The clinical significance of the potassium stress ECG.
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Biomedical subjects
Publications and source records attributed to K Oversohl.
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The importance of thrombocyte function in atherogenesis is discussed in the light of experimental and clinical results. Adhesion and aggregation of thrombocytes on an intact or injured artery wall may be the first step to atherosclerotic plaque. In vitro measurements of aggregation, in vivo measurements of thrombocytic survival time and microscopic and histological examinations are all consistent in showing a rise in aggregation of thrombocytes in the early stages of arteriosclerosis. The measurement of thrombocyte function is therefore recommended in addition to the known risk factors in patients with a greater risk of arteriosclerosis.
The electrocardiogram on exercise with a graduated load on the bicycle ergometer has proved of value as a screening method for coronary heart disease and arrhythmias. A horizontal or descending ST junction depression of 0.1 mv in the left precordial lead is considered a significant ischemic reaction. The present paper reports the practical performance and evaluation of findings of the method. The prognostic significance of a pathological ECG on exercise with regard to the occurrence of a coronary heart disease and the progression of the disease are pointed out.
Clinical, haemodynamic and angiographic findings in 50 patients with congestive cardiomyopathy were related to subsequent clinical course (mean observation period of 40 months). Ejection fraction and changes in mean pulmonary "wedge" pressure on ergometric exercise proved to be the most reliable criteria for judging left-ventricular function. During the period of observation 11 patients had died, in 15 the clinical state had deteriorated by one or two functional classes, and in 24 there had been no change. Patients with progressing disease differed from those clinically unchanged by having a smaller cardiac index, increased end-diastolic left ventricular pressure, higher pulmonary arterial pressure and smaller ejection fraction. Prognosis was no worse with atrial fibrillation than with sinus rhythm. Four of 13 patients with left bundle branch block died during the observation period and in seven the clinical state had deteriorated by one or two functional classes. The tested variables apparently have a good prognostic value.
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