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J L Neimann

Publications and source records attributed to J L Neimann.

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

[Long-duration electrocardiographic recording in 33 patients with obstructive cardiomyopathy].

A prospective study of arrhythmias was performed in 33 patients with hypertrophic cardiomyopathy with obstruction by Holter monitoring. The aim of the study was to assess the incidence of "occult" arrhythmias in this condition and to establish a "profile" of high risk patients from clinical, echocardiographic and haemodynamic data. The Holter monitoring demonstrated asymptomatic arrhythmias in 31 of the 33 patients (94%). A supraventricular arrhythmia was detected in 15 cases (45%), including 7 episodes of supraventricular tachycardia (21%). Ventricular arrhythmias were observed in 28 patients (85%), including 5 episodes of ventricular tachycardia (15%). Some patients presented several types of arrhythmia. A number of patients with arrhythmia including short bursts of ventricular tachycardia were asymptomatic during Holter monitoring; conversely, other patients complained of dizziness or syncope but had no arrhythmias. A retrospective study of clinical, echocardiographic and haemodynamic data showed no difference between patients with and patients without arrhythmias. Medium-dose betablocker therapy (propranolol, 110 mg/day) did not seem to protect patients with hypertrophic cardiomyopathy with obstruction from arrhythmias. We conclude that Holter monitoring should form part of the routine evaluation of patients with cardiomyopathy with obstruction, and that potentially dangerous arrhythmias should be treated by anti-arrhythmic agents other than betablockers. This attitude could reduce the incidence of syncope and eventually decrease the risk of sudden death in this condition.

Adult↗
PubMed1984

[Retrospective study of the role of systematic coronarography in patients with heart valve diseases].

The aim of this study was to assess retrospectively the valve of routine coronary angiography in the investigation of patients with valvular heart disease. Between 1978 and 1981, 598 patients over 40 years old underwent left heart catheterisation with routine coronary angiography. In the group with a medical history of angina or infarction (N = 149), there were 49 cases (33%) of severe coronary artery disease (greater than or equal to 70%) and 17 cases of moderate coronary artery disease (11%); of the 49 patients with severe lesions, 2 died after catheterisation, 8 were considered to have too high an operative risk because of their coronary disease and 19 were operated. Valve replacement was associated with a procedure for myocardial revascularisation in 15 cases. In the group without angina (N = 449), severe coronary lesions were much less common (3.6%) and only 5.1% had moderate coronary disease. Severe coronary lesions were found more frequently in certain sub-groups: Stage IV dyspnoea (9%), patients over 65 years of age (11.5%), and coronary calcification (24%). Of the 39 patients without angina and over 50% narrowing on coronary angiography, 17 underwent isolated valve surgery, and 9 underwent combined valvular and coronary surgery (2% of catheterised patients without angina; 3.5% of patients operated without angina. These results show that routine coronary angiography is fully justified in patients with valvular heart disease and a history of angina as vital information is obtained in a high proportion of cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

[Echographic rediscovery of an anatomical structure: the Chiari network. Apropos of 16 cases].

In 1897, the anatomist Chiari described a structure in the right atrium connected to the Eustachian valve identified as the embryological vestige of the right valve of the sinus venosus. This structure was then forgotten. Recently, Werner described the echocardiographic appearances. During 1981, 1 600 consecutive patients underwent 2D echocardiography and the right atrium (RA) was visualised in several incidences. Abnormal RA echos fulfilling the echocardiographic criteria of the Chiari network were detected in 16 cases. The 2D echo appearances were as follows: a fine, mobile echo crossing the RA at right angles to its long antero posterior axis; arising from the anterior border of the orifice of the inferior vena cava, variably attached to the RA walls (lateral, superior, interatrial septum). The recordings were made from the transverse parasternal and apical or subcostal 4 chamber views. An M mode recording of this structure usually guided by the sector scan was made in 13 patients. This showed a fine curvilinear echo animated by antero-posterior vibrations during the cardiac cycle situated behind the anterior tricuspid leaflet. The pathological associations of the 16 patients in whom the Chiari network was demonstrated were as follows: 5 congenital cardiopathies including 3 ASDs, 1 isolated abnormal pulmonary venous drainage, 1 complex case comprising 1 ASD and 5 acquired lesions: aortic endocarditis; chronic cor pulmonale, idiopathic atrial fibrillation, pericarditis and coronary artery disease. Six patients did not appear to have cardiac disease. This structure was confirmed at surgery in 2 cases: the operative findings were a fine network of filaments stretching from the orifice of the inferior vena cava (Eustachian valve) to the RA walls.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1982

[Comparison of various methods of diagnosis of the mitral valve (author's transl)].

