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Biomedical subjects

M Cárdenas

Publications and source records attributed to M Cárdenas.

At least 19 recordsLinked to original sources
PubMed1992

Multiple sclerosis in Chile.

So far as we know this series of 68 cases is one of the first clinical accounts of multiple sclerosis in South America. Average age of onset was 30.7 years and female:male ratio was 2:1. The most frequent initial symptom was motor impairment and less frequent was visual loss. Most affected site of involvement in established cases was the optic nerve. There were no familial cases. The severity of the disease in Chile proved to be the same as elsewhere. No characteristic clinical pattern peculiar to the region emerged.

Chile↗
PubMed1989

Multiple sclerosis following optic neuritis in Chile.

Twenty three unselected cases of optic neuritis were re-examined between 2 and 18 years after the onset of the disease, with a mean of 9.7 years. Only 8/23 (35%) had unilateral non-recurrent disease. One patient only (4.3%) went on to develop multiple sclerosis. These findings support the impression that demyelinating disease varies considerably in Latin America compared with northern industrialised countries.

Adolescent↗
PubMed1975

Electrocardiographic criteria for the diagnosis of left anterior fascicular block. Left axis deviation and delayed intraventricular conduction.

The two current criteria for diagnosis of left anterior fascicular block (LAFB) were evaluated; they are marked left axis deviation (LAD) and a delay in the time of inscription of the intrinsicoid deflection (ID) in lead aVL asynchronous to V6. From 400 electrocardiograms with a LAD of --30 degrees or greater, 62 percent showed asynchronous activation of the left ventricle. There was only a general relationship between the degree of LAD and delayed ID in aVL. The incidence of delayed ID in aVL was as follows: 2 percent with mean frontal QRS axis at 0 degrees; 9 percent at --15 degrees; 41 percent at --30 degrees; 69 percent at --45 degrees; 82 percent at --60 degrees; and 100 percent at --75 degrees or greater. The lack of correlation between both criteria in many instances questions their validity. The LAD alone should not be considered synonymous with LAFB. Recognition of delayed inscription of the ID in aVL is a useful supplemental criterion for diagnosis.

Bundle-Branch Block↗
PubMedDate not supplied

[Atrioventricular conduction disorders following total correction of tetralogy of Fallot. Analysis of the electrogram of the bundle of His].

A study was made of the electric activity of the atrioventricular (AV) conduction system in basal conditions and with atrial stimulation in order to discover the type, severity and prognosis of the AV disturbance in cases of total correction of tetralogy of Fallot. The authors studied thirteen patients from the Paediatric Department of the National Institute of Cardiology who had undergone such surgery, 7 males, 6 females from 3 to 22 years old. All presented advanced RBBB and sinus rhythm; in the immediate postoperative period, one presented complete transitory A-V block which required a stand by pacemaker; in 2 cases there was a first degree AV block; in two other, LAH and LPH. In 5 cases atrial stimulation was made with single charges and progressive frequency. Measurements were taken at the customary intervals. In basal conditions, prolongation of the AH interval was only found in 2 patients, both with first degree AV block in the peripheral EKG; both patients were taking digitalis. The HV interval was longer than normal in 3 cases, with one of these showing also a lengthened AH interval. The atrial stimulation showed prolonged ventricular activation in 2 cases, one of them with normal basal HV interval. The authors conclude that this procedure permits: 1) The discovery of alterations in the AV conduction system which could not be found in a peripheral EKG. 2) Localization of the site of the lesion. 3) The finding of disturbances of the ventricular conduction by atrial stimulation. 4) Identification of those patients who, after a complete correction of tetralogy of Fallot, show a potential high risk of developing complete complete AV block or of sudden death. 5) The establishment of a real prognosis in these patients.

Adolescent↗
PubMedDate not supplied

[Long term prevention of thromboembolic accidents with acetylsalicylic acid in auricular fibrillation patients].

For the past few years various authors have reported the antiplatelet action and prolongation of bleeding time with the use of acetyl-salicilic acid. In the present work, we review the frequency of thromboembolism in a group of patients with rheumatic or sclerotic heart disease with atrial fibrillation, in which the treatment with coumarins was suspended and substituted for 1 gram of aspirin P.O. daily. The results were compared with a similar group studied by Cárdenas and col. During the time of the observation 10 patients had 14 thromboembolic accidents, slightly predominated by the emboli in the inferior members and in the cerebral vascular territory. The mortality was 2.5% and in 9 patients hemorrhages of little importance appeared, which could have been caused by the ASA, although it can not be proven. In comparing the results of this work with the above mentioned of Cárdenas, it appeared that the number of thromboemboli, of deaths, and secondary accidents in the group treated with ASA was less than in the group which received coumarin or which were maintained without treatment. Based on the results, it can be concluded that it is possible to substitute the coumarins with acetyl-salicilic acid in the prevention of thromboembolism, in patient with rheumatic or sclerotic heart disease with atrial fibrillation.

Adult↗
PubMedDate not supplied

[Bradyarrhythmias in the acute phase of myocardial infarct].

The functioning of the Intensive Care Units has permitted a better study and treatment of the arrhythmias which complicate the acute phase of myocardial infarction. 1,100 charts of patients admitted to the Coronary Unit of the National Institute of Cardiology of Mexico were reviewed. Acute myocardial infarction was demonstrated in 819 of them by the usual methods. The frequency and characteristics of the following bradiarrhythmias were studied: sinus bradicardia, sinus stoppage, seno-atrial block, migration of the atrial pacing, union rhythm and slow ventricular tachycardia. Sinus bradicardia was presented in 23.7% of the infarctions, sinus stoppage in 2.4%, migration of the atrial pacing in 9.4%, nodal rhythm in 7.2% and slow ventricular tachycardia in 7.8%. Bradiarrhythmias, generally considered as "lesser" arrhythmias, favor the appearance of lethal arrhythmias, regardless of the degree of mechanical failure, and thus should be treated actively.

Acute Disease↗
PubMedDate not supplied

[Auricular Q wave in right precordial derivations. New sign of left auricular growth].

The authors present four cases of rheumatic heart disease with severe dilatation of the left atrium which reached the right profile in the radiologic study. An initial negative deflexion of the P-wave (qP) in the right precordial leads was recorder in these cases. The presence of qP was interpreted in view of the atrial activation and the solid angle of the right precordial leads as a variation of potential of the right atrial ceiling and/or of the high interatrial septum, a consequence of the dislocation of the right atrium produced by severe dilatation of the left atrium, demonstrated radiologically in the cases studied. Thee presence of qP is another undoubtably valuable sign for inferring a severe displacement of the left atrium toward the right profile.

Adolescent↗
PubMedDate not supplied

[Aneurysm of the left ventricle associated with inactive rheumatic heart