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Biomedical subjects

A de Meester

Publications and source records attributed to A de Meester.

At least 19 recordsLinked to original sources
PubMed2004

[Doppler ultrasound and aortic regurgitation. Evaluation of the sensitivity and specificity of Doppler findings].

PURPOSE: The purpose of this study was to determine the sensitivity and specificity of arterial Doppler findings of aortic regurgitation to assess if the amplitude of changes of Doppler tracings can accurately quantify the degree of regurgitation. PATIENTS AND METHODS: We analysed and compared the arterial Doppler tracings and echocardiograms of 250 patients. RESULTS: Even if the obvious pitfall of vascular stenoses is avoided, the global sensitivity of arterial Doppler findings for aortic regurgitation remains weak (30%). However, our study demonstrates that it can reach 100% if only significant AR (> or =2/4) is taken into account. Since the clear false-positive cases have been carefully excluded from the very start, the specificity of the classical criteria already proves excellent (above 95%). It will reach perfection if additional simple criteria gathered from the data mentioned in this study are considered. Quantifying precisely the degree of aortic regurgitation on the basis of arterial Doppler tracings is impossible. Nevertheless, we show that it is easy to identify significant AR (> or =2/4) that should be further assessed with echocardiography. CONCLUSION: Arterial Doppler sonography is unable to detect all cases of aortic regurgitation but those that are overlooked are not significant (1/4). If AR signs happen to be detected by arterial Doppler, the amplitude of the leak cannot be accurately determined based on tracing analysis. Yet, simple criteria will indicate whether it is important enough (> or =2/4) to require complementary echocardiogram, with well documented accuracy for morphological and hemodynamic evaluation.

Aortic Valve Insufficiency↗
PubMed2002

[Recommendations for the management of acute chest pain. Report of the Belgian Interdisciplinary Group on Acute Cardiology].

The Belgium Interdisciplinary Working Group on Acute Cardiology (BIWAC), including cardiologists, intensivists and urgentists was formed to give consensus regarding the management of acute chest pain in the prehospital and the early hospital phases. General recommendations and critical pathways are proposed to improve the treatment of the patients with acute coronary syndromes.

Acute Disease↗
PubMed2002

[Recommendations for management of acute chest pain. Report of the Belgium Interdisciplinary Working Group on Acute Cardiology].

The Belgium Interdisciplinary Working group on Acute Cardiology, including cardiologists, intensivists and urgentists was formed to provide consensus regarding the management of acute chest pain in the prehospital and the early hospital phase. General recommendations and critical pathways are proposed to improve the treatment of the patients with acute coronary syndromes.

Acute Disease↗
PubMed2001

ICD malfunction caused by excessive defibrillation charge time.

A 71-year-old man with a history of myocardial infarction and syncopal ventricular tachycardia received an ICD. Progressively, increased defibrillation charge times of the ICD were observed. During a fast ventricular tachycardia, the patient collapsed. The underlying malfunction could be documented by ICD telemetric interrogation. An excessive charge time was recorded causing subsequent delayed therapy. The ICD was considered potentially ineffective and required a generator exchange. This case report underlines the possible factors affecting the ICD charge times. Excessive charge time must be considered as a rare, or underestimated, cause of ICD malfunction, requiring generator replacement.

Aged↗
PubMed2000

Symptomatic pericarditis after influenza vaccination: report of two cases.

The authors report two cases of benign acute pericarditis after the patients received vaccinations against influenza virus. The diagnoses were confirmed by serologic changes and by the findings of 12-lead electrocardiogram and echocardiography. Symptoms and clinical status improved on aspirin therapy. The authors underline the possible mechanisms of this rare complication of influenza vaccination.

Acute Disease↗
PubMed1999

Paroxysmal atrioventricular block induced during head-up tilt test.

