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Biomedical subjects

E D Grech

Publications and source records attributed to E D Grech.

33 records · Page 2Linked to original sources
PubMed1994

Termination of reperfusion arrhythmia by coronary artery occlusion.

Reperfusion arrhythmias may be a cause of sudden death in acute myocardial infarction. A patient underwent successful coronary artery recanalisation by primary percutaneous transluminal coronary angioplasty (PTCA) for acute myocardial infarction. In this patient an idioventricular rhythm with a severe haemodynamic effect developed within one minute of deflation of the PTCA balloon. Sinus rhythm was immediately restored by reinflating the balloon and thus reinterrupting the supply of oxygenated blood. This suggests that reperfusion with consequent reoxygenation is a primary factor in arrhythmogenesis.

Aged↗
PubMed1993

Free-radical generation during angioplasty reperfusion for acute myocardial infarction.

We describe direct and quantitative evidence of free-radical production in the early stage after recanalisation in a patient undergoing primary coronary angioplasty for acute myocardial infarction. After successful initial dilation, the procedure was complicated by re-occlusion of the artery at the same site, with subsequent fall in free-radical generation. After repeat angioplasty, recanalisation was again accompanied by increased free-radical production.

Angioplasty, Balloon, Coronary↗
PubMed1993

Traumatic mitral valve rupture during the Hillsborough football disaster: case report.

Ninety-five spectators died from crush injuries and asphyxiation at the Hillsborough football ground in Sheffield, England on April 15, 1989. Survivors suffered a spectrum of compression injuries to the chest, including documented cardiac injuries although these were not permanent. We report the case of one survivor who developed an isolated traumatic mitral valve rupture during the crush, and may require mitral valve replacement at a later date.

Echocardiography↗
PubMed1993

Differential free-radical activity after successful and unsuccessful thrombolytic reperfusion in acute myocardial infarction.

BACKGROUND: Free-radical generation after successful thrombolysis in acute myocardial infarction may jeopardize ischaemic but viable myocardium, thus limiting the optimal benefits of reperfusion. METHODS: Circulating free-radical activity was assessed in 25 consecutive patients with acute myocardial infarction. Those who successfully reperfused (Group A) were compared with those who did not (Group B). We also compared patients who had or had not developed Q waves and patients with and without previous angina or myocardial infarction. All patients presented within 6 h of the onset of chest pain and received standard intravenous streptokinase therapy. Free-radical activity in serial serum samples collected over 72 h was measured using the percentage molar ratio (PMR) of the concentrations of 9,11-linoleic acid to 9,12-linoleic acid, and malonaldehyde concentration. RESULTS: Throughout the study period Group A (n = 11) showed significantly greater change in serum PMR and malonaldehyde levels compared with Group B (n = 14) (P < 0.01). PMR differences between the two groups were most pronounced at 3 and 12 h (P < 0.001). Patients with non-Q-wave myocardial infarction (n = 5) showed significantly greater changes in serum PMR and malonaldehyde levels (P < 0.01) compared with those with Q-wave infarction (n = 20). A history of previous infarction or angina had no apparent effects on the changes in serum free-radical activity. CONCLUSIONS: Successful early reperfusion and non-Q-wave myocardial infarction are both associated with a significantly greater increase in the levels of markers of serum free-radical activity immediately after infarction. The results support present concepts of free-radical-mediated reperfusion injury. Use of these assays may identify those patients who may be at risk from free-radical-mediated reperfusion injury.

Aged↗
PubMed1993

Histopathological examination of specimens removed during directional coronary atherectomy in patients presenting with crescendo angina show mural thrombus.

Thrombus formation over a fissured coronary atheromatous plaque has been shown by post mortem histological examination to be the pathophysiological mechanism responsible for myocardial ischaemia in those patients who died following a crescendo pattern of angina. Histological examination of plaques responsible for a crescendo pattern of angina in patients who do not die has not been available until recently. We describe two patients who presented with a crescendo pattern of angina. A new technique of coronary revascularization, directional coronary atherectomy, produced symptomatic relief and resolution of myocardial ischaemia. Histological examination of material from the stenosis responsible for their myocardial ischaemia, obtained using this technique, confirmed thrombus formation overlying a fissured atheromatous plaque.

Adult↗
PubMed1992

Family history as an independent risk factor of coronary artery disease.

The relationship between family history of ischaemic heart disease and the presence of coronary heart disease was studied in 387 patients undergoing routine coronary arteriography prior to valve replacement. One hundred and seven patients (27.6%) had a family history of ischaemic heart disease. Of these, 52 (48.6%) had significant coronary artery disease compared with 60 of 280 (21.4%) patients without a family history (P < 0.001). The overall severity (coronary score) and extent (number of vessels) of coronary artery disease was greater in those patients with a family history (P < 0.001). Moreover, the incidence of significant coronary disease increases as the number of relatives with ischaemic heart disease also increase (P < 0.001). Multiple logistic regression analysis suggests that family history is an independent predictor of the presence of significant coronary artery disease.

Adult↗
PubMed1992

Delayed complications after myocardial contusion.

A 45 year old farmer was kicked in the chest by a horse. In the days following the injury episodic breathlessness developed and he was admitted to hospital with right ventricular failure and pulmonary emboli. Echocardiography showed global right ventricular dysfunction but a right ventricular mural thrombus, the likely source of the pulmonary emboli, was not seen. He gradually recovered after treatment with anticoagulant. One month later he presented with a further complication--complete atrioventricular dissociation--that required a dual chamber pacemaker implantation. This patient had few initial manifestations of right ventricular myocardial contusion and this case illustrates that such patients should be closely monitored for delayed complications.

Contusions↗
PubMed1984

Propranolol concentrations in blood serum, seminal plasma and saliva in man after a single oral dose.

A single dose of 80 mg racemic propranolol hydrochloride was administered by mouth to six healthy male volunteers. The mean concentration achieved in seminal plasma at 2 h after dosing was almost identical to that in blood serum. The concentrations of propranolol in seminal plasma and saliva were much less than those known to reduce sperm motility by 50% in vitro. The concentrations in saliva did not reflect those in blood serum. Propranolol in the dose administered in this study is unlikely to affect fertility by its presence in saliva or semen.

Administration, Oral↗
PubMedDate not supplied

Percutaneous transluminal coronary angioplasty and acute myocardial infarction.

Percutaneous transluminal coronary angioplasty (PTCA) may be performed at various time intervals after acute myocardial infarction (MI), and may be combined with thrombolytic therapy. This article reviews the data on the role of PTCA in acute MI, and summarises current opinion.

Angioplasty, Balloon, Coronary↗