[Dynamic phonocardiology].
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Biomedical subjects
Publications and source records attributed to G Lairy.
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A new case of pseudo-Cockett syndrome is reported. Both the clinical picture and the anatomic characteristics were unusual. Apparently, no similar cases have been reported in the medical literature. The relation between the cause of venous compression and it's results (thrombosis upstream and embolism downstream) could not be stated from data reviewed in the literature. No well-defined plan of management has been described. However, in the case reported here, therapeutic decisions gave satisfactory results.
The authors report the case of a 34 year old woman admitted to hospital for attacks of atrial tachycardia inducing very poorly tolerated junctional tachycardia at 260 beats/min. The attacks were always induced by swallowing and could be reproduced at will. Electrophysiological studies could only be undertaken after the administration of large doses of amiodarone. An exclusively retrograde rapidly conducting paranodal accessory pathway was demonstrated with triggering of runs of reentrant tachycardia. No underlying gastro-oesophageal or cardiac disease apart from thromboembolism was found. Swallowing-induced supraventricular tachycardia is rare and possible mechanisms are discussed. The arrhythmia may be triggered by direct mechanical stimulation, by changes in vagosympathetic tone, or by an association of the two phenomena. Previously published reports describe similar clinical situations resulting from a variety of different mechanisms.
In reviewing a series of twelve cases treated surgically for deep venous thrombosis, with an admittedly short follow up (2 months to 2 years), the authors stress the beneficial effects of venous surgery. The postoperative mortality rate was zero and the morbidity rate marginal. They underline the importance of phlebographic exploration leading to earlier diagnosis, and list the therapeutic indications which vary according to the case and may include a supporting heparinotherapy and fibrinolytic treatment in a specialized center. They advocate venous surgery which has the twofold merit of preventing embolic complications and attenuating postphlebitic sequelae.
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Pulmonary embolism and preventive anticoagulant therapy of ederly patients in hospital. Statistical survey of their respective risks. The incidence of pulmonary embolism as a cause of death seems the higher as its strikes old people (above 60) affected by cardiovascular diseases and who are bed tied; the interest of preventive anticoagulant treatment (PAT) remains controversial. This matter has been studied over a period of 5 years from the files of a geriatric cardiology department; 455 anatomo-clinical documents have been set up. This survey confirms the frequency of mortality by pulmonary embolism (23,9 %) and its diminution under long-term preventive anticoagulant treatment 6,6 %). The anticoagulant therapy does not increase the risk of haemorrhagic accidents, from the point of view of frequency, but slightly increases it if one considers the number of days spent in hospital. As a conclusion, the preventive anticoagulant treatment seems positive insofar as contra-indications are strictly observed, in particular the digestive ones. The mechanism of some hemorrhagic accidents with or without PAT remains sometimes difficult to explain.
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