Biomedical subjects

L A Wellford

Publications and source records attributed to L A Wellford.

4 recordsLinked to original sources

PubMed1995

Narrow complex tachycardias.

Narrow complex tachycardias are those cardiac rhythms with a ventricular rate of more than 100 beats per minute and a QRS complex width of less than 0.12 seconds. They originate either from the SA node, from atrial tissue itself, or from in or around the AV node. The term SVT is generally accurate for such tachycardias. By diagnosing the source of an SVT and appreciating its likely cause, therapy can be more precisely, safely, and effectively guided to treat these patients. Atrial and junctional rhythms can be treated with vagal maneuvers, drugs from classes I to IV and other antiarrythmic agents, magnesium, and cardioversion. Some patients may be candidates for surgical or catheter ablation.

Anti-Arrhythmia Agents↗

PubMed1994

Prosthetic heart valve.

There are tens of thousands of patients with prosthetic heart valves implanted today, and although complications are infrequent, this may not hold true as patients live longer with prosthetic valves and as more and newer valves are implanted. A familiarity with the management of such patients will aid the emergency physician in the evaluation of this increasing population of patients and will enable the early detection of potentially deadly complications.

Bioprosthesis↗

PubMed1993

Changing presentation of coronary heart disease in an inpatient population within the U.S. military health care system.

This study examines the changing presentation of coronary heart disease (CHD) in an inpatient population at Brooke Army Medical Center. The specific objectives of the study were to examine the presentation of CHD in a population unbiased by diagnosis-related group (DRG) reimbursements and to assess the importance of unstable angina and prior history of disease in the presentation of CHD. One thousand fifteen discharges in 1985 and 1,304 discharges in 1990 with the diagnosis of CHD were reviewed by cardiologists for evidence of symptomatic heart disease at the time of hospitalization. Forty percent of these charts were accepted into this study. The presentation rates of CHD were 1% with sudden death, 26% with myocardial infarction, 64% with angina, and 9% with congestive heart failure (CHF). During the study period, stable angina, Q-wave infarctions, and the myocardial infarction case fatality rate decreased (p < 0.05) and CHF and non-Q wave infarcts increased (p < 0.001). However, unstable angina was the most common presentation of CHD, and differences (p < 0.05) were noted in the presentation of CHD in patients with and without a prior history of disease. This study demonstrates the significance of unstable angina and prior history of CHD in an environment free of bias from DRG reimbursements.

Adult↗

PubMedDate not supplied

Survival with acute primary coronary artery dissection: a case report and review of the literature.

Primary coronary artery dissection is a rare etiology of acute myocardial infarction (AMI) that often has devastating consequences. We present the case of a 46-year-old male survivor of primary coronary artery dissection who was diagnosed angiographically. He suffered a non-Q-wave MI but had no electrocardiographic (ECG) changes during his course. A review of the literature of primary coronary artery dissection, particularly those diagnosed antemortem, is provided.

Aortic Dissection↗