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Biomedical subjects

F M Albanesi Filho

Publications and source records attributed to F M Albanesi Filho.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Beta-hemolytic streptococcus endocarditis in an adolescent with hypertrophic cardiomyopathy].

A 15 year-old male adolescent was hospitalized in a severe septic condition, due to infectious endocarditis which abided for 20 days. The admittance echocardiogram displayed a mitral valve vegetation in conjunction to a hypertrophic cardiomyopathy. In spite of applied antibiotics the patient expired. The authors emphasize the diagnostic difficulties of this compound entity and stress the need of antibiotic prophylaxis for patients who bear a hypertrophic cardiomyopathy, even in those with a non-obstructive disposition.

Adolescent↗
PubMed1994

[Cardiac involvement in systemic lupus erythematosus. An echocardiographic evaluation].

PURPOSE: To study, by a non-invasive method, patients with systemic lupus erythematosus (SLE), to evaluate possible cardiac involvement. METHODS: A hundred-eight lupic patients, 60 of them during activity, were studied, independently of cardiovascular signs and symptoms, by M-mode and two-D echocardiography and Doppler. Among the patients in the acute phase, 19 had never used steroid therapy before. RESULTS: Echocardiographic evaluation showed cardiac involvement in all patients who were in clinical activity. Seven had myocardial involvement with systolic impairment. In 35 patients, pericardial effusion was found, all in the acute phase. Regarding endocardial involvement, there were valve thickening in 54 patients in group I (acute phase), valve vegetations in eight and one with mitral valve prolapse. There were only six with valve thickening in group II (remission). Pulmonary hypertension was observed in 15 patients in the activity group and in two during remission. CONCLUSION: Echocardiogram has showed how frequent cardiac involvement is in SLE, especially during disease activity and being independent of previous steroid therapy. As it is a non-invasive method, it could be used in a routine protocol in the evaluation and follow-up of these patients.

Adolescent↗
PubMed1994

[Clinical and hemodynamic aspects of non-obstructive coronary lesions. A comparative retrospective study].

PURPOSE: To study the clinical and hemodynamic aspects of a group of patient presenting non-obstructive coronary lesions. METHODS: We reviewed 963 coronary angiographies performed at a same institution. The 52 patients presenting only stenosis < or = 50% after semi-quantitative measurement composed group I, which was compared with two other groups consisted of 52 patients each: one, with patients presenting univascular lesion > 50% (group II) and the other with normal coronary arteriographies (group III). RESULTS: Mean age was similar in groups I and II (49.4 +/- 6.89 and 51.3 +/- 7.86, p > 0.05) and significantly higher than that of group III (44.8 +/- 6.81, p < 0.05). Risk factors did not discriminate group I (GI) from groups II (GII) and III (GIII). During a follow-up period of 63 months, the number of hospital admissions due to cardiac events and repetitions of coronary arteriography were similar in GI and GII, being significantly less frequent in GIII (p < 0.00001 and 0.001; p < 0.01 and 0.05, respectively). By the end of the follow-up period, though angina and heart failure functional classes had been similar in the three groups, patients in groups I and II were using more medications than those in group III (p < 0.0001 and 0.00001). Mean ejection fractions (%) were lower in GI and GII (67.04 +/- 10.13 and 68.90 +/- 11.32) than in GIII (74.69 +/- 6.40, p < 0.01). Lesions were predominantly proximal in GI when compared with GII (p < 0.05). Length, simmetry, ulceration, thrombus and proximal shoulder showed no difference between GI and GII. CONCLUSION: Patients with non-obstructive coronary lesions were similar to those with univascular lesion > 50% regarding several aspects and were considerably different from those with normal coronary arteries.

Cineangiography↗
PubMed1994

[Influence of atrial fibrillation in the natural history of hypertrophic cardiomyopathy].

