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J Willis Hurst

Publications and source records attributed to J Willis Hurst.

At least 19 recordsLinked to original sources
PubMed2006

The interpretation of electrocardiograms: pretense or a well-developed skill?

There must be no pretense in medicine. When a physician orders an electrocardiogram on a patient he or she must be able to interpret it. Not only that, he or she must understand the mechanism responsible for the abnormality and how the abnormality fits, or does not fit, with the other data collected from the patient.

Attitude of Health Personnel↗
PubMed2005

Observational data suggesting there are electrocardiographic abnormalities that strongly suggest the presence of chronic heart failure.

Almost nothing is written about the electrocardiographic abnormalities that may suggest the presence of chronic heart failure. Indeed, one often hears that the electrocardiogram does not indicate anything about the function of the ehart. This paper discusses several abnormalities that often predict the presence of chronic heart failure. The information presented is from observations and not from scientific studies. The author urges those who are interested to complete a scientific study based on the premise that such observations may be correct. After all, many scientific studies have been created because of observational data that suggested a certain phenomenon.

Electrocardiography↗
PubMed2005

Thoughts about the ventricular gradient and its current clinical use (Part I of II).

The concept of the ventricular gradient was conceived in the mind of Frank Wilson in the early 1930s. Wilson, a mathematical genius, believed that the calculation of the ventricular gradient yielded information that was not otherwise obtainable. The method of analysis was not utilized by clinicians at large because the concept was not easy to understand and because the method used to compute the direction of the ventricular gradient was so time consuming that clinicians could not use it. Grant utilized the concept to create vector electrocardiography, but he believed that if his method of analysis was used, it was not often necessary to compute the direction of the ventricular gradient. He did, however, describe an easy way to compute the direction of the ventricular gradient. The current major clinical use of the ventricular gradient is to identify primary and secondary T-wave abnormalities in an electrocardiogram showing left or right ventricular hypertrophy or left or right ventricular conduction abnormalities. In addition, the author uses the term ventricular time gradient instead of ventricular gradient in an effort to clarify the concept. Finally, the author discusses the possible clinical significance of a normally directed but shorter than normal ventricular time gradient, an attribute that has not been emphasized previously.

Action Potentials↗
PubMed2005

Thoughts about the ventricular gradient and its current clinical use (part II of II).

The concept of the ventricular gradient was conceived in the mind of Frank Wilson in the early 1930s. Wilson, a mathematical genius, believed that the calculation of the ventricular gradient yielded information that was not otherwise obtainable. The method of analysis was not utilized by clinicians at large because the concept was not easy to understand and because the method used to compute the direction of the ventricular gradient was so time consuming that clinicians could not use it. Grant utilized the concept to create vector electrocardiography, but he believed that if his method of analysis was used, it was not often necessary to compute the direction of the ventricular gradient. He did, however, describe an easy way to compute the direction of the ventricular gradient. The current major clinical use of the ventricular gradient is to identify primary and secondary T-wave abnormalities in an electrocardiogram showing left or right ventricular hypertrophy or left or right ventricular conduction abnormalities. In addition, the author uses the term ventricular time gradient instead of ventricular gradient in an effort to clarify the concept. Finally, the author discusses the possible clinical significance of a normally directed, but shorter than normal, ventricular time gradient, an attribute that has not been emphasized previously.

Adult↗
PubMed2004

Worrisome thoughts about the diagnosis and treatment of patients with Brugada waves and the Brugada syndrome.

The Brugadas have made a significant contribution to medicine. Their discovery of a new clinical syndrome and ECG abnormalities has created a great deal of interest and has opened Pandora's box. Here, we discuss some worrisome thoughts about the condition. We stress the need for improved diagnostic criteria and treatment because it is not always possible to perform coronary arteriography, electrophysiological studies, right ventricular myocardial biopsy, and MRI in all patients in whom ST-segment abnormalities are seen in the ECG, especially in patients who are asymptomatic. Accordingly, further research is needed to guide the clinician in the diagnostic and therapeutic problems of patients who have unusual ST segments in leads V1 and V3. We present a patient who illustrates the problem.

Asia↗
PubMed2003

Will the nation need more cardiologists in the future than are being trained now?

This article supports the view that in the future our nation will need more general cardiologists who perform no high-tech procedures than we are currently training. It also addresses the reason graduates of American medical schools, especially women who make up 40% to 50% of the graduating class, are not choosing cardiology fellowship programs as they were previously. A remedy for this serious problem is offered.

Biomedical Technology↗
PubMed2003

A new terminology for describing left and right ventricular conduction abnormalities.

The words we use to describe a medical condition should match our knowledge of it. Unfortunately, at times, the words we used long ago persist after new knowledge of the subject has become apparent; so it is with left and right ventricular conduction system abnormalities. The words left or right bundle-branch block no longer reflect our knowledge of the condition. Accordingly, this essay describes a new terminology that more accurately describes the numerous abnormalities that compose left and right ventricular conduction system block as well as their numerous subsets. A brief account of the cardiac conditions associated with the conduction defects is also presented.

Bundle-Branch Block↗
PubMed2003

Osborn waves in the electrocardiogram, hypothermia not due to exposure, and death due to diabetic ketoacidosis.

Hypothermia usually occurs because a patient has been exposed to a cold environment; however, a number of nonenvironmental conditions may produce hypothermia. This report relates the clinical course of a patient whose hypothermia was due to severe diabetic ketoacidosis. In addition, we review the causes of hypothermia and Osborn waves beyond exposure to cold temperature. Hypothermia due to diabetic ketoacidosis is an uncommon complication of a common disease that carries with it clinically significant consequences. Accordingly, we believe that all clinicians should be aware of this potential complication of diabetic ketoacidosis and should be able to recognize the importance of the electrocardiogram in such patients.

Body Temperature↗
PubMed2002

Tricyclic antidepressants and the Brugada syndrome: an example of Brugada waves appearing after the administration of desipramine.

Since its initial description in the early 1990s, the Brugada syndrome has become increasingly familiar to active researchers and practicing clinicians. The Brugada wave, a characteristic electrocardiographic abnormality of downsloping ST-segment elevation in leads V1-V3 and right bundle-branch block morphology, has now been associated with an increased risk of sudden death. Currently, very little is known about the relationship between the Brugada syndrome and tricyclic antidepressants. Accordingly, we report the case of a patient who developed prominent Brugada waves with the administration of increasing doses of desipramine. We believe the mechanism of Brugada wave augmentation or production secondary to tricyclic antidepressants is consistent with the current model of early repolarization. We also speculate that the increased risk of sudden death that may occur with tricyclic antidepressants could be related to the development of the Brugada syndrome. We advocate the judicious use of tricyclic antidepressants in cardiac and elderly patients, with careful monitoring of the electrocardiogram for the development Brugada waves.

Aged↗
PubMed2002

Realdo Colombo.

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Anatomy↗