PubMed Health⌕ Search

Biomedical subjects

F Marsico

Publications and source records attributed to F Marsico.

At least 55 records · Page 3Linked to original sources
PubMed1982

Treatment of paroxysmal supraventricular tachycardia in infancy with digitalis, adenosine-5'-triphosphate, and verapamil: a comparative study.

The treatment of paroxysmal supraventricular tachycardia (PSVT) in infancy with digitalis, adenosine triphosphate (ATP) and verapamil is reported. Treatment was successful in about 90% of the patients treated with ATP and verapamil and in 61--71% of the patients treated with digitalis (Lanatoside C). Verapamil terminated the tachycardia within 2 minutes of administration in most instances and ATP in less than 1 minute. Digitalis, however, took as long as 2 hours; it was therefore excluded as the drug of first choice in emergencies, and is better suited for treating patients with poor hemodynamics. Side effects with ATP are common but short-lived. With verapamil, side effects are rare, but may be serious if certain contraindications are not taken into account. Digitalis in the dose used in this trial rarely produced side effects. We conclude that ATP or verapamil is the drug of first choice for quick termination of PSVT in infancy.

Adenosine Triphosphate↗
PubMed1981

Right atrial outlet atresia with straddling left atrioventricular valve. A form of double outlet atrium.

We present three hearts showing right atrial outlet atresia with straddling left atrioventricular valve; clinical data of two of the patients are reported. For semantic and practical reasons we believe the terms tricuspid or mitral atresia should not be used in these cases, and atrial outlet atresia is preferable; for similar reasons we prefer to use stradding left or right atrioventricular valve. These anomalies represent an interesting form of double outlet atrium and diagnosis clinically may be possible if the existence of the anomaly is considered. Differentiation from common atrioventricular canal with atrial outlet atresia is important since total repair, which is possible for this last anomaly, does not seem feasible in cases like ours. Classifications of tricuspid atresia may have to be enlarged to include cases with double outlet from either ventricular chamber or anatomically corrected malposition. Characterisation of the right ventricular chamber is difficult; we believe that description of its morphology and the type and mode of its connections should be used.

Heart Atria↗
PubMed1981

[Electrocardiographic and vectorcardiographic examinations in differential diagnosis of cyanotic congenital cardiopathies with interventricular defect and obstruction of pulmonary outflow].

The value of the electrocardiogram and vectorcardiogram for the diagnosis of congenital heart diseases with VSD and pulmonary obstruction is illustrated. Three types of electrocardiographic pattern are encountered: 1) pressure overload to the right ventricle (Tetralogy of Fallot, DORV, TGA); 2) left ventricular hypertrophy (TA, UH with outlet chamber to the right); 3) Inversion of septal activation (Correct TGA, UH with outlet chamber to the left). In the diagnosis of the anomalies of the first group, absence of P wave alteration, downward and rightward QRSA, lack of s wave in AVF and terminal forces of the QRS loop under the O point suggest Tetralogy of Fallot. In DORV and TGA the QRSA may be directed upward to the right or to the left and P wave may show overload pattern of the right ventricle. Moreover, in DORV conduction delays on the right bundle branch and/or increased voltage of the R wave in V1 may be observed. In diagnosis between TA and UH with outlet chamber to the right, a leftward displacement of QRSA, an overload pattern of RA and absence of clockwise rotation of the QRS loop on the H plane suggest the former disease. These electrocardiographic data, as well as pathological considerations, made us keep these two form distinct from a clinical point of view. Finally, recording of LV potentials in V1 or to its right with AV conduction abnormalities are typical of corrected TGA; in UH with outlet chamber to the left no conduction defects are observed. In UH with outlet chamber anterior o slightly to the left, ECG pattern is rS on all the praecordial leads and a left posterior hemiblock is present in 40% of the cases of second type.

Diagnosis, Differential↗
PubMed1981

[Electrocardiographic and vectorcardiographic aspects of tricuspid atresia].

18 patients, less than one year old, with tricuspid atresia have been studied and the electrocardiographic pattern has been correlated to the hemodynamic data and type of ventriculo-arterial connection. The origin of the most frequent electro-vectorcardiographic pattern, such as the variable direction of electrical axis, left ventricular hypertrophy, the right atrial overload, the frequent counterclockwise rotation of the QRS loop on the various planes and the increased voltage of the 0.01" and LMSV spatial vectors are discussed. Moreover, the relevance of anatomic features of the two ventricles and of the position of the conduction pathways in determining the different electrocardiographic pattern in the two types of ventriculo-arterial connection, is underscored. On the basis of our results the opportunity to maintain a distinction between tricuspid atresia and single ventricle, at least from a clinical point of view, seems justified.

Electrocardiography↗
PubMed1981

[The contrast echocardiography for the diagnosis of the venous system anomalies. Echo-angiographic correlations (author's transl)].

Contrast echocardiography is described as an important technique for the diagnosis of the anomalies of the venous system. Six patients with intrahepatic interruption of the inferior vena cava (IVC), ten patients with persistent left superior vena cava (PLSVC) connecting to coronary sinus (CS), one patient with PLSVC connecting to left atrium (LA) and ten patients, control group, with normal venous connections were studied by two-dimensional echocardiography; the injections of dextrose were made into the left hand, right hand, leg; the locations of the transducer were: subcostal position, parasternal and suprasternal. All patients underwent cardiac catheterization and cineangiography. When the injection was made into a leg vein, in the patients with infrahepatic interruption of the IVC we observed the contrast medium descending from the superior vena cava into the right atrium (RA). In the cases with PLSVC connecting to CS, contrast medium injected into the left hand, the sequential clouding of CS, RA and right ventricle was seen. The pattern of opacification in the case of PLSVC connecting to LA is discussed. In conclusion, contrast echocardiographic study of the connections of the venous system may be useful in planning the way for cardiac catheterization and also for the diagnosis of some anomalies which might be mistaken even at the time of the hemodynamic study.

