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D Pioselli

Publications and source records attributed to D Pioselli.

11 recordsLinked to original sources
PubMed1987

[Diagnostic reliability of clinical and instrumental data in identifying the presence of coronary disease in women with chest pain].

The present study was performed to assess the reliability of clinical symptom, rest and exercise electrocardiogram, exercise Thallium myocardial scintigraphy, as well as rest and exercise radionuclide angiocardiography, in order to detect significant coronary artery disease in 85 female patients with chest pain, who underwent coronary angiography. Of these, 54 underwent Thallium myocardial scintigraphy, 53 rest and exercise radionuclide angiocardiography. We have evaluated sensibility, specificity and positive and negative predictive value for each single variable or every possible combination. Within the population examined, Thallium myocardial scintigraphy reaches the highest sensibility (92%), specificity (92.5%), positive predictive (81%) and negative predictive value (97%). In comparison with all other clinical or instrumental parameters, taken either single or in combination. By subdividing the sample in two groups, of 20 and 65 patients respectively on the basis of the clinical symptom angina or thoracoalgy, with different predominance of coronaropathy (60 and 15%), Thallium myocardial scintigraphy is confirmed to be the most reliable diagnostic test (within the angina group sensibility 86%, specificity 100%, positive predictive value 100%, negative predictive value 83%, within the thoracoalgy group sensibility 100%, specificity 91%, positive predictive value 70%, negative predictive value 100%). However, within the thoracoalgy group, a negative maximal exercise test and a normal rest radionuclide angiocardiography detect patients with low probability of coronaropathy (negative predictive value respectively 100% and 93%). Within the angina group only Thallium myocardial scintigraphy significantly increases the predictive value of the angina symptom itself with respect to the presence of coronaropathy (positive predictive value of angina symptom alone 60%, of angina symptom plus Thallium myocardial scintigraphy 100%).

Adult↗
PubMed1984

[Abnormal electrocardiographic changes induced by hypocalcemia secondary to extracorporeal circulation].

We report hereby the case of a 20-year-old woman, whose electrocardiogram showed unusual repolarization abnormalities 36 hours after open heart surgery. They were due to pure hypocalcemia (7,1 mg/100 ml) secondary to extracorporeal circulation, were sudden in onset, transient, variable within a few minutes, and immediately suppressed by intravenous calcium chloride. Some of the changes were similar to those already reported in literature (lengthening of QT and ST segments, changes in T wave voltage but not duration) whereas other were quite unusual i.e. the extreme variability and transientness of these changes, the marked ST level alterations and the presence of wide and diphasic U waves. Intravenous administration of 2 g of calcium chloride was followed by immediate and complete normalization of the electrocardiographic tracing.

Adult↗
PubMed1975

[Short and long term prognosis of intraventricular conduction disturbances in myocardial infarction (author's transl)].

Intraventricular conduction disturbances (IVD) were found in 181 (21,9%) out of 828 patients with acute myocardial infarction. Isolated RBBB was present in 6,3% of cases; both RBBB and LAH or LPH in 3,4%; isolated LAH in 5,8%; LBBB in 3%; suspect blocks of the three brances [RBBB+LAH+first degree atrio-ventricular block (AVB), or LBBB+first degree AVB] in 2,9% of cases. The severe mortality (41%) during hospitalisation of patients with IVB seems to be due to the haemodynamic impairement: cardiogrnic shock was observed in 20% of these patiens and acute pulmonary oedema in 18%. Transient or permanent complete AVB occurred during hospitalisation in 24,3% of these patients. The occurrence of complete AVB was higher (54%) in patients in whom suspect block of three branches was present. It was found that the progression of IVD to complete AVB increased the mortality rate to 48%. The short term prognosis of patients with IVD does not seem to be improved by prophilactic electrical stimulation, but the rate of deaths for asystolia is reduced. The mortality rate after one year of patients discharged from hospital was 25%; suspect three branches IVD died suddenly and 2 progressed to complete AVB. In the author's opinion the implantation of permanent electrical stimulation is indicated in patients showing IVD of the three branches assessed using His bundle electrgram during the acute phase of myocardial infarction.

Acute Disease↗