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Biomedical subjects

C A Warnes

Publications and source records attributed to C A Warnes.

68 records · Page 4Linked to original sources
PubMed1984

The heart in massive (more than 300 pounds or 136 kilograms) obesity: analysis of 12 patients studied at necropsy.

Observations are described in 12 massively obese patients (5 women, 7 men), aged 25 to 59 years (mean 37), who weighed 312 to more than 500 pounds (mean 381). Seven patients had had systemic hypertension, 4 hypersomnia or sleep apnea, 2 diabetes mellitus, and 1 patient symptomatic coronary artery disease. Five patients died suddenly from undetermined causes, 2 from right-sided congestive heart failure, 1 patient from acute myocardial infarction; 1 from aortic dissection; 1 from intracerebral hemorrhage; 1 from a drug overdose, and 1 soon after an ileal bypass. The heart weight was increased in all 12 patients. The heart weight to body weight ratio expressed as a percent ranged from 0.22 to 0.61 (mean 0.37) (normal for men 0.42 to 0.46 [mean 0.43], normal for women 0.38 to 0.46 [mean 0.40]). The left ventricular cavity was dilated in 11 patients and the right ventricular cavity in all 12. Only 2 patients (aged 42 and 59 years) had 1 or more major epicardial coronary arteries narrowed greater than 75% in cross-sectional area by atherosclerotic plaque, 1 of whom had no symptoms of myocardial ischemia. Of 664 five-millimeter segments from the 4 major epicardial coronary arteries from 11 patients (mean 60 per patient), 431 (65%) were narrowed 0 to 25% in XSA, 143 (21%) were narrowed 26 to 50%, 73 (11%) were narrowed 51 to 75%, and 17 (3%) were narrowed 76 to 100%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue↗
PubMed1984

Sudden coronary death: relation of amount and distribution of coronary narrowing at necropsy to previous symptoms of myocardial ischemia, left ventricular scarring and heart weight.

The amount and distribution of coronary arterial narrowing by atherosclerotic plaque at necropsy is described in 70 victims, aged 22 to 81 years (mean 50), of sudden coronary death. Of 3,484 five-millimeter segments examined (mean 50 per patient) from the 4 major (left main, left anterior descending, left circumflex and right) coronary arteries, 950 (27%) were narrowed 76 to 100% in cross-sectional area (XSA), 1,127 (32%), 51 to 75%; 689 (20%), 26 to 50%; and 718 (21%), 0 to 25%. More extensive severe narrowing occurred in the proximal than in the distal halves of the left anterior descending, left circumflex and right coronary arteries. Comparison between the 31 previously symptomatic victims (angina pectoris or a clinical acute myocardial infarction or both) with the 39 victims who had previously been asymptomatic disclosed a significantly higher mean percent of severely narrowed (76 to 100% XSA) 5-mm segments (30 vs 25%, p less than 0.005) and lower mean percent of minimally narrowed (0 to 25% XSA) segments in the symptomatic group (15 vs 25%, p less than 0.001). Comparison of the 31 patients who had a healed myocardial infarction at necropsy with the 39 patients who did not disclosed a higher mean percent of 5-mm segments narrowed 76 to 100% in XSA (33 vs 24%, p less than 0.001) and a lower mean percent of segments narrowed minimally in those with a left ventricular scar (13 vs 26%, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

Comparison at necropsy by age group of amount and distribution of narrowing by atherosclerotic plaque in 2995 five-mm long segments of 240 major coronary arteries in 60 men aged 31 to 70 years with sudden coronary death.

