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Biomedical subjects

J Edelstein

Publications and source records attributed to J Edelstein.

At least 37 records · Page 2Linked to original sources
PubMed1984

Myocardial infarction in the distribution of a patent anomalous left circumflex coronary artery.

Anomalous origin of the left circumflex coronary artery is the most common congenital coronary artery anomaly. Myocardial infarction has been seen in the distribution of this anomalous vessel. This has been noted most typically when the vessel is atherosclerotic. Sudden death and myocardial infarction, however, also have been seen in a case without atherosclerotic involvement. This is a case report of a 45-year-old man who suffered a myocardial infarction after strenuous and sustained physical effort and who was found to have nonatherosclerotic coronary arteries with an anomalous left circumflex coronary artery arising from the right sinus of Valsalva.

Coronary Vessel Anomalies↗
PubMed1983

Interactions among the critical factors affecting sinus node function: the quantitative effects of the duration and frequency of atrial pacing and of vagal and sympathetic stimulation upon overdrive suppression of the sinus node.

A multifactorial analysis was used in anesthetized dogs in order to characterize the effects of the duration of overdrive, the atrial pacing interval, and the frequencies of vagal and sympathetic stimulation on overdrive suppression of the sinus node. The sinus node recovery time (SNRT) and the summated effect (SE) over the first 20 cardiac cycles were measured with various combinations of the independent variables. We conclude that (1) both the rate and the duration of overdrive have significant effects on SNRT and SE; (2) vagal stimulation has greater effects on SNRT and SE than does the rate or duration of overdrive; (3) sympathetic stimulation had only a small effect on overdrive suppression; and (4) there were significant interactions between vagal stimulation and the duration of overdrive and between the duration and rate of overdrive, but not between sympathetic and vagal stimulation.

Animals↗
PubMed1982

The electrocardiogram in obesity.

The electrocardiographic abnormalities ascribed to morbid obesity were analyzed in a group of 144 patients without apparent clinical cardiovascular pathology and compared with a control group of 100 normal weight patients. Fifty-eight patients in the obese group were re-analyzed after significant weight loss and the electrocardiographic findings compared with their initial changes when they entered the program. The QRS voltage for the obese group was slightly lower than the voltage of the normal population; but in a significant number of the patients restudied after weight loss, the QRS voltage decreased (37 out of 58 patients). In inferolateral leads non specific flattening of the T wave was observed in the obese group (71/144); it became normal as they lost weight. The P and QRS axes of the obese group initially were within normal limits but more to the left; they moved slightly to the right, although still within normal limits as the patients lost weight. Two conclusions can be drawn from the study: a) low voltage is not a significant feature in the ECG of the obese and, b) the most consistent finding in obese patients is a flattening of the T wave.

Adolescent↗
PubMed1982

Gray hair in black males a possible risk factor in coronary artery disease.

Premature gray hair has been reported to be associated with coronary artery disease (CAD) in white males. Premature gray hair also occurs in black males despite a reported lower incidence of coronary artery disease in this group. In order to determine if premature gray hair is associated with coronary artery disease in a black male population, we prospectively studied 120 patients. Forty black males with proven CAD had gray hair in 100 percent of the cases as compared to 55 percent in a control series of 80 black males. The appearance of gray hair occurred at an earlier age in the black patients with CAD. The interrelating mechanism between premature gray hair and CAD in black males is not clearly understood at this time, but we think it represents a clinically significant observation.

Adolescent↗
PubMed1981

The doctor's dilemma--how and when to tell parents that their child is handicapped.

As part of a larger study aimed at enhancing the development of young children with Down syndrome, information was collected regarding the time at and circumstances in which 32 couples were told of their child's handicap. In addition, the level of their present acceptance or rejection of their child in the family was assessed. The findings indicated that early disclosure of the handicap was one of the most important factors associated with parental acceptance and nurture of a mentally handicapped child. Other factors of importance were the nature of the information given by the informant and the position in the family of the handicapped child.

Persons with Disabilities↗
PubMed1981

Thallium-201 myocardial redistribution imaging 24 hours following stress exercise.

Twenty-four-hour 201-thallium chloride redistribution images in conjunction with immediate postexercise images were evaluated to determine their value in distinguishing coronary artery ischemia from remote infarction. Cardiac angiography, including selective right and left coronary angiography and left ventriculography, was also performed. For 43 patients with a prevalence of coronary artery disease of 0.58, 24-hour redistribution images indicated the presence of remote infraction with a predictive value of 0.75 and the absence of infarction with a predictive value of 0.92. Twenty-four-hour redistribution images are considered to be clinically efficacious, convenient for scheduling purposes, and useful as an alternative to other redistribution intervals.

Adult↗
PubMed1980

Observer performance with computer-generated images of 201Tl-Cl myocardial perfusion.

The effect of simple image processing on the interpretation of 201Tl-Cl myocardial perfusion images were evaluated by ROC analysis. Polaroid images of the cathode ray tube of an Anger camera and computer-processed transparent images recorded in color and shades of gray were examined by multiple observers. A total of 198 observer responses was accumulated for each of five image formats. The observer responses were compared with results established by coronary angiography. Better observer performance was obtained for all computer-generated images except in the region of low false positive values. The responses for color-scale formats were, in general, superior to those from the gray-scale formats. No significant improvement in observer performance resulted from the use of background subtraction with a rescaling of the 16-level gray scale to the residual information. When nine-point smoothing was applied to the color-scale display format, there was a poorer observer response.

