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C Pintaudi

Publications and source records attributed to C Pintaudi.

5 recordsLinked to original sources

[Functional heart murmur and echocardiography: a solved problem?].

BACKGROUND: Is it really vanished the need for echocardiography in the differential diagnosis of functional pediatric murmurs? METHODS: To this aim 260 children (132 males, 128 females; age range 1-84 months) were examined with auscultatory cardiac murmur. All children underwent a clinical and instrumental evaluation (ECG and echocardiography) from two pediatric cardiologists with independent assessment. RESULTS: Two hundred and ten patients (Group A) were evaluated clinically with functional murmur, 45 patients (Group B) with pathological murmur, 5 patients (Group C) with uncertain pathology. ECG showed changes in 1 Group B patient. Echocardiography showed pathology in 15 Group A patients (6 patients with patent foramen ovale, 5 patients with interatrial defect, 2 patients with bicuspid aortic valve, 1 patient with mitral insufficiency, 1 patient with restrictive cardiomyopathy). Pathology was excluded in 3 Group B patients, and in 2 Group C patients. In our clinical analysis echocardiography showed sensitivity 75%, specificity 97%, positive predictive value 90%, and negative predictive value 92%. CONCLUSIONS: In our experience we suggest to perform echocardiographic examination in children with functional murmur for complete assessment.

Child↗

Malignant ventricular arrhythmia in the Wolff-Parkinson-White syndrome during amiodarone treatment.

The ventricular rate during rapid atrial rhythms is related in Wolff-Parkinson-White (WPW) syndrome to antegrade effective refractory period of the accessory pathways. Among the many antiarrhythmic drugs available, amiodarone is most commonly used for its large therapeutic window and very long half-life. We report a case of cardiac pre-excitation syndrome in a young male patient in whom amiodarone therapy (3000 mg/weekly) was instituted to modify the dangerous ventricular response during atrial fibrillation (shortest R-R interval 190 ms, ventricular rate 210 beats/min). Four months later, starting pharmacological treatment, a new electrophysiological study documented a malignant ventricular arrhythmia: during atrial fibrillation the minimum R-R interval was 160 ms and the ventricular rate 280 beats/min. Finally, the possible mechanism of paradoxical effect observed in our patient is hypothesized. Amiodarone could favor conduction over the accessory pathways by slowing or blocking conduction into the atrioventricular node and decreasing concealed retrograde conduction into the accessory bypass tract by normally conducted beats.

Adult↗

[Magnesium salts in the treatment of ventricular tachycardia].

We report the results of magnesium sulphate (MgSO4) infusion in 10 patients with different ventricular arrhythmias: 6 torsade de pointes (2 with total A-V block, 1 with acute myocardial infarction and 3 with lengthening of the Q-Tc due to antiarrhythmic and/or diuretic treatment), 1 bidirectional ventricular tachycardia (on chronic treatment with digoxin (0.5 mg/day) and diuretics), and 3 polymorphic ventricular ectopic beats plus ventricular tachycardia runs (2 with hypertensive and 1 with ischemic cardiomyopathy). MgSO4 in normal saline was given at low rate (50 mg/min) and continued 2 hours after disappearance of arrhythmia, and the infusion was repeated at the same rate for 60-90 min twice daily for the next 3-4 days. In all patients the drug was effective and no side effects were observed. The heart rate and Q-Tc interval remained unchanged from baseline values. Serum creatinine concentration was normal. Serum Mg++, 60 minutes after the beginning of the infusion, was comparable to control values in all the patients, except 2 with hypomagnesemia. Finally, we can conclude that MgSO4 is an useful therapeutic tool for the treatment of various ventricular tachycardias.

Aged↗

[Diabetes mellitus and spontaneous hypoglycemia. Report of a clinical case with extrainsular neoplasm].

The authors report a case of hypoglycemia in a subject with NIDDM and CAD. The clinical syndrome, which was diagnosed as an induced form for a long time, was found to be spontaneous and caused by metastasised kidney neoplasm. This led to considerable problems of differentiated diagnosis owing to the concomitance of diabetes and vascular pathology. An adequate assessment of the clinical findings and the instrumental and biohumoral tests would have enabled a more rapid diagnosis, thus allowing a correct therapeutic approach to be adopted.

Aged↗