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Biomedical subjects

F Kerr

Publications and source records attributed to F Kerr.

At least 37 records · Page 2Linked to original sources

Myocardial rupture in acute myocardial infarction: report of experience and review.

A review of eight cases of myocardial rupture following myocardial infarction confirmed the association of rupture with advanced age, a preponderance of females, hypertension, and physical exercise after infarction. In four patients, electrocardiograms recording the events of rupture showed further S-T elevation, supraventricular tachycardia, and conduction defects. One case of septal rupture showed increase in the amplitude of the P waves. The combination of these changes with sudden reappearance of chest pain, development or worsening of congestive cardiac failure with hypotension, and the appearance of a precordial systolic murmur should aid in the earlier diagnosis of this complication which may be amenable to surgery. Successful repair of rupture has been reported during the acute phase of infarction and after variable periods of delay.

Acute Disease↗

Prognosis of new and worsening angina pectoris.

The natural history of new and worsening angina pectoris was studied in 251 men aged under 70 years. Most were ambulant and all were referred by selected general practitioners to a special hospital clinic over two and a half years. Heart attacks developed in 39 patients, nine of whom died. Seventy-two per cent of the attacks occurred within six weeks of the onset or worsening of angina. Of the 212 patients who did not suffer myocardial infarction and who were clinically reviewed six months after their first attendance 66 had been pain free for the previous three months and 14 had experienced only infrequent attacks of angina. Of the 128 men aged under 65 years who were previously in employment 81% had returned to full-time work six months after their first attendance. A discriminant function analysis using many variables was made to develop a predictive index that would allow patients with new or worsening angina who were likely to develop serious cardiac complications to be identified. This did not prove possible, and the only predictive factor of significance was an increased cardiothoracic ratio. The syndrome of new and worsening angina has a low risk of early death, and many patients are symptom free six months later. In general, emergency coronary arteriography and surgery is not indicated.

Adult↗

Electrocardiographic changes produced by interventricular septal rupture.

The electrocardiogram was recorded during spontaneous rupture of the interventricular septum in a patient after myocardial infarction. The electrocardiographic abnormalities included an increase in the sinus rate, elevation of the ST segment, decrease in Q wave size, and increase in the height and width of the P wave.

Aged↗

Interaction between cardiovascular responses to sustained handgrip and Valsalva manoeuvre.

Interactions between the cardiovascular responses to the Valsalva manoeuvre and sustained handgrip were analysed in 5 men with untreated mild hypertension and 4 young normal subjects. Though set at a higher level, there was a normal blood pressure response to the Valsalva manoeuvre during concurrent sustained handgrip in 4 of the 5 hypertensive subjects. At the end of the handgrip period in which the Valsalva manoeuvres were performed, the blood pressure was higher and the heart rate lower than in the control period of sustained handgrip. The fifth subject developed a 'square wave' Valsalva response, which returned to a normal response when sustained handgrip was discontinued. Analysis of RR interval changes in the normal subjects showed that both the tachycardia during, and the bradycardia after, the Valsalva strain period were significantly reduced during simultaneous sustained handgrip. These results show that the two reflexes interact, but only to a minor extent, and that the baroreflex response is modified by sustained handgrip, rather than overridden as had previously been suggested. In view of the effect on the blood pressure and heart rate, subjects should avoid performing a Valsalva manoeuvre during sustained handgrip testing.

Adult↗

A double-blind trial of patient-controlled nitrous-oxide/oxygen analgesia in myocardial infarction.

The analgesic effect of self-administered nitrous oxide 50%/oxygen 50% ('Entonox" analgesic apparatus) was compared with air given by the same method in a double-blind trial in 81 patients with myocardial infarction. Self-administered nitrous oxide/oxygen, which was associated with a low frequency of side-effects, proved significantly more effective than air in the early relief of severe cardiac pain, but not in the relief of moderate or slight pain or when administration was continued after ten minutes.

Adult↗

Weight carrying after myocardial infarction.

The blood-pressure responses to carrying a 15 kg. weight in a shoppong basket, and in a rucksack on the back, were compared in 13 ambulant male patients who were convalescing from an uncomplicated myocardial infarction. In 8 of the patients a sustained-handgrip test was also performed. Carrying the weight in the hand produced a distinct increase in blood-pressure, which did not occur when the weight was carried on the back. There was also a significant increase in blood-pressure during sustained handgrip. In view of the lack of symptoms with these circulatory changes, it is concluded that more specific advice about the possible dangers of sustained static exercise should be given to patients recovering from myocardial infarction.

Activities of Daily Living↗