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Biomedical subjects

H R Jenzer

Publications and source records attributed to H R Jenzer.

At least 37 records · Page 2Linked to original sources
PubMed1990

Tricuspid valve endocarditis in the drug addict: a reconstructive approach ("vegetectomy").

This report describes the case of a 24-year-old female heroin addict with large tricuspid valve vegetation, recurrent septic pulmonary emboli, and renal failure, due to immune-complex nephritis. The clinical course was initially complicated by acute hepatitis A. Because of recurrent emboli and persistent fever despite adequate antibiotic therapy she underwent excision of the vegetation ("vegetectomy") and tricuspid valvuloplasty. She was well at follow-up 12 months later with trivial tricuspid regurgitation shown by doppler-echocardiography. Kidney and liver function were normal. Right-heart endocarditis in drug addiction and therapeutic approaches are discussed. In selected cases "vegetectomy" and valvuloplasty offer a promising therapeutic alternative.

Adult↗
PubMed1988

[Activities of intensive care units in 1986].

Based on a yearly evaluation carried out by the Swiss Society for Intensive Care Medicine and the Swiss Nurses Association, statistical reports for 1986 from 72 recognized intensive care units are presented.

Critical Care↗
PubMed1988

[Idiopathic atrial fibrillation: the course in paroxysmal and chronic forms].

Among 85 patients (including 16 women) with lone or idiopathic atrial fibrillation, 38 had a purely paroxysmal form while 47 showed chronic fibrillation, usually after a paroxysmal onset. Serious complications (congestive heart failure, syncope and embolic events) occurred in only two paroxysmal cases but in 11 chronic cases (rate of complications per year was 1.3% and 3.8% respectively). Thromboembolism was only observed after chronic fibrillation lasting longer than one year. Paroxysmal patients may be characterized by typical anamnestic features, namely short episodes of arrhythmia (usually less than 24 hours) and constant causative circumstances (mainly vagal stimulation). In these cases antiarrhythmic drugs are not usually recommended.

Adult↗
PubMed1987

[Mitral annular calcification in dialysis patients].

Degenerative mitral anular calcifications (MAC) are most often found between the posterior mitral anulus and the left ventricular posterior wall. In advanced stages they may encircle the mitral valve and thus involve the insertion of the anterior mitral leaflet and the posterior part of the aortic root. They are usually found only after the age of 70. Among 33 patients on chronic dialysis for renal failure who were investigated by echocardiography (2-D and m-mode) we found an MAC incidence of 55% but no cases among a control population of the same age and sex (p less than 0.001). The diameter of the calcification exceeded 5 mm in 9 cases out of 18. Four of these calcifications extended in a circular fashion around the mitral valve. Additional significantly associated echocardiographic features included dilatation of the left atrium and sclerosis of the aortic root and valve. Furthermore, 12 patients with MAC had dysfunction of the mitral valve (p less than 0.05), viz. 10 isolated mitral valve regurgitations and 2 mitral stenosis, combined with regurgitation. The patients with MAC were older than those without MAC, their mean duration of dialysis was longer and parathormone level higher. The incidence of mitral anular calcifications is much higher among patients on chronic dialysis. The clinical significance of these calcifications lies primarily in the consequent dysfunction of the mitral valve.

Adult↗
PubMed1983

Cardiac arrhythmias in patients on maintenance hemodialysis.

17 patients on maintenance hemodialysis were monitored for cardiac arrhythmias using ambulatory electrocardiographic recording. Atrioventricular dissociation was found in a patient with an elevated serum digoxin concentration, intradialytic supraventricular tachycardia had been present in a second patient during acute uremic pericarditis prior to the study. Ventricular premature beats (VPB) were absent or of low grade (occasional/uniform) in 14 patients and did not increase on dialysis. 3 patients had potentially dangerous VPB of higher grades (multiform, salvos or R on T) which occurred on or after dialysis in 2. 2 of these 3 patients were overdigitalized, and 2 had severe cardiac disease (amyloid, old myocardial infarction). Several other risk factors (age, hypertension, cardiac hypertrophy, smoking, hyperlipidemia, electrolyte changes) did not seem to be of importance for VPB. In these patients on maintenance hemodialysis, potentially dangerous VPB were rare and occurred mainly during or after dialysis in patients with preexisting heart disease and/or digitalization.

Arrhythmias, Cardiac↗
PubMed1981

[Severe heart insufficiency after acute myocardial infarct: follow up].

