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Biomedical subjects

C Shub

Publications and source records attributed to C Shub.

66 records · Page 4Linked to original sources
PubMed1981

Cardiac papillary fibroelastomas. Two-dimensional echocardiographic recognition.

Papillary fibroelastomas are benign tumors of the heart and are most often incidental findings at cardiac surgery or autopsy. Rarely, symptoms or even sudden death can occur. We report two cases of cardiac papillary tumors diagnosed by two-dimensional echocardiography and successfully excised. One patient was asymptomatic and had a 1-by 1-cm papilloma of the mitral valve. The other patient had intermittent chest pains and diaphoresis associated with a 1.5- by 1-cm aortic valve papilloma.

Adult↗
PubMed1980

The value of redundancy in chronic bipolar pacemaker electrode systems.

Bipolar pacing systems, because of the presence of two intracardiac electrodes, provide lead redundancy. This allows conversion of bipolar to unipolar pacing or the reversal of lead polarity. During a 3-year period, this redundancy was utilized in 34 (13.7%) of 248 patients with chronic bipolar lead systems during follow-up pacemaker surgery. Of the 34 patients, elective pulse generator change was the most frequent indication for surgery (23 patients) and in this group redundancy was used most often to select the lead configuration with the highest R-wave amplitude and lowest stimulation threshold, or to solve the problem of weld defects of the connector pins or frayed insulation. The remaining 11 patients underwent surgery for pacemaker system malfunction and in this group redundancy was used to avoid the need for lead repositioning or placement of a new catheter system. Lead redundancy in those patients in whom bipolar pacing has been selected provides flexibility at the time of additional pacemaker surgery, and its use may obviate the need for a change in catheter system when stimulation thresholds are excessive, wire fraction is irreparable, or bipolar sensing signals are inadequate.

Electrodes, Implanted↗
PubMed1979

An unusual mediastinal lipoma simulating cardiomegaly.

A patient with vague, nonspecific symptoms was initially thought to have an enlarged cardiac silhouette on chest roentgenogram, and a primary intracardiac disorder was suspected. At surgery, a mediastinal lipoma was diagnosed and excised. The roentgenographic appearance represents an unusual presentation of a mediastinal tumor.

Adult↗
PubMed1978

The management of acute quinidine intoxication.

A 16-year-old patient survived severe intoxication with quinidine. Hypotension, rapidly progressing to oliguria and shock, was resistant to the usual therapeutic interventions but responded favorably to the use of an intra-aortic balloon pump. Some hemodynamic implications are discussed. Pulmonary edema occurred and was treated with positive end-expiratory pressure. Electrocardiographic disturbances in conduction, transient bradycardia and recurrent ventricular arrhythmias characterized the initial 36-hour critical period. Unexplained electrolyte abnormalities occurred and further complicated management.

Adolescent↗
PubMed1976

Detecting intrapulmonary right-to-left shunt with contrast echocardiography. Observations in a patient with diffuse pulmonary arteriovenous fistulas.

Contrast echocardiography has been useful in detecting intracardiac right-to-left shunts. In a patient with hereditary hemorrhagic telangiectasia and diffuse pulmonary arteriovenous fistulas, we have demonstrated the feasibility of detecting intrapulmonary right-to left shunting using this technique. After venous injection of indocyanine green dye, the characteristic contrast flow pattern consisted of a markedly delayed appearance of echoes in the left ventricle.

Adult↗
PubMedDate not supplied

The value of two-dimensional echocardiography and Doppler examination in the assessment of hypertensive patients: a pilot study.

There has been hesitation in accepting the routine use of echocardiography in patients with hypertension. The concept of "limited" or "focused" echocardiography has been introduced but incompletely evaluated. In this prospective observational cohort study, 100 consecutive hypertensive adults underwent comprehensive two-dimensional echocardiography and Doppler assessment regardless of referral question. Patients were categorized on the basis of echocardiographic referral questions into two groups: (1) determination of left ventricular mass only (limited echocardiography) and (2) determination of left ventricular mass and associated cardiac problems. In group 1, missed diagnoses were rare (5%). Additional, clinically relevant information was provided by comprehensive echocardiography in 9% of patients. Doppler echocardiography did not provide any additional useful information in group 1 but was useful in group 2. In both groups, echocardiography affected clinical management. In patients referred for determination of left ventricular mass only, the equivalent of limited echocardiography, missed diagnoses are rare. Additional, clinically relevant information is provided in only a small number of patients by comprehensive two-dimensional echocardiography. Comprehensive two-dimensional echocardiography, including Doppler echocardiography, was useful in selected patients referred with hypertension and other cardiac problems and should be part of the echocardiographic assessment of such patients. With careful selection of hypertensive patients, limited echocardiography can be a cost-effective strategy.

Cost-Benefit Analysis↗
PubMedDate not supplied

Two-dimensional echocardiographic calculation of left ventricular mass as recommended by the American Society of Echocardiography: correlation with autopsy and M-mode echocardiography.

The American Society of Echocardiography (ASE) has recommended diastolic area length and truncated ellipsoid methods for estimating left ventricular (LV) mass by two-dimensional (2D) echocardiography. The major goals of this retrospective study were to (1) assess the correlation between ASE-recommended 2D and M-mode echo-derived measurements of LV mass, (2) compare the two ASE-recommended 2D echocardiography methods, and (3) compare the echo-derived LV mass with anatomic LV mass. The study included 2D echocardiograms obtained within 30 days of death from 34 patients who subsequently underwent autopsy and 2D echocardiograms of 56 normal subjects. The formula used for measurement of M-mode echo-derived LV mass was LV mass = 0.8 (ASE-cube LV mass) + 0.6 gm. For 2D echo-derived LV mass, the ASE-recommended area length and truncated ellipsoid methods in systole and diastole were used, with and without incorporating the papillary muscles into the myocardial shell. LV mass derived by M-mode echocardiography was comparable to that derived by 2D methods, and it is reasonable to use this technique for normally shaped ventricles. When the papillary muscles were included into the myocardial shell, diastolic 2D methods overestimated autopsy LV mass. Both diastolic area length and truncated ellipsoid methods were comparable to autopsy LV mass. When the papillary muscles were excluded, the systolic area length method showed the best agreement with autopsy LV mass.

Aged↗
PubMedDate not supplied

Effects of pinacidil on the heart: serial electrocardiographic and echocardiographic observations.

In a prospective, double-blind study comparing pinacidil to hydralazine in mild systemic hypertension, 33 patients were followed with serial echocardiograms and electrocardiograms. There were four study groups: pinacidil and hydralazine (long-term therapy), and pinacidil and placebo (short-term therapy). There were no significant changes in mean echo LV mass or in LV systolic function in any of the groups. One patient in each group developed LVH de novo despite decreases in blood pressure. Four patients receiving pinacidil therapy (23%) developed new T-wave abnormalities and in 1, the initially abnormal T waves returned to normal at follow-up. Seven of 9 T-wave abnormalities were minor (Minnesota Code) and were not associated with any echocardiographic abnormality. One patient in the placebo group also developed new minor T-wave abnormalities. One patient receiving pinacidil therapy who had new major T-wave abnormalities developed cardiac ischemia. There were no other cardiac events.

Clinical Trials as Topic↗