PubMed Health⌕ Search

Biomedical subjects

L Gould

Publications and source records attributed to L Gould.

At least 37 records · Page 2Linked to original sources
PubMed1978

Premature hair graying: a probable coronary risk factor.

Hypertension, diabetes mellitus, hypercholesterolemia, and smoking are known coronary risk factors. It has been our impression that premature graying of the hair also predisposes individuals to myocardial infarctions. To test this hypothesis, we evaluated all of the patients under the age of 50 who were admitted to the coronary care unit between 1974 and 1976 with a proven diagnosis of a myocardial infarction. There were 50 patients. Thirty-eight did not have premature graying. Twelve of the male patients (24%) had virtual total graying of the hair which made them appear older than their stated age. The graying in these patients started on the average at 29 years. Five of these patients state that other family members had premature hair graying. The incidence of diabetes, hypertension, and smoking was similar in those with and without premature hair graying. This preliminary study suggests that premature graying of the hair is associated with premature cardiovascular disease. It should probably be regarded as a coronary risk factor and used to identify patients at increased risk.

Adult↗
PubMed1978

Hemodynamic effects of phentolamine in valvular abnormalities.

Seven patients with mitral insufficiency and seven patients with aortic insufficiency were studied by right and left heart catheterization. Hemodynamic observations were made during a control period and during the infusion of phentolamine. Significant declines in the pulmonary artery mean pressure, left ventricular end diastolic pressure, peripheral resistance, and arteriovenous oxygen difference were seen in both groups. The cardiac index increased significantly in the two groups. Phentolamine therapy produced favorable hemodynamic effects because of its vasodilating action as well as its positive inotropic effects.

Aortic Valve Insufficiency↗
PubMed1977

The syndrome of normal electrocardiograms, accessory pathways and paroxysmal tachycardias.

Tachycardias may be associated with the pre-excitation syndrome, a short PR interval or a prolonged QT interval. This report describes seven patients whose electrocardiograms (ECGs) did not reveal any of the above-named conditions. All of the patients presented with syncopal episodes, and the history of palpitations was elicited in five of the patients. His bundle electrogram studies in all of the patients showed an essentially unchanged AH interval with atrial pacing rates up to 180 beats/min. This can only be explained by a total bypass of the AV node. Two of the patients were also paced from the ventricle, and an unchanged pacing stimulus to A wave interval was observed. This signifies in these patients a functioning bypass pathway in the retrograde direction as well. Thus it would appear that pre-excitation cannot by eliminated as a diagnostic possibility even if the ECG is normal.

Aged↗
PubMed1977

Electrophysiological properties of phentolamine in man.

The effects of phentolamine, 0-3 mg/min given intravenously for 15 minutes, on His bundle electrograms were studied in 11 patients with heart disease. Recordings were made at varied heart rates, using atrial pacing. Phentolamine significantly reduced the AH interval in every patient but it had no effect on the HV interval. Functional and effective refractory periods were measured with the use of the atrial extrastimulus technique. The effective refractory period of the atrium and atrioventricular node as well as the functional refractory period of the atrioventricular node all significantly decreased after phentolamine infusion. This improvement in conduction is probably mediated by a release of catecholamines.

Adolescent↗
PubMed1977

Aneurysms of the pulmonary arteries.

A case of bilateral pulmonary artery aneurysms is presented. Serial cardiac catheterizations over an 8-year period showed remarkably little hemodynamic change. Thus there may be a long period of clinical and hemodynamic stability in this condition.

Adult↗
PubMed1977

Fibroplastic parietal endocarditis with eosinophilia.

A 44-year-old woman with marked eosinophilia, leukocytosis, congestive heart failure, and the murmur of mitral stenosis had a restrictive type of pulse contour at cardiac catheterization. A right atrial angiogram revealed a huge right atrium, a small right ventricle, and a dilated contractile outflow tract consistent with the diagnosis of Loeffler's endocarditis. A marked conduction delay at the atrial level was demonstrated by His bundle electrogram studies.

Adult↗
PubMed1977

His bundle electrograms in 51 patients requiring permanent transvenous pacemakers.