PURPOSE: To evaluate the influence of atrial fibrillation in the natural history of hypertrophic cardiomyopathy. METHODS: Eighty-eight patients under ambulatory treatment were studied. Most of them presented the asymmetric type of hypertrophic cardiomyopathy (87.5%). Group I (77 cases) was formed by patients who had never had atrial fibrillation and group II (11 cases) by those who had this arrhythmia paroxysmal or established. RESULTS: In group I, with ages 48.02 +/- 14.82 years, left atrial dimensions 4.21 +/- 0.66 cm, there was one sudden death; 69 were treated by clinical means and 7 by surgery; no patient developed thromboembolism neither cardiac failure. In group II, with ages 58.02 +/- 11.04 years and left atrial dimension 5.32 +/- 0.45 cm, there were 4 deaths, 4 thromboembolisms and 3 with cardiac failure; all received only clinical treatment, having improved in clinical status in 71.42% after amiodarone therapy. CONCLUSION: Atrial fibrillation was present in 12.5%, mostly in the asymmetric type, and in patients after 5th decade, all of them with enlarged left atrium (> 4.7 cm), with highest morbidity (thromboembolism and cardiac failure) and mortality. Among the survivors, amiodarone therapy improved functional class in 71.42%.

Adolescent↗
PubMed1993

[Aortic insufficiency due to quadricuspid aortic valve].

In a 45 year old patient with clinic diagnosis of aortic regurgitation the two-dimensional echocardiography demonstrated a quadricuspid aortic valve and severe aortic regurgitation by Doppler. The quadricuspid aortic valve is a rare pathology, usually not associated with other cardiovascular pathologies and in which there is evolution with aortic regurgitation due to malposition of the four cusps.

Aortic Valve↗
PubMed1992

[Myocardial ischemia with stable angina pectoris: clinico-ergometric evaluation after the use of diltiazem].

PURPOSE: To evaluate the efficacy of diltiazem versus placebo in patients with stable angina. METHODS: Eight-seven angina pectoris patients, mean age of 57 +/- 9, 82 white and 79 male were evaluated in a randomized, double-blind trial of two groups of patients diltiazem and placebo, 3 to 4 tablets a day (diltiazem 180 to 240 mg daily). The patients were evaluated after laboratory tests and clinical-ergometric examinations. A coronary arteriography was performed on study entry. RESULTS: The average of anginal attacks, number of weekly sublingual nitrate, heart rate, systolic and diastolic pressure at rest and at the end of diltiazem period were significantly lower (p < 0.05) regarding same periods on placebo. The percentage of depression for ST-segment was lower for diltiazem when compared with placebo (p < 0.05) and the percentage of patients that reach higher stages in the ergometric test was significantly better for diltiazem. Heart rate and systolic plus diastolic pressures after exercise did not differ in both groups. CONCLUSION: Diltiazem reduced the clinical and electrocardiographical aspects and raises the effort tolerance during the ergometric test in patients with stable angina.

Adult↗
PubMed1992

[Hypocalcemia causing heart failure].

A 39-year-old female patient with refractory heart failure has been studied. On February, 1982 she was submitted to right lobar thyroidectomy for remotion of the left thyroid lobe. Following the surgery, she had signs of hypocalcemia and the diagnosis of secondary hypoparathyroidism and heart failure had been made. Seven months after she had acute pulmonary edema, cardiomegaly III (cardiothoracic index = 0.58) with predominant left atrial and left ventricular hypertrophy, which were confirmed by echocardiogram (ECO). The ECO also demonstrated low contractility of the left ventricle. The QT interval was increased on the electrocardiogram (QTc = 0.50 s), the calcium was 5.0 mg/dl with calciuria of 28 mg/day; phosphatemia was 4.8 mg/dl and phosphaturia of 214 mg/day. The level of thyroid hormones (T3 and T4) were in the normal ranges despite the TSH was increased in the beginning of the disease. She was first treated with digitalis, diuretic and vasodilator drugs, thyroid hormone and oral calcium. She had progressive hemodynamic improvement when higher doses of calcium were given with D3 vitamin. The most significant result of this treatment was reduction of the heart size that come back to normal. At the present time patient is treated with thyroid hormone, calcium and D3 vitamin only.

