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Biomedical subjects

J B McGuinness

Publications and source records attributed to J B McGuinness.

16 recordsLinked to original sources
PubMed1993

Early diagnosis of acute myocardial infarction: CK-MB and myoglobin compared.

We have measured changes in plasma concentration of creatine kinase MB (CK-MB) and myoglobin in 50 patients admitted to the Coronary Care Unit with chest pain of presumed cardiac origin. Eight serial blood samples were obtained in the 6 h period following admission and both CK-MB and myoglobin concentrations were measured. We compared the performance of single values of both tests. Myoglobin concentration, in the coronary care population studied, proved to be as specific as CK-MB concentration (92.6% in both cases) but with sensitivity of 100% being achieved 1.5 h post admission rather than 4 h post admission in the case of CK-MB. On this evidence, measurement of plasma myoglobin could prove useful in the rapid diagnosis of myocardial infarction with consequent effects on optimal Coronary Care utilisation and selection of patients for thrombolytic therapy.

Adult↗
PubMed1981

Combined vasodilator therapy in the treatment of chronic heart failure.

Treatment of resistant congestive cardiac faiure by vasodilators is now well accepted. Twelve such patients were started on Isosorbide Dinitrate and Hydralazine therapy and monitored for 24 hours. Oral treatment was then continued indefinitely. This group responded well to combined therapy and four had their regimes altered in the light of haemodynamic observations. It was then concluded that this type of treatment can be tailored to the individual patient to produce the best effects on preload and afterload.

Blood Pressure↗
PubMed1977

Vasodilator therapy in acute myocardial infarction. Use of sublingual isosorbide dinitrate.

The haemodynamic effect of a long-acting vasodilator isosorbide dinitrate has been studied in 10 patients after an acute myocardial infarct, all of whom had evidence of left ventricular failure. Left ventricular filling pressure measured as the mean pulmonary artery wedge pressure was raised in all patients and fell significantly from 20+/-6 to 13+/-5 mmHg (P less than 0-001) within 10 minutes of sublingual isosorbide dinitrate. This 35 per cent fall in left ventricular preload was accompanied by significant fall in mean pulmonary artery pressure from 30+/-7 to 20+/-4 mmHg (P +less than 0-001) and mean right atrial pressure from 11+/-3 to 6+/-2 mmHg but cardiac output measured by thermodilution was unchanged. Mean systemic blood pressure was also significantly reduced. This improvement in left ventricular performance resulting from a reduction in left ventricular filling pressure and systemic blood pressure indicates that there may be a place for long-acting vasodilator in the treatment of acute myocardial infarction.

Aged↗
PubMed1976

First electrocardiogram in recent myocardial infarction.

The admission electrocardiogram (ECG) was studied in 898 patients admitted to a coronary care unit over two years. The diagnosis made from this tracing was compared with that made at the end of the patient's stay. About half the cases of recent myocardial infarct were diagnosed from the admission ECG, but accuracy rose to 83% with serial ECG's in the unit. The ECG is important but not entirely reliable in the early detection of acute myocardial infarction, which should be largely a clinical diagnosis.

Coronary Care Units↗
PubMed1976

The elderly in a coronary unit.

The clinical features of myocardial infarction were compared in 104 patients over the age of 70 and 399 younger patients admitted to a coronary care unit. Absence of an age bar at 70 years has increased the number of admission to the unit by 24%, and the number of patients with proved infarcts by 26%. Severe complications are more common and mortality is doubled in the elderly. Although immediate management of primary ventricular fibrillation is as successful in older as in younger patients, treatment of the elderly with less dramatic conditions is less successful. The elderly survivors tend to spend longer in the coronary unit and subsequently in the general medical ward.

Adult↗