Fifty-one patients required the implantation of a Cordis Omnis-Stanicor permanent pacemaker. His bundle electrograms studies, which included right atrial pacing and sinoatrial (SA) node postsuppression recovery times, were performed prior to the implantations. Pacing and sensing thresholds were obtained in all patients. Syncope or episodes of dizziness were the presenting symptoms in virtually every patient. Twenty-eight of the 51 patients had the sick sinus syndrome. Only nine patients were in complete heart block, and an additional nine were in second-degree heart block. The His bundle electrogram technique was not particularly helpful in selecting the potential pacemaker candidate. The symptomatic patient with second- or third-degree heart block requires a pacemaker. In the sick sinus syndrome, the His bundle electrogram was a disappointing tool in detecting abnormalities. In chronic bundle branch block, the His bundle electrogram appears to play a major role. A prolonged H-V interval in a symptomatic patient, in whom a specific noncardiac cause cannot be identified, signifies that a pacemaker is required.

Adult↗
PubMed1976

The effect of nitroglycerin on atrioventricular conduction in man.

His bundle electrograms were performed on 10 patients with organic heart disease. Six patients had had a recent myocardial infarction. Recordings were made at various rates utilizing right atrial pacing. Nitroglycerin, 1/150 gr, was administered to all 10 subjects, and the P-A, A-H, H-Q and H-S intervals were determined before, and immediately after the disappearance of the sublingually administered nitroglycerin. A significant decrease in the A-H interval occurred with negligible effects on the P-A, H-Q and H-S intervals. At the atrial pacing rate of 100/min, the average A-H interval fell from the control value of 152 msec to 129 msec after the administration of nitroglycerin (p less than 0.02); at the pacing rate of 130/min, the A-H interval decreased from 194 to 133 msec (p less 0.05). Second degree heart block occurred at higher pacing rates in six patients after nitroglycerin administration as compared to the control value. The average postsuppression sinoatrial recovery time control value of 1,083 msec decreased to 906 msec after nitroglycerin administration (p less than 0.01). These findings demonstrate that nitroglycerin can improve conduction through the A-V node.

Adult↗
PubMed1976

Phentolamine.

The clinical uses of phentolamine have widened since its introduction as an anti-hypertensive agent. The vasodilating action of the drug as well as its postive inotropic effects have led to its use in treating congestive heart failure. Recently, phentolamine has been use by several groups to improve left ventricular function in acute myocardial infarction. There appears to be great promise for the use of phentolamine in this clinical setting. The drug given intravenously or orally can suppress ventricular premature beats and supraventricular premature beats. However, the experience of phentolamine as an antiarrhythmic agent is still limited. Similarly, the relief of angina pectoris by phentolamine requires confirmation by additional clinical studies. Phentolamine can be used as a provocative test in idiopathic hypertrophic subaortic stenosis. Since it does not produce cardiac arrhythmias, it may be safer than isoproterenol. The comparative effectiveness of phentolamine and isoproterenol in diagnosing I.H.S.S. is unknown. Phentolamine has been advocated for several years as a beneficial agent for the treatment of shock. The experience is still limited to a few groups who have reported favorable results. Phentolamine has been used as a bronchodilator and a pulmonary artery dilator. The preliminary reports appear favorable. However, continused investigation is warranted. A sensitive measurement of the blood levels of phentolamine is not available. When this is accomplished, further insight into the metabolism of this drug will be forthcoming.

Angina Pectoris↗
PubMed1976

Hemodynamic effects of steroids in cardiac disease.

The hemodynamic effects of intravenous methylprednisolone were documented by right heart catheterization in seven patients with an acute uncomplicated transmural myocardial infarction 1 to 9 days after the onset of symptoms. Intracardiac pressures, brachial artery pressure, and cardiac output were determined before and 1 hour after the termination of the methylprednisolone infusion. Two grams of methylprednisolone were infused over a 20 minute period. The brachial pressure rose from a mean of 82 to 90 mm. Hq (N.S.). The brachial artery mean pressure fell in the one patient with a 1-day-old infarction, and it rose in the six patients with an older infarction, from 83 to 94 mm. Hg (p less than 0.01). As the brachial artery pressure rose in one patient, chest pain and marked ST-segment elevation occurred which were relieved by nitroglycerin. This experience promoted us to terminate the steroid study. There was a nonsignificant increase in the cardiac index and wedge pressure. The raise in the brachial artery pressure with an infarction older than 1 day was an unexpected finding, since steroids are presumed to be vasodilating agents.

Adult↗