Acute Disease↗
PubMed1992

[Acute myocardial infarct in a patient with dextrorotation].

A 79-year-old woman developed myocardial infarction associated with acute pulmonary edema. The electrocardiogram recorded QRS complex of QS type in V1 with upper ST extending from V3R to V6R. The polarity of the P wave in bipolar leads was positive, so compatible with dextrorotation complicated by myocardial infarction. The dextrorotation was confirmed with chest roentgenogram and echocardiogram.

Aged↗
PubMed1992

[Familial complete atrioventricular block in patients with hypertrophic cardiomyopathy].

The association of spontaneous complete heart block and hypertrophic cardiomyopathy is rare. We have studied three patients of the same family, two brothers and one nephew, ages 19-41 years, with hypertrophic cardiomyopathy confirmed by hemodynamic and angiographic studies. All patients were treated with permanent cardiac pacemaker implant. They are asymptomatic, aging 33 to 55 years, with follow-up of 157 to 176 months after the onset of the heart block.

Adult↗
PubMed1991

[Significance of prolonged PR interval in patients with His bundle branch block, bifascicular type].

PURPOSE: Evaluation of the prolonged PR interval and its predictive value for trifascicular block in individuals with bifascicular His bundle branch block. PATIENTS AND METHODS: 55 patients, 36 male and 19 female aged 57 + 15.8 years with bifascicular bundle branch block type have been studied. 11 cases had complete left bundle branch block and 44 cases had complete right bundle branch block with left anterior and superior division block. His bundle electrogram and atrial stimulation were performed in all patients. The atrial stimulation rate originating the Wenckebach phenomenon (SP) of the A-V conduction, and the A-H and H-V intervals were compared with the PR interval of the surface electrocardiogram. Patients were divided into three groups according to the PR interval: group I, Pr less than 200 ms, group II, PR between 190-280 ms and group III, PR greater than or equal to 280 ms. RESULTS: There was not linear correlation between the PR interval and WP in the three groups. There was a weak linear ascending correlation between the PR and A-H intervals in groups I and II (r + 0.59 and + + 0.43, respectively) and there was a descending correlation in the group III (r. - 0.64, P less than 0.05). In relation to the H-V interval there was not linear correlation with the PR interval in groups I and II, but there was a good ascending linear correlation in the group III (r 0.84, P less than 0.01). The incidence of prolonged A-H and H-V intervals increased as the PR interval was larger. CONCLUSION: The prolonged PR interval with bifascicular bundle branch block means, in the majority of cases, diffuse damage of the conduction system involving the A-V node and the infranodal region; starting from 280 ms, the delayed PR interval suggests involvement predominantly below the A-V node: to a higher PR interval corresponds a higher H-V interval and also, to a relatively shortest A-H interval.

Bundle of His↗
PubMed1991

[Apical lesion of the left ventricle in clinical evolution of chronic Chagas cardiopathy].

PURPOSE: Study of clinical evolutionary aspect in patients with apical lesion of chronic Chagas' heart disease diagnosed by left cineventriculography. PATIENTS AND METHODS: 55 patients, 32 female, aged 22 to 69 years with epidemiologic data and positive serological tests, all presenting cardiovascular symptoms, 20 in cardiac failure (10 with left ventricular failure and 10 in congestive heart failure). Heart size was normal in 35 patients and 20 showed cardiomegaly on chest X-ray examinations (slight in 8, moderate in 6 and marked in 6), EKG showed premature beats in all patients and conduction defects in 38 instances with a predominance of right bundle branch block associated with left anterior divisional block in 19 cases. The following morphological aspects of the apical lesions were observed: mammillary--23 (41.82%); digital--18 (32.73%) and semilunar--14 (25.45%). In 8 cases (14.54%) intraventricular thrombi were detected and in 10 (18.18%) there were associated dyskinetic areas. RESULTS: The clinical course of 36 patients (65%) has been followed in the out patient department for 35 to 192 (97.83) months. Seven patients (12.73%) did not return for consultation after having been studied for 22 to 56 (42.83) months, and 12 (22%) died after a follow-up period of 19 to 176 (68.58) months. Detection of 17 thromboembolic episodes occurred in the 14 (25%) patients, 9 pulmonary encephalic and 1 peripheric, very frequent in patients with cardiac failure (11/14-78%). Cardiac pacemakers were implanted in 18 cases due to complete A-V block in 11, to sinus node dysfunction in 6, and to sinus arrest in 1. Among the survivors 29 (80%) maintained a normal heart size. The most frequent cause of death (12) was heart failure in 8, followed by cerebrovascular attacks in 3 and malignancy in 1. The estimated survival in 192 months was of 75.8%, males (74.5%) and females (76.6%). A presence of heart failure however was a limiting factor, with estimates of 96.8% survival in patients without cardiac decompensation, as compared to 36.5% in cases with heart failure. CONCLUSION: The apical lesion is an additional factor of mortality in Chagas' heart disease after the development of congestive heart failure.

