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Biomedical subjects

F T Gjestvang

Publications and source records attributed to F T Gjestvang.

7 recordsLinked to original sources
PubMed2001

[Thrombotic or embolic stroke?].

BACKGROUND: Transoesophageal echocardiography reveals a possible source of embolism in many patients who present with acute brain ischaemia. The aim of this study was to observe the prevalence of possible sources of embolism in a representative Norwegian stroke population in a county hospital with a defined reference population. METHODS: All 103 patients with ischaemic stroke or transient ischaemic attack admitted to our hospital during a five-month period were enrolled. We performed transthoracic echocardiography in 98 patients, transoesophageal echocardiography in 83, and Doppler examination of the precerebral arteries in 92. RESULTS: Mean patient age was 72 years; 19 patients had atrial fibrillation. Examinations revealed 70 potential sources of embolism in 55 patients. Twenty-eight findings were in the heart. Five patients had thrombi in left-sided heart chambers. Ten patients had patent foramen ovale; 11 had atrial septal aneurysm; four had both. Thirty-three had atheromas of the aorta with a protrusion of more than 4 mm, ten of them with mobile elements. Nine patients had carotid stenosis of high grade or carotid occlusion ipsilateral to a hemispheric stroke. INTERPRETATION: Potential precerebral sources of embolism are common in a representative population of patients with ischaemic stroke. Atheromas of the aorta may be an important contributor to brain ischaemia.

Aged↗
PubMed1999

[Low molecular heparin in a pregnant women with heart valve prosthesis].

Women with a prosthetic heart valve who wish to bear a child face a difficult choice. Continued medication with warfarin during pregnancy will offer her a reasonable good protection against thrombosis, but carries a considerable risk of teratogenic effects. Subcutaneously administered heparin is an alternative to warfarin. Standard (unfractionated) heparin has not offered sufficient protection against valve thrombosis, which may be a life-threatening complication. We were contacted by a woman who wished to become pregnant and who did not want to use warfarin if this implied a risk for the foetus. We followed a protocol using low molecular weight heparin in rather high doses. The dose was adjusted according to the results of blood test controls, which confirmed increased need for anticoagulation as the pregnancy evolved. Serial eccocardiography excluded valve thrombosis. The woman needed psychological support from her general practitioner. No complications occurred, and she gave birth to a normal child. We describe the various alternatives for anticoagulant treatment in pregnant women with mechanical heart valves. The choice of anticoagulant regimen and their consequences must be thoroughly discussed with the woman.

Adult↗
PubMed1996

[Surgical treatment of a tricuspid valve myxoma].

We report on a resection of a myxoma arising from the septal leaflet of the tricuspid valve in a 62 year-old female. A tricuspid valvuloplasty was performed. At follow-up 27 months after surgery echo cardiography showed a normal tricuspid valve without any evidence of insufficiency.

Female↗
PubMed1995

QRS prolongation as an indicator of risk of ischemia-related ventricular tachycardia and fibrillation induced by exercise.

The majority of patients with serious ventricular arrhythmias induced by exercise have ischemic heart disease. These arrhythmias, however, develop only in a minority of the patients with coronary artery disease. The aim of this study was to investigate whether patients with ventricular tachycardia or fibrillation produced by exercise-induced ischemia exhibit any premonitory electrocardiographic indicators of arrhythmia propensity and whether arrhythmia suppression by myocardial revascularization abolished these changes. High-quality exercise electrocardiograms (50 mm/sec) from 30 case patients with ventricular tachycardia and fibrillation produced by exercise-induced ischemia were studied before and after surgical revascularization. These results were compared with those obtained from 30 control patients matched for age, sex, heart disease, and preoperative exercise capacity. The resting and peak exercise electrocardiograms were examined separately in a blinded manner with respect to QRS duration, ST-segment depression, and JT intervals. Patients with bundle branch block patterns were excluded. The QRS duration at rest was similar in case and control patients preoperatively and increased significantly with exercise in both groups. However, the QRS prolongation was larger in the case group, in which it was 11 +/- 3 msec compared with 4 +/- 2 msec in the control group (p = 0.043). QRS prolongation > or = 15 msec predicted ischemia-related ventricular arrhythmias in 73% of the patients. After surgical revascularization, there was no QRS prolongation with exercise in either group. In both groups, the QRS prolongation was associated with significant ST-segment depression, which was larger in the case patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Case-Control Studies↗
PubMed1992

[Familial hypocalciuric hypercalcemia].

Familial hypocalcuric hypercalcemia is a condition that is often incorrectly diagnosed and treated. We studied a family with seven members who had familial hypocalcuric hypercalcemia. In four of the family members it was difficult to make the diagnosis. A correct diagnosis was made in the other three on the basis of known family history. Subtotal parathyroidectomi was carried out on three of the family. After operation, two of these experienced a relapse, and one became permanently hypocalcemic.

Adult↗
PubMed1991

[Determination of intact parathyroid hormone in patients with calcium metabolism disorders].

We have used an immunoradiometric assay (IRMA) to measure intact PTH. The serum-levels of PTH followed a log-normal distribution in a population of 85 healthy post-menopausal women, with a geometric mean of 1.9 pmol/l and a range of 0.8-6.1 pmol/l. The correlation between measurements performed using the IRMA and a radioimmunoassay which measured the C-terminal portion of the PTH molecule was 0.85. It was only the IRMA, however, that could measure subnormal values. Two of 27 patients with primary hyperparathyroidism had PTH-values in the upper reference interval. The rest of the patients had elevated levels. Patients with hypercalcemia due to malignancy had subnormal or low normal (less than 2.5 pmol/l) PTH values. Half of the patients with hypoparathyroidism had PTH below the limit of detection. Four subjects with familial hypercalciuric hypercalcemia had normal (3) or slightly elevated PTH-levels.

Adult↗