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Biomedical subjects

I M Graham

Publications and source records attributed to I M Graham.

10 recordsLinked to original sources
PubMed1992

Echocardiographic abnormalities in ankylosing spondylitis.

Twenty four patients with ankylosing spondylitis of 10 or more years' duration were assessed for evidence of cardiac disease. Seven patients (29%) had evidence of cardiac disease, including one patient with a pericardial effusion, three with conduction abnormalities, and two with aortic incompetence. Aortic incompetence in one patient was clinically silent and was detected only with Doppler echocardiography. This patient had, in addition, thickening of the posterior aortic wall, an echocardiographic feature not previously described in ankylosing spondylitis. There was no evidence of aortic valve disease in a control group matched for age and sex. Patients with ankylosing spondylitis and cardiac abnormalities were older, had a longer disease duration, and more peripheral joint disease than those without cardiac abnormalities. Doppler echocardiography is a useful technique in the assessment of cardiac disease in ankylosing spondylitis and may detect aortic valve disease at an early preclinical stage.

Adult↗
PubMed1990

The prevalence and outcome of ventricular arrhythmias in acute myocardial infarction.

One hundred and seventy-two consecutive cases of acute myocardial infarction (MI) admitted to a coronary care unit were studied with regard to ventricular arrhythmias--pre-mature ventricular contractions (PVC), ventricular tachycardia (VT) and ventricular fibrillation (VF). Sixty-seven (39%) patients had ventricular arrhythmias (PCC-VT-VF), of whom 17 (9.8%) had VT and 11 (6.4%) VF. VT and VF, but not total arrhythmias, were more common in anterior infarctions. Fifty-six out of 67 (83.5%) of these patients arrived at Accident & Emergency (A&E) within the first six hours of onset of chest pain. Ten out of 11 (91%) patients who had VF did so in the first six hours. PVCs were poor predictors of the occurrence of VF (positive predictive value 5.9%). Forty-three patients (84%) who had PVCs did not develop any further arrhythmias. Spontaneous heart rate had no influence on the occurrence of ventricular arrhythmias. Frequent PVCs were more commonly associated with progression to VT and VF. In 30 cases (88%) lignocaine was effective. There was no death due to VT/VF and all responded to drugs and/or cardioversion.

Adult↗
PubMed1989

Diagnostic value of the apex beat.

100 patients were examined without knowledge of other findings to assess the value of apex displacement as a sign of cardiomegaly; 25 had a radiographic cardiothoracic ratio greater than 50%. The apex was located in only half of the patients, palpability being influenced by frame size, percentage ideal body weight, and percentage body fat. By comparison with the cardiothoracic ratio, apex displacement beyond the midclavicular line as the diagnostic test for cardiomegaly had a specificity of 76%, a sensitivity of 59%, a positive predictive value of 59.4%, and a negative predictive value of 76.9%. Another clinical sign of cardiomegaly, apex more than 10 cm from the midsternal line, was more sensitive but even less specific.

Aged↗
PubMed1979

Age, sex, and ischaemic heart disease as prognostic indicators in long-term cardiac pacing.

The influence of age, sex, and overt ischaemic heart disease on survival after pacing was studied in a population of 427 patients. The median survival for the whole group was 7.75 years. Women between 55 and 74 years and men between 65 and 74 years enjoyed median survivals in excess of 10 years. Patients over 74 years and men with ischaemic heart disease had median survivals of the order of 5 years and 3 1/2 years, respectively. The findings may help to match generator lifetimes to patient-survival prospects.

Adolescent↗
PubMed1979

Coexistence of asymmetric septal hypertrophy and aortic valve disease in adults.

Echocardiography detected asymmetric septal hypertrophy (ASH) in five of 200 adults being assessed for aortic valve surgery. Four of these were among 119 patients with dominant aortic stenosis, which was severe in three. ASH was confirmed at the time of aortic valve replacement in two of these patients; the third declined operation. The finding of ASH in only one of 81 patients with free aortic reflux is consistent with chance association. While the same explanation could apply to the higher prevalence in those with aortic stenosis, it may be that a long-standing pressure overload can trigger inappropriate septal hypertrophy in predisposed individuals.

Adolescent↗
PubMed1977

Factors affecting the 5 year survival rate of men following acute coronary heart disease.

A total of 213 male patients who survived an initial episode of acute coronary inusfficiency or myocardial infarction for 28 days have been followed for 5 years. The effect of age, weight, severity of infarction diastolic blood pressure, serum cholesterol, and cigarette smoking at the time of the initial attack on postinfarction morbidity and death was examined. Only severity of infarction adversely influenced the long-term mortality rate; none of the factors studied was related to subsequent morbidity. The effect of subsequent cigarette smoking on morbidity and death was noted over the 5 year period. Smoking did not affect subsequent morbidity but there was an increased death rate among those who continued to smoke. This effect of smoking was independent of the severity of infarction. Improved long-term survival may be predicted for patients who stop or markedly reduce cigarette smoking.

Acute Disease↗