Adult↗
PubMed1991

[Assessment of third-degree congenital atrioventricular block by ergometric tests].

PURPOSE: To analyse the use of the exercise testing as the method of initial evaluation, following a prognostic indicative of patients with congenital complete heart block. METHODS: Five patients were analysed (3 men and 2 woman) with ages between 7 and 34 years (mean = 22.8). The patients were submitted to a treadmill exercise testing using the Bruce protocol 1 and symptom limited. RESULTS: In all patients the atrial frequency increased from a median of 74.40 bpm in the basal to 155.20 bpm in the maximum effort; the atrial chronotropism was a little below that calculated based on the age of the patients. The median of the ventricular frequency in the maximum effort was 94.80 bpm, very different from that foreseen and showing a deficit of ventricular chronotropism. The median consumption of oxygen was 35.68ml0(2)/Kg/min. In one patients (20%) there was not any change in the ventricular frequency with the effort, in 3 (60%) complex ventricular arrhythmia arise during the effort and in one (20%) a definitive ventricular pacemaker was implanted. CONCLUSIONS: The exercise testing is a simple method of initial evaluation, providing information as chronotropism, functional capacity and the presence of arrhythmias, that can be very useful in the evaluation of prognostic. The presence of complex ventricular arrhythmias during the exercise is indicative of a more regular follow-up.

Adams-Stokes Syndrome↗
PubMed1991

[Evaluation of syncope in patients with chronic Chagas heart disease].

PURPOSE: To evaluate causes of syncope in patients with Chagas' disease and intraventricular conduction disturbances. METHODS: Nine patients have been studied, being seven males. Average of 49 years. The studied consisted of His Bundle electrogram, determination of Wenckebach period (WP), sinus node recovery time (SNRT), atrial stability and programmed ventricular stimulation (PVS). RESULTS: Monomorphic ventricular tachycardia (VT) was induced in five patients (55.5%), WP depression was observed in three cases, H-V interval prolongation occurred in three cases and the SNRT was normal in hall patients. In one case the electrophysiological study was completely normal. Among five patients with induced VT, with a mean follow-up period of seven months, one died suddenly, three became asymptomatic with antiarrhythmic drugs and one went on a non pharmacological therapy. In the other four patients with a mean follow-up period of 21 months, three are asymptomatic and one presents occasional dizziness (patient with a normal study). Among the patients with VT four presented recurrent syncope while in the group of patients without VT (four patients) all had only one syncopal episode. CONCLUSION: Patients with intraventricular disturbances, Chagas' disease and syncope, VT may be responsible for the symptoms in approximately 44% of cases. The PVS must be considered as a routine in the investigation of these patients.

Adult↗
PubMed1991

[Silent coronary artery-left ventricular fistula and acute myocardial ischemia].

A 65-year-old woman developed severe coronary insufficiency associated with papillary muscle dysfunction. She was submitted to cineangiocoronarography which ruled out obstructive coronary disease. Coronarography revealed a communication between the coronary arteries and the left ventricle, but a coronary arterial fistula was not seen. The possibility of this uncommon form of coronary drainage to the left ventricle, named silent fistula, being the cause of myocardial ischemia related to the coronary steal phenomenon is discussed.

