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Biomedical subjects

H D Friedberg

Publications and source records attributed to H D Friedberg.

At least 19 recordsLinked to original sources
PubMed1995

Latex versus iodinated contrast media anaphylaxis in the cardiac cath lab.

A 65-year-old man had bypass surgery 10 years previously with pulmonary artery catheter monitoring. Shortness of breath and mitral regurgitation necessitated repeat left and right heart catheterization using a pulmonary artery catheter. Before any iodinated contrast media exposure, the pulmonary artery catheter was inserted and within 2 min the patient developed anaphylaxis associated ventricular fibrillation. It was discovered that the pulmonary artery catheter used in the cath lab had a latex balloon and that the patient had been exposed to latex 10 years ago. Latex induced anaphylaxis is rarely considered in the differential diagnosis of patients with hypersensitivity reactions in the cath lab, intensive care unit, and operating room. The principal reason for failure to recognize the latex balloon as a potential allergen is that most health professionals are not aware that almost all pulmonary artery catheters contain a latex balloon. The risk of an allergic response to latex is 0.8% for the general population. Others at high risk include those who have had multiple surgical procedures and interventions with repeated latex exposure. Five to 10% of all U.S. health professionals and those performing household duties wearing latex gloves have an allergic response to latex. Latex hypersensitivity is an IgE dependent reaction, while iodinating contrast medium reaction is an IgE independent reaction. If latex hypersensitivity is suggested by pre-procedural history or if the patient falls into a high-risk group, pre-procedural skin testing and/or latex IgE radioallergosorbent (RAST) should be performed.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1989

Laser angioplasty of totally occluded coronary arteries and vein grafts: preliminary report on a current trial.

CLINICAL PERSPECTIVE: Among the various laser angioplasty systems and atherectomy devices currently in clinical trials, the Lastac system appears to be particularly suitable for treating totally occluded coronary arteries and vein grafts. Preliminary results of a clinical trial in more than 35 patients show a recanalization rate of 92% and no complications attributable to the laser. Restenosis has occurred in five cases; in three of these, the arteries were reopened with laser or conventional angioplasty.

Angioplasty, Balloon↗
PubMed1980

Evaluation of unusual QRS complexes produced by pacemaker stimuli--with special reference to the vectorcardiographic and echocardiographic findings.

Fifty-seven patients with electronic pacemakers were studied from electrocardiograms (ECGs), vectorcardiograms (VCGs), and echocardiograms. Thirty-nine patients with transvenous right ventricular (RV) pacemakers showed a left bundle branch block (LBBB) pattern and nine patients with transvenous RV pacemakers showed a right bundle branch block (RBBB) pattern. There was no evidence of perforation of the right ventricle or malposition of the catheter electrode. Eight patients with left ventricular (LV) pacemakers showed a RBBB pattern and one showed a LBBB pattern. The maximal QRS vector of a RBBB pattern induced by RV pacing was directed leftwards and anteriorly, whereas that of a RBBB pattern induced by LV pacing was oriented rightwards and posteriorly. A rapid posterior motion of the left side of the interventricular septum (IVS) during the early systole, and/or anterior or flat motion of the IVS during the ejection period were almost exclusively limited to cases with RV pacing, regardless of the ECG wave form. There was one exceptional case in LV pacing, which showed a LBBB pattern with the same septal motion as that in RV pacing. However, the maximal QRS vector in this case was directed inferiorly, which is in sharp contrast to that in the RV pacing which was directed superiorly. Based on the hypothesis that the ECG wave form by LV pacing might be equivalent to that in a case of perforated right ventricle, the following conclusions can be drawn from the present study. (1) A RBBB pattern in RV pacing could be differentiated from perforation of the right ventricle. The following findings may support uncomplicated RV pacing: (a) the left and anterior orientation of the maximal QRS vector, and (b) a rapid initial posterior septal motion during the early systole and/or a paradoxical anterior septal motion during the ejection period. (2) A LBBB pattern with inferior orientation of the maximal QRS vector would suggest perforation of the right ventricle.

Adult↗
PubMed1978

Studies of acute myocardial infarction with intermittent bundle branch and hemiblock.

Two cases of transient hemiblock occurring during the course of acute myocardial infarction are reported. The transient manifestation permits the accurate evaluation of the diagnostic features of the hemiblocks as modified by acute infarction. One case reflects the development of left bundle branch block due to bilateral post-divisional block which inter alia permits the study of left bundle branch block in the presence of acute myocardial infarction.

Aged↗
PubMed1975

Reappearance of anterior QRS forces after coronary bypass surgery. An electrovectorcardiographic study.

This report describes the reappearance of anterior QRS electrical forces in six patients after direct coronary arterial bypass surgery. Each patient had severe coronary artery disease including a segmental stenosis of the left anterior descending artery. Revascularization was performed by direct anastomosis of the left mammary artery to the left anterior descending coronary artery and saphenous vein bypass of other stenotic coronary arteries. Preoperative electrocardiograms and vectorcardiograms showed patterns of anterior wall myocardial infarction with absent or diminutive anterior QRS forces. In each case, postoperative studies demonstrated the regeneration of anterior QRS forces within 10 days of operation. Although these patients represent a small percent of those with a preoperative pattern of infarction who undergo coronary revascularization, the findings demonstrate that electrically silent areas of myocardium may be altered and are not always synonymous with myocardial cell death. Chronic myocardial ischemia may in certain instances produce electrocardiographic and vectorcardiographic patterns of myocardial infarction that may be reversible upon reestablishment of perfusion to ischemic areas.

Adult↗