Cardiac Catheterization↗
PubMed1981

Comparative accuracy of cross-sectional echocardiography and cineventriculography for left ventricular evaluation after myocardial infarction.

223 patients with a previous myocardial infarction (MI) 29-68 years old, have been studied in a double-blind manner both by 2D-Echocardiography and cineventriculography. 5 cross-sectional views and 2 angiographic projections have been employed in order to assess the presence of aneurysm and the motion of the left ventricle. The left ventricle has been divided into 5 anatomic regions: interventricular septum, anterolateral, posterolateral, apical and inferior walls. By cineangiography an aneurysm was diagnosed in 89 patients (one pseudoaneurysm); by 2D-Echo in 83 patients an aneurysm was diagnosed, whereas in the 6 remaining patients the Echocardiogram was nondiagnostic (specificity 100%, sensitivity 93%). Concerning regional motion characteristics, 997 (89%) of 1115 regions were visualized and 905 (91%) correctly identified according to the angiographic findings. Of 92 discrepancies (9%): 64 were attributed to 2D-Echo (69%) and 28 (31%) were attributed to cineangiography; most of the discrepancies attributed to echo resulted from minor grades of asynergy which caused unresolved disagreements between the Echo and angiography findings. It is concluded that Cross-sectional echocardiography is a valuable tool for the diagnosis of aneurysm of the left ventricle (specificity 100% and sensitivity 93%) and for the study of wall motion characteristics. In cases with generalized abnormality of left ventricle motion, resulting in a picture of congestive cardiomyopathy, 2D-Echo can be a substitute for cineangiography. In all other instances both techniques can provide more complete information on ventricular wall abnormalities.

Adult↗
PubMed1981

[Pulmonary stenosis with intact interventricular septum: qualitative and quantitative analysis of the vectorcardiogram (author's transl)].

Eighty-one patients suffering from pulmonary stenosis with intact interventricular septum were divided into two groups according to their age: Group I (greater than 2 years), Group II (less than 2 years). In Group I, patients with RVSP up to 50 mmHg have been included in subgroup A; patients with RVSP from 50 to 90 mmHg in subgroup B, patients with RVSP greater than 90 mmHg in subgroup C. In Group II forms with RVSP less than or equal to 60 mmHg have been considered moderate and forms with RVSP greater than 60 mmHg severe. The rotation and duration of the QRS loop on the various planes, presence of a terminal slowing, the ratios 0,01"/LMSV and 0,02"/LMSV, the LMSV and the RMSV in order to assess the most significant vcgraphic parameters to predict severity of the stenosis have been analysed. A fair correlation has been found between RMSV and RVSP (r = 0,55 in Group I; r = 0,54 in Group II). The AA. conclude that a counterclockwiseloop on the H plane and the presence of a terminal slowing are the most reliable parameters for recognizing the light forms, while the clockwise loop on the H plane and a markedly increased voltage of RMSV indicate more severe stenosis.

Adolescent↗
PubMed1980

[Enlarged coronary sinus. Mono and bidimensional echocardiographic aspects (author's transl)].

One case of enlarged coronary sinus with a total anomalous pulmonary venous connection (TAPVC) is described. The echocardiographic findings are compared to those seen in cases with persistence of the left superior vena cava (PLSVC). The diagnosis has been established by single crystal and two-dimensional echocardiography, by cardiac catheterization and angiography and was confirmed at surgery; post-operative echocardiographic control was performed. The differential diagnosis between TAPVC or PLSVC and other anomalies which may simulate a dilated coronary sinus is discussed. The differences between TAPVC and PLSVC by contrast echocardiography are reported.

Cardiac Catheterization↗
PubMed1980

[Anatomical corrected malposition. Report of two new cases (author's transl)].

Two new cases of anatomically corrected malposition of great arteries (A-V concordance or discordance; V-GA concordance; subaortic conus) are reported. One of these has been studied from the autoptic specimen and is in situs solitus with A-V concordance (SDL), which is the most common form of such alteration. The second case, studied by angiography, is in situs inversus with A-V concordance (ILD). This form has been described only once in the literature, but some Authors still consider it "possible" such an anormally rather than reported as yet. Finally the anomalies most frequently associated to the MACGA and the possible morphogenesis are valuated.

Child↗
PubMed1979

[Acute treatment with verapamil of paroxysmal supraventricular tachycardia and atrial flutter in paediatric age (author's transl)].

43 patients, 3 days to 12 years old, presented 68 paroxysms of supraventricular tachycardia and 2 crises of atrial flutter. 6 patients had a WPW syndrome and only 7 had an associated cardiac disease; the remaining had no other complaint but the arrhythmia. Verapamil, administered in the dose of 0.125-0.25 mg/Kg intravenously, interrupted critically the tachycardia in virtually all cases. The flutter was converted to atrial fibrillation with a slower ventricular rate. No adverse effects were observed but in two cases: one had a cardiac arrest promptly relieved and another a ventricular bradycardia corrected by atropine. Both cases had received an overdose of the drugs.

Age Factors↗