Aged↗
PubMed1991

[Evaluation of the PR intervals in normal and prolonged maximum limit with short QRS].

PURPOSE: Evaluation of the A-V node function by determining the Wenckebach period (WP) and atropine response in cases of normal PR interval, PR interval at maximum normal range and prolonged PR interval, all with short QRS. PATIENTS AND METHODS: 129 patients, 79 male and 50 female, aged 17 to 84 years (mean 59), asymptomatic or with complaints of palpitations, dizziness, presyncope or syncope has been studied. ECG showed supra-ventricular tachycardia, first degree A-V block or intermittent Mobitz I type A-V block and sick sinus syndrome. Preexcitation (WPW) syndrome and longitudinal A-V dissociation were excluded. Electrical transoesophageal atrial stimulation was performed in all patients for evaluating the PR interval and WP. Atropine test was performed in a group of 16 patients. Based on the values of the WP, patients were divided into three groups: group I, WP greater than or equal to 125 ppm (N = 88); group II, WP ranging 125-110 ppm (N = 16) and group III, WP less than or equal to 110 ppm (N = 25). RESULTS: There was a good decreasing lineal correlation between the PR interval and the WP only in the group III (r = 0.76, p less than 0.01). PR interval greater than 240 ms had greatest and significant incidence in the group III in relation to the other groups in which the number of WP post-atropine normalization was observed. CONCLUSION: There is a strong linear decreasing correlation between the PR interval of the ECG and the WP in individuals with WP less than or equal to 110 ppm. PR interval greatest than 0.24 ms corresponds better to WP below 110 ppm (mean 90 ppm) and the majority of these patients do not normalize the WP with the atropine. We suggest the term "first degree A-V block" for those cases with PR interval greater than 240 ms and "A-V depression" for the cases with PR interval shorter than 240 ms when recorded on the surface electrocardiogram and have been normalized with atropine.

Adolescent↗
PubMed1991

[Intrapericardial lipoma].

A 27 year-old female patient presented with atypical chest pain. 2-D echocardiogram and thorax computed tomography revealed intrapericardial tumor. The patient was operated on for removal of the tumor, which turned out to be two isolated lipomas. The patient had a rapid postoperative recuperation.

Adult↗
PubMed1991

[Thromboembolism in patients with apical lesion caused by chronic chagasic cardiopathy].

The thromboembolism in patients with apical lesion of the chronic Chagas' heart disease diagnosticated by left cineventriculography are present in this study. The series comprises 32 females and 23 males between the ages of 22 and 69 years, all presenting cardiovascular symptoms, 20 in cardiac failure (10 with left ventricular failure and 10 in congestive heart failure). Heart size was normal in 35 instances and 20 showed cardiomegaly on chest X-ray examinations (slight in 8, moderate in 6 and marked in 6). The following morphological aspects of the apical lesions were observed: mammillary-23 (41.82%); digital-18 (32.73%) and semilunar-14 (25.45%). In 8 cases (14.54%) intraventricular thrombi were detected and 10 these were associated with discinetic areas. Seventeen episodes of thromboembolism occurred in 14 (24.45%) patients including 7 to the brain, 9 to the lung and 1 to the iliac right artery, mostly in patients with heart failure. Eight were women and 6 were men, varying between 30 and 62 years of age, the morphological aspects of the apical lesion were semilunar in 8 and mammillary in 6. Cardiac pacemakers were implanted in 8 cases due to complete A-V block in 6, to sinus node disfunction in 1, and to sinus arrest in 1. In 4 cases (28.57%) intraventricular thrombi were detected, in 3 occasioned thromboembolism to the brain. Thrombo-embolic phenomena occurred in the 11 nonsurvivors. The most frequent cause of death was heart failure in 8 followed by cerebro-vascular attacks in 3, after a follow-up period of 19 to 176 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