This study compares the information supplied by auscultation, echocardiography and left ventriculography in the diagnosis of mitral prolapse from a study of the world literature and a personal study. A click on auscultation or a telesystolic click murmur is noted in almost 74 p. cent of cases. Echocardiography may lead to false negatives in partial prolapse of the posterior valve and in ventriculography, even judged according to strict and restrictive criteria they may make errors by excess. Telemetric echocardiography may assess in an overall way the number or prolapsed valvular structures and the degree of mitral incompetence. The respective indications of the 3 methods are given in detail.

Echocardiography↗
PubMed1981

[Abnormal vascularisation of the right inferior pulmonary lobe by an aberrant coronary artery. Apropos of 2 uncommon cases].

Pulmonary vascularisation by the coronary vessels does not seem to have been previously described. The authors report 2 cases of vascularisation of the righ lower lobe by an atrial branch of the right coronary or circumflex arteries. Several pathogenic hypotheses are discussed. No definite conclusions can be drawn despite postmortem examination in one case. Pulmonary sequestration would seem to be very probably although there are a few contradictory findings. Acquired inflammatory conditions alone or associated with the congenital malformation cannot be excluded. These anomalies pose difficult therapeutic problems for cardiologists as they are discovered during coronary angiography for angina. The question of a "pulmonary steal" syndrome aggravating the coronary insufficiency possibly requiring both a pulmonary and a cardiac operation may be raised. From the pulmonary point of view, other methods of investigating patients with pulmonary sequestration and haemoptysis of unknown origin could be indicated.

Coronary Vessel Anomalies↗
PubMed1980

[Obstructive mitral vegetations in bacterial endocarditis. Disappearance after migration as an embolism].

An unusual form of mitral valve endocarditis was observed on echocardiography. A 49 year old female with well tolerated mitral stenosis and mild aortic incompetence contracted staphylococcal endocarditis. Pulmonary venous hypertension developed and the diastolic murmur increased. The echocardiogramme showed voluminous vegetations obstructing the stenosed mitral orifice in diastole, simulating a left atrial myxoma. An acute ischaemic episode of the lower limb occurred under antibiotic therapy. A voluminous fibrino-cruoric infected embolus was extracted from the iliac artery and a second echocardiogramme showed the intra mitral mass to have disappeared. Concurrently, the diastolic murmur decreased and the signs of intolerance disappeared. When the infective process seemed to have been controlled, the patient died suddenly. Post-mortem examination showed fresh mitral endocardial lesions and renal and splenic infarcts. Five cases of mitral obstruction by vegetations have been previously reported, three of which had echocardiographic studies. The echocardiographic image is stereotyped and resembles a myxoma wedged in the mitral orifice but without the intra atrial mass. This type of mitral obstruction complicated moderate mitral stenosis in all cases. Regression of the echographic appearances of valvular vegetations has been reported in rare cases, but we were unable to find another case of embolism of vegetations reducing the valvular obstruction.

Adult↗
PubMed1979

[Epidemiological profile of patients with myocardial infarction and normal coronary arteriography].

Of a total of 4,800 coronary arteriogrammes, 1,280 of which were carried out after myocardial infarction, 25 cases of proven infarction with normal coronary arteriography, confirmed by several "blind" interpretations, were retained. The interval between acute infarction and coronary arteriography was usually less than 6 months. The average age of the patients was 36.9 years, affecting more women than in classical coronary artery disease. The acute infarction was nearly always the first symptom. Cigarette consumption and hormonal factors is women were coronary risks factors of note. Ventricular sequellae were frequent, cardiac failure exceptional, exercise testing nearly always negative and occupational rehabilitation usually normal. It would seem that this affection is less serious than classical myocardial infarction due to atheroma probably because the non-infarcted myocardium is healthy, but the true prognosis of this type of coronary accident will only be revealed by long term studies. In the meantime the most useful investigations and the management of these patients are discussed.

Adolescent↗
PubMed1979

[Right ventricular dysplasia; a study in 7 cases].

Seven new cases of right ventricular dysplasia are described, five of which were complicated by ventricular tachycardia. The frontiers of this syndrome are unclear and it is uncertain whether it should be considered as a separate disease entity, or as a minor form of "paper thin" right ventricle or Uhl's disease.

Adult↗