A 71-year-old female with vasovagal near-syncope suffered from paroxysmal second-degree AV block during Holter monitoring. AV block was easily reproduced during head-up tilt test. She was successfully treated with a dual chamber pacemaker. This treatment is unusual and the role of cardiac pacing in patients with vasovagal symptoms is reviewed.

Aged↗
PubMed1997

Usefulness of isoproterenol in the induction of clinical sustained ventricular tachycardia during electrophysiological study.

Electrophysiological testing remains the basic procedure in the assessment of life-threatening sustained ventricular tachycardias (VT). The predictive value of inducible VT depends on the baseline stimulation protocol and probably on some other factors, including automatic balance. We report the cases of four patients, with a history of myocardial infarction, who experienced recurrent episodes of syncope; the clinical aspects of the syncope were suggestive of syncopal VT. With a baseline protocol, electrophysiological testing only allowed the induction of well-tolerated non-sustained VT. Using the same stimulation protocol (rapid ventricular pacing or basal ventricular stimulation with 2 extra-stimuli), monomorphic sustained VT that had the same ECG morphology, as non-sustained VT, could only be induced while low doses of isoproterenol (1-2 micrograms/min) were being administered. In these cases, increased sympathetic tone appears to be prerequisite for a sustained VT reproducing the patients clinical symptoms and discomfort. To conclude, in some patients with recurrent symptoms, including syncope suggestive of ventricular arrhythmia, low-dose infusion of isoproterenol may facilitate the induction of of clinical sustained VT and increase the predictive value of electrophysiological testing. Possible mechanisms of ventricular arrhythmogenesis by isoproterenol are discussed.

Adrenergic beta-Agonists↗
PubMed1996

[Malignant mitral valve prolapse: apropos of a case].

The authors report the case of a 67-year-old woman, with mitral valve prolapse, for more than 20 years. She recently complained of attacks of syncope and clinical ventricular tachycardia; ventricular fibrillation was induced during programmed stimulation. The patient seemed to be at high risk for sudden cardiac death, and was therefore treated with an automatic implantable defibrillator. The pathophysiology and risk factors of sudden cardiac death in mitral valve prolapse are discussed.

Aged↗
PubMed1996

[Traumatic myocardial infarction caused by lead shot].

The authors report the case of a 32 year old woman who was shot with a shotgun. Acute inferior wall infarction was detected fortuitously on electrocardiography and coronary angiography showed occlusion of the right coronary artery with lead shot. The single coronary lesion, absence, of other cardiac complications (haemopericardium, cardiac perforation, ...) and the favourable outcome with conservative medical treatment has not been previously reported to the authors' knowledge.

Adult↗
PubMed1995

[Chest pain and electrocardiographic changes in the presence of stenosis of the left common coronary artery].

Twelve-lead electrocardiogram were studied in 40 consecutive patients with angiographic left main coronary artery disease. The ECG were analysed during chest pain. The most frequent pattern was a ST elevation (> 0.1 mV) in lead a VR alone or with ST depression (> 0.2 mV) in the anterior or lateral leads. In coronary artery disease patients, the 12-lead electrocardiogram at rest remains the best test to detect patients at higher risk for massive myocardial infarction or death.

Chest Pain↗
PubMed1995

[Major prolongation of the QT interval observed in the course of massive pulmonary embolism].

The authors report the case of a 68-year-old woman who suffered from an acute massive pulmonary embolism. The common electrocardiographic findings were not observed, but rather an extreme QT prolongation. The patient has been successfully treated by thrombolysis. After a few days, the electrocardiogram normalized. These electrocardiographic changes have not yet been described in the medical literature.

Aged↗
PubMed1995

Successful radiofrequency ablation of a true paraHissian accessory pathway.

Radiofrequency catheter ablation seems to become a first-line therapy for patients with paroxysmal tachycardias using an accessory pathway. We report the case of a 31-year-old woman who suffered from drug-resistant recurrent reciprocating tachycardia, using an uncommon accessory pathway. The 12-lead electrocardiogram in sinus rhythm showed the following characteristics: a positive delta waves in leads I, II, aVL, aVF, QRS axis = 0 degrees, R/S in lead V1 < 1, and a special QRS pattern in the precordial leads (QS or Qr in V1-V3 and QRS transition > V3). A deep septal parahissian accessory pathway has been localized using classic endocardial mapping procedures and has been confirmed during successful radiofrequency catheter ablation. Normal auriculo-ventricular conduction has been totally preserved. No complications or recurrence were observed during the follow-up. We have reviewed the electrophysiologic criteria to confirm this rare accessory pathway location.

Adult↗
PubMed1994

[Myocardial revascularization using Vineberg's procedure; 23 years follow-up].

The authors report the case of a patient followed up for 23 years after a double myocardial implantation of the internal mammary arteries (Vineberg technique) for unstable angina. The result of this procedure of surgical revascularisation has been very satisfactory to date. The authors believe this to be the longest follow-up reported in the medical literature.

Angina, Unstable↗
PubMed1994

Torsades de pointes and aborted sudden death after implantation of a cardioverter defibrillator.

Recent publications have demonstrated that the implantable cardioverter defibrillator (ICD) improves survival in patients with ventricular tachycardia (VT) or fibrillation (VF) by reducing arrhythmic death. We report the case of a patient with a history of an old myocardial infarction and a left ventricular dysfunction, who presented four episodes of syncope associated with a hemodynamically not well tolerated sustained VT, who had easy inductible clinical VT during electrophysiologic study and required an ICD. After a follow-up of 2 months, the patient presents a complete AV block and multiple episodes of torsades de pointes that sometimes degenerate into VF. The ICD delivered 64 adequate and well-tolerated shocks during 10 hours before and during the hospital admission. We programmed a VVI pacing rate at 65 bpm and no more arrhythmia was observed. The left ventricular ejection fraction was not altered afterwards. In conclusion, we experienced the temporary efficacy of the ICD in the treatment of incessant torsades de pointes, without myocardial injury.

Aged↗
PubMed1994

[Abnormal origin of the left coronary artery from the pulmonary artery trunk; a fortuitous discovery in a 52 year-old man].

Anomalous origin of the left coronary artery from the pulmonary artery is a rare congenital abnormality but with a very poor prognosis at birth. Myocardial ischaemia, infarction and sudden death are common. Cases diagnosed in adulthood are exceptionally rare. The authors describe the case of an asymptomatic 52 year old man with this congenital abnormality diagnosed after routine electrocardiography had shown sequellae of anterior myocardial infarction. This case would seem to be one of the rarest cases diagnosed fortuitously at this age. In view of the good clinical tolerance of the disease and the absence of residual ischaemia on effort, the patient was treated medically.

Coronary Angiography↗
PubMed1994

[Long-term follow-up of patients with complete congenital auriculo-ventricular block treated with a cardiac stimulator].

The congenital complete heart block (CCHB) is a rare affection. In our two centers, in a period of 10 years, 1405 pacemakers were placed and only 10 (0.71%) for CCHB. We review the clinical history, the EKG's, echocardiography and Holter monitoring of these 10 patients. All of them were symptomatic. After pacemaker implantation, symptoms were improved in 90%. No death or other morbidity were observed during the long-term follow-up. So, the clinical outcome of patients with CCHB who underwent prophylactic pacemaker implantation seems to be associated with an excellent prognosis.

Adult↗
PubMed1994

[Late diagnosis of tetralogy of Fallot in an asymptomatic adult].

The authors report a case of Fallot's tetralogy found in an asymptomatic adult patient. Echocardiography and cardiac catheterization confirmed the diagnosis. Life expectancy without surgery is usually short and our patient's survival is therefore uncommon. This case probably represents the oldest patient with uncorrected tetralogy found in the literature.

Age Factors↗