wall motion was used on echocardiographic examination performed during the late hospital phase, to evaluate left ventricular function. Two groups of pts were considered: group A constituted by 38 pts with complication detected during follow-up that ranged 4 to 18 months; group B by 33 pts with no cardiac events for the same period. The relation of the wall motion score with each group and the location of myocardial infarction was performed. RESULTS: In group A, the mean score index was 1.67 in pts with angina, 1.08 in pts with heart failure and 0.82 in pts who died. The mean score index was 1.25, 1.57 and 1.18 respectively in pts with an anterior, inferior and antero-inferior infarction. In group B, the mean score index was 1.70 in pts with an anterior infarction, 1.85 in those with an inferior infarction and 1.33 in the patient with an antero-inferior infarction. Patients with a non-Q wave infarction had a mean score index of 2. The mean score index was significantly different between group A and B (respectively 1.33 vs 1.79; p less than 0.00001) and a mean score index of 1.53 was considered the mean risk value. CONCLUSIONS: Two-dimensional echocardiography performed during hospital predischarge permits risk stratification after acute myocardial infarction, specially for death and heart failure.

Adult