Biomedical subjects

A S Kapoor

Publications and source records attributed to A S Kapoor.

14 recordsLinked to original sources

PubMed1988

Transfer of acutely ill cardiac patients for definitive care. Demonstrated safety in 755 cases.

The safety of transporting acutely ill cardiac patients for cardiac catheterization has not been established. We describe 755 consecutive patients sent by ambulance from community hospitals to a tertiary center during an 18-month period. Eighty-seven percent of the patients were class III or IV New York Heart Association classification for angina. At catheterization, left ventricular dysfunction (ejection fraction less than 55%) was present in 40%. Forty-three percent of patients required urgent intervention (coronary artery bypass surgery or percutaneous transluminal coronary angioplasty). The patients were transported by paramedic ambulance up to 99 km (less than or equal to 62 miles) without a physician in attendance. No complications occurred in patients transferred within our guidelines. We believe that seriously ill cardiac patients can be transferred safely for definitive care. A single tertiary center providing immediate access to catheterization and surgical facilities can service a large population and many community hospitals.

Acute Disease↗

PubMed1986

Observer variation in the echocardiographic diagnosis of mitral valve prolapse.

To assess inter- and intraobserver variation in the echocardiographic diagnosis of mitral valve prolapse, three independent observers analyzed M-mode echocardiograms (n = 80) and two-dimensional echocardiograms (n = 65) of patients with a mobile midsystolic click with or without a late or holosystolic murmur. In addition, a control group of 100 normal echocardiograms were interspersed among the echocardiograms of patients with mitral valve prolapse and were then interpreted. Each of the three observers analyzed all M-mode and two-dimensional echocardiograms initially and then 2 weeks later for the presence or absence of mitral valve prolapse. M-mode echocardiographic criteria for mitral valve prolapse consisted of late systolic posterior motion (greater than or equal to 3 mm) of one or both mitral leaflets or holosystolic hammocking (greater than or equal to 3 mm) of one or both mitral leaflets. Two-dimensional echocardiographic criteria for mitral valve prolapse consisted of: posterior systolic arching of one or both mitral leaflets in the parasternal long-axis view, and/or posterior systolic bowing of one or both mitral leaflets in the apical four-chamber view posterior to the plane of the mitral anulus, and/or excessive posterior coaptation of the mitral leaflets in either view flush with or posterior to the plane of the mitral anulus. There was insignificant observer variation both in the M-mode and two-dimensional echo groups, as determined using Cochran's Q test.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1986

A case of ventricular undersensing in the DDI mode: cause and correction.

A case is presented that demonstrates a confusing problem of ventricular undersensing in the DDI pacing mode. Electrocardiographic monitoring of the patient after pacemaker implantation revealed intermittent ventricular channel outputs which appeared to be inappropriate. These occurred a period of time after the intrinsic R wave, equal to the programmed AV interval. This problem was caused by ventricular lead undersensing, which resulted when the patient's intrinsic rate was such that the intrinsic ventricular complex occurred during the ventricular blanking period. The problem was corrected by reprogramming the blanking period.

Cardiac Pacing, Artificial↗

PubMed1985

Sustained effects of transdermal nitroglycerin in patients with angina pectoris.

The antianginal efficacy of a transdermal therapeutic delivery system for nitroglycerin (TNG) was compared with that of placebo in a double-blind crossover study. Twenty-five patients with stable angina pectoris were evaluated. The transdermal system delivered 5 mg of nitroglycerin over a 24-hour period and was applied once every 48 hours. Treadmill exercise testing (Bruce protocol) was done 48 hours after the patch was applied in the first phase of the crossover and at the conclusion of the second phase of the crossover, 48 hours after the final dose of the second treatment. Exercise performance was significantly improved (P less than 0.05, analysis of covariance) with TNG as compared with placebo, as were frequency of episodes of angina and nitroglycerin consumption (P less than 0.05, analysis of variance). The incidence of mild-to-moderate headache in patients was greater during treatment with TNG (20%) than during placebo treatment (6.7%). Four cases of mild transient dermatitis and occasional reports of dizziness, lightheadedness, and nausea were noted.

Administration, Topical↗

PubMed1981