Computers↗
PubMed1980

Noninvasive visualization of right coronary artery aneurysms.

2 cases of right coronary artery aneurysm visualized with M-mode and cross-sectional echocardiography are described. Echocardiographic visualization of right coronary artery aneurysms is possible when substantial dilation is located proximally.

Aged↗
PubMed1979

Evaluation of phentolamine as a provocative test for idiopathic hypertrophic subaortic stenosis.

Intravenous injection of phentolamine potentially offers a better provocative test for aortic left ventricular outflow tract obstruction than do Valsalva's maneuver, inhalation of isoproterenol, or of amyl nitrite. In hemodynamic studies, phentolamine enhanced myocardial contractility, and decreased afterload with only induction of slight tachycardia. Phentolamine (5 mg.) was administered intravenously to five patients who had idiopathic hypertrophic subaortic stenosis, and 35 patients who had valvular dysfunctions, after which echocardiographic and phonocardiographic recordings were performed. Recordings were of high quality despite changing hemodynamics. Systolic pressures fell an average of 20 mm. Hg; no pressure fell below 90 mm. Hg; there was no notable increase in heart rate. In the five patients with typical idiopathic hypertrophic subaortic stenosis, the amyl nitrite increased the obstructive index from 39.6 +/- 12 to 51 +/- 18.9 (P less than 0.05); whereas, phentolamine increased the obstructive index to 69.8 +/- 25.6 (P less than 0.015). After a 2 week course of oral administration of 80 mg. of propranolol daily, and then either inhalation of amyl nitrite or injection of phentolamine, there was no change from the mean resting obstructive index. Phentolamine appears to be a safe, simple and specific diagnostic agent, and more potent than amyl nitrite in eliciting dynamic obstruction in IHSS; phentolamine and amyl nitrite do not affect the obstructive index in patients with beta blockade.

Amyl Nitrite↗
PubMed1978

Extraluminal or intraluminal inferior vena cava occlusion in pulmonary embolism.

Twenty-five cases of extraluminal and 47 of intraluminal inferior vena caval (IVC) occlusion for management of pulmonary embolism were reviewed. A comparison of results obtained with both methods suggests that the IVC umbrella filter provides the safer, more reliable means of IVC interruption in patients whose condition fulfills the criteria for caval occlusion. The simplicity of this technique and the fact that it can be performed under local anesthesia justify its consideration as the procedure of choice for IVC occlusion and permit its use in severely ill patients. On the basis of our positive findings, we now recommend that extraluminal occlusion be reserved for patients in whom insertion of the IVC umbrella is technically impossible.

Adult↗
PubMed1978

Coronary involvement after a single myocardial infarction. Coronary angiography study.

Coronary angiography was performed in 95 patients 3 months to 3 years after a single myocardial infarction. The patients were categorized into 4 groups according to coronary angiography findings: group I with three or four vessels diseased; group II with two vessels diseased; group III with one vessel diseased, and group IV with normal arteries. Vessel disease was considered present if 50% of the lumen was narrowed. The patient population was almost equally distributed among group I (26), group II (26), group II (33) and group III (34). Group IV included only 3 patients in this retrospective study.

Adult↗
PubMed1976

Prolapsing mitral valve leaflet syndrome. A spectrum that includes cleft posterior mitral valve.

Two patients with a prolapse and cleft posterior mitral leaflet were studied. The first case had an associated ostium secundum type atrial septal defect. In both cases, the pansystolic regurgitation of contrast material during angiography corresponded to the pansystolic configuration of the murmur. In each instance, the systolic murmurs displayed a late systolic accentuation during the maximal prolapse of the mitral valve. The echocardiographic studies demonstrated only a late systolic prolapse which in both patients corresponded angiocardiographically to the maximum buckling of the pansystolic prolapse. Echocardiographic and angiocardiographic features of cleft posterior mitral valve leaflet are discussed.

Angiocardiography↗
PubMed1976

Ventricular septal defect complicating acute myocardial infarction. Echocardiographic demonstration confirmed by angiocardiograms and surgery.

The echocardiographic findings in one patient with a ventricular septal perforation as a result of an acute anteroseptal myocardial infarction are presented. Continuous echocardiographic scanning enabled us to demonstrate a septal discontinuity below the atrioventricular junction. The correct echocardiographic diagnosis was confirmed angiocardiographically. After surgical repair of the ventricular septal defect, the echocardiogram failed to reveal the septal discontinuity previously present. A search of the literature did not disclose any report of similar echocardiographic findings.

Adult↗
PubMed1975

Tricuspid whoop.

The present report describes a patient with a whooping murmur secondary to tricuspid insufficiency. The main features of this tricuspid whoop were as follows: variable in time, moving from mid to late systole; unpredictably associated with normal respiratory phases; after deep inspiratory apnea was almost constantly present.

Angiocardiography↗