A comparison of the amount and distribution of coronary arterial narrowing by atherosclerotic plaque at necropsy is described in each of four decades (31 to 70 years) of 60 male victims of sudden coronary death (SCD). Of 2995 five-mm segments examined (mena 50 per patient) of the four major (left main [LM], left anterior descending [LAD], left circumflex [LC], and right) coronary arteries, no significant differences were observed in the mean percent of 5 mm long segments narrowed severely (76% to 100% in cross-sectional area [XSA]) in each decade: 33% in the five patients aged 31 to 40 years, 29% in the 27 patients aged 41 to 50 years, 26% in the 18 patients aged 51 to 60 years, and 30% in the 10 patients aged 61 to 70 years. The mean percent of 5 mm segments severely narrowed was significantly (p less than 0.05) greater in the proximal halves than in the distal halves of the LAD, LC, and right coronary arteries in only the two older decades. The mean percent of 5 mm segments minimally (0% to 25%) narrowed, however, was significantly higher in the younger than in the older decades. Thus, as groups, both young and old victims of SCD have similar amounts of severe coronary narrowing, but the younger victims have a greater proportion of their major coronary arteries minimally narrowed.

Adult↗
PubMed1983

Wear of the metallic studs on the composite seat of the 2320 Starr-Edwards aortic valve and its clinical consequences.

The 2320 Starr-Edwards aortic valve has a composite seat with metallic studs that protrude through the cloth. Certain clinical and morphologic findings are described in 6 patients who had this prosthesis in situ for 50 to 144 months (mean 92). Considerable disruption of the cloth covering both struts and base, and varying degrees of wear of the metallic studs that line the luminal side of the prosthetic ring occurred in each. Excessive stud wear resulted in severe disruption of the cloth lining the interior of the prosthetic ring. Cloth disruption may be associated with hemolytic anemia, embolic consequences, or both. Of our 6 patients, 4 had severe hemolytic anemia, 4 had neurologic events compatible with emboli and 1 died suddenly. Stud wear as observed in the 2320 series Starr-Edwards prosthesis also may occur in the models 2310 and 2400 prostheses, which have the same composite seat.

Adult↗
PubMed1983

Effect of elevating the wrist on the radial pulse in aortic regurgitation: Corrigan revisited.

Five patients with severe aortic regurgitation had their intraarterial radial pulse recorded simultaneously with the external radial artery deflection of the other wrist. Recordings were made with the arms horizontal and repeated after elevation of the wrists, until the arms were vertical. Elevating the arm of a patient with aortic regurgitation increased the pulsation recorded over the radial artery, lowered mean intraarterial pressure, and reduced the pulse pressure. The results suggest that elevation increases the compliance of the arterial wall, primarily by moving the artery to a lower position on its pressure-volume curve. The same changes occurred in 5 normal subjects but were less pronounced.

Adult↗
PubMedDate not supplied

Cor triatriatum dexter in an adult diagnosed by transesophageal echocardiography: a case report.

Cor triatriatum dexter is a rare congenital heart malformation in which a persistent right sinus venosus valve divides the right atrium into two chambers. Before echocardiography, this anomaly has been rarely diagnosed before surgery or death. This is a case of cor triatriatum dexter in an adult with lifelong exertional cyanosis and dyspnea. A definitive diagnosis of cor triatriatum dexter with associated heart defects was best made by transesophageal echocardiography at 47 years of age. Subsequent surgical intervention confirmed all of the echocardiographic findings and successful correction of the defects was performed.

Cor Triatriatum↗
PubMedDate not supplied

Mitral flow velocity curves as a function of different loading conditions: evaluation by intraoperative transesophageal Doppler echocardiography.

Transesophageal pulsed wave Doppler echocardiography was performed intraoperatively on 10 patients undergoing coronary artery bypass operation. Mitral flow velocity curves and hemodynamic values were recorded during control conditions and intravenous infusion of (1) nitroglycerin, (2) phenylephrine, and (3) fluids. During nitroglycerin infusion blood pressure and wedge pressure decreased, peak filling velocity decreased, and deceleration time increased compared with control values. During infusion of phenylephrine blood pressure increased, there was a trend toward a decrease in peak filling velocity, and deceleration time increased. During infusion of fluids wedge pressure increased, deceleration time decreased, and peak filling velocity increased. Mitral flow velocity curves are therefore altered by changes in hemodynamic loading conditions.

Adult↗