An attempt is made to identify and establish the prognostic significance of a subset of patients at high risk after myocardial infarction in need of different therapeutic interventions, using clinical variables of a recently published prospective postinfarction follow-up study. The survivors with anterior myocardial infarction, severe left ventricular dysfunction and ventricular premature depolarizations, making up 15% of the population, have the greatest potential for mortality reduction by appropriate intervention after infarction. The dominance of mechanical and electrical factors in the high risk group necessitates a combined therapeutic approach. The rapid decline in the survivorship curve, with a rapid decline during the first 6 months of the posthospital period implies different intervention regimes at different chronologic intervals in the convalescence phase after myocardial infarction.

Arrhythmias, Cardiac↗
PubMed1980

[Arrhythmias in patients on long-term hemodialysis].

17 patients on maintenance hemodialysis were monitored for cardiac arrhythmias by ambulatory electrocardiographic recording. Only 3 patients had ventricular premature beats of potentially dangerous grades. Two of these cases were overdigitalized and two had severe cardiac disease (amyloid, old myocardial infarction).

Adult↗
PubMed1980

[Significance of echocardiography in monitoring blood circulation].

The ability to perform bedside examinations in acutely ill patients, the sensitivity of the technique and the accuracy of serial examinations have led to increasing use of echocardiography in the intensive care setting. In addition to diagnostic information, the procedure provides the clinician with objective reproducible data for noninvasive evaluation of follow-up and therapeutic action. It provides an important approach to the patient with cardiac enlargement and congestive heart failure. In the patient with chest pain it may detect a cause of ischemia other than coronary artery obstruction and in the presence of unquestionable coronary artery disease it provides information towards early recognition and follow-up of complications. In acute left-sided heart failure it helps in the delineation of conditions amenable to specific therapeutic interventions. Echocardiograpy may point to the origin of systemic emboli by detecting mitral and valvular vegetations in infectious endocarditis, mitral stenosis and in rare cases of atrial myxoma. It may accelerate decisions for invasive procedures.

Abdomen, Acute↗
PubMed1979

[The echocardiogram in mitral anulus calcification].

In agreement with the known high incidence of mitral anulus calcification in elderly patients, the authors have found corresponding calcifications in echocardiographic examinations in 61 patients as the single or additional cause of an abnormal systolic or diastolic murmur. The intracardiac calcifications were known of from the chest X-ray only in 6 patients. The echocardiograms served to locate and estimate the amount of the calcification. Calcifications of the aortic cusps, found in 75% of patients, may be of degenerative origin. The echocardiographic presentation of the degenerative calcifications can be misinterpreted either as postrheumatic valvular disease, posterior pericardial effusion or hypertrophic cardiomyopathy. Registration by continuous sector scan was necessary to differentiate these entities.

Aged↗
PubMed1978

[Uremic pericarditis: clinical aspects, echocardiography, therapy].

Over a 2-year period uremic pericarditis was observed in 11 of 62 patients treated by chronic dialysis. The uremic state appeared to be the most important contributing factor in these patients. Chest pain, fever and a pericardial friction rub were observed in the majority of patients; the illness may however be silent. Echocardiography proved to be the single most helpful diagnostic procedure. Intensive hemodialysis, indomethacin or steroid therapy given systemically or intrapericardially are generally accepted in the management of pericarditis. Although indomethacin produced regression of the clinical symptoms in these patients, the volume of fluid within the pericardial sac diminished in 3 of 9 patients only. 6 patients were given systemic steroid treatment and this was followed by prompt resolution of the effusion. Surgery was not necessary. All patients had an uneventful recovery.

Adult↗
PubMed1977

[Echocardiography in infectious endocarditis].

The effectiveness of echocardiography was evaluated in 36 cases of anatomically documented infective endocarditis during the period 1972 to 1976. Valvular vegetations were found in 47% and destructions in 58% of this group. Echocardiography is a valuable tool in the certification of clinically suspected infective endocarditis and in the delineation of a subgroup of patients with valvular vegetations and destruction of aortic and mitral valve leaflets. Echocardiography may therefore play a decisive role in the selection of patients for surgical intervention despite active infection.

Adult↗
PubMed1976

[Echocardiography in hypertrophic obstructive cardiomyopathy].

The echocardiographic anomalies seen in 16 patients with proven hypertrophic obstructive cardiomyopathy (HOCM) are described. With use of a standardized technique and critical evaluation of the individual signs, echocardiography provides a simple and accurate means of confirming the diagnosis of HOCM, following the course and evaluating therapy.

Adolescent↗