Biomedical subjects
Publications and source records attributed to B Ee.
A 50-year-old male was admitted to hospital for repeated episodes of chest pain due to unstable angina. Serial electrocardiograms were all normal except for one electrocardiogram, recorded during chest pain, which showed isolated U wave inversion in leads I, V4 and V5. Subsequently, selective coronary arteriography showed isolated 99% stenosis of his left main coronary artery.
The association of myasthenia gravis and periodic paralysis in thyrotoxicosis has not been reported before. We describe a Chinese man with thyrotoxicosis and myasthenia gravis, who subsequently developed periodic paralysis. The possible aetiological links are discussed.
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Atrial flutter occurring in patients with the Wolff-Parkinson-White syndrome is extremely uncommon. We describe a patient with this arrhythmia which converted to sinus rhythm and normal conduction following intravenous administration of disopyramide.
We describe two patients who presented with precordial continuous murmurs which were diagnosed clinically as due to patent ductus arteriosus; however, two-dimensional echocardiographic and pulsed Doppler echocardiographic studies showed dilatation of the left main coronary artery with turbulent flow during systole in the lumen in both patients. Subsequent selective coronary angiographic studies showed bilateral coronary artery-pulmonary artery fistula in one patient and left coronary artery-pulmonary artery fistula in the other. This study illustrates that in a patient presenting with a continuous murmur which is suggestive of patent ductus arteriosus, such two-dimensional and pulsed Doppler echocardiographic findings as were seen in our patients should immediately alert the physician that he may be dealing with a case of coronary arterial fistula.
The immediate hypotensive effect of oral nifedipine was assessed in 15 patients with moderate to severe hypertension. Supine and erect blood pressure and heart rates were measured before and 30 minutes after 10 mg nifedipine. The results showed that there was a significant (p less than 0.001) reduction in both systolic and diastolic pressures. There was a slight increase in heart rate and mild postural hypotension but neither appeared to be significant. It is concluded that nifedipine given by the oral route is an effective agent for the rapid lowering of elevated blood pressure and deserves further evaluation as an agent for the management of hypertensive emergencies.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The M-mode echocardiographic findings seen in 5 patients with acute rupture of the aortic valve leaflets due to infective endocarditis are described. These findings embrace a wide spectrum of abnormalities seen in the aortic root in diastole and they are (1) fine, high frequency oscillating echoes, (2) thick oscillating bands of echoes, and (3) dense shaggy echoes loosely attached to the aortic valve leaflets. Three patients showed persistence of these aortic root echoes right up to the level of the left ventricular outflow tract. All 5 patients demonstrated early closure of the mitral valve and exaggerated motion of the interventricular septum and the posterior wall of the left ventricle. Two patients died from the illness and the remaining 3 had successful aortic valve replacement after appropriate antibiotic therapy. The aortic valve and the aortic root were carefully examined in all 5 patients either at necropsy or at operation. Two patients had leaflet perforation alone, whereas the remaining 3 had both leaflet perforations as well as vegetations. An attempt was made to correlate morphologic findings with the echocardiographic abnormalities. It is concluded that it is frequently difficult from abnormal echoes in the aortic root alone to differentiate between ruptured leaflets and vegetations. However, the presence of the combination of early closure of the mitral valve, exaggerated motion of the interventricular septum and the posterior wall of the left ventricle, together with abnormal aortic root echoes as described above should strongly suggest acute rupture of the aortic valve leaflets due to infective endocarditis, or in rare cases myxomatous degeneration of the aortic valve.
M mode echocardiography first started in the University Department of Medicine in early 1976. There has been a steady increase in the total number of procedures done yearly. The value of M mode echocardiography in the various cardiovascular disorders is discussed and the current status and future prospects of this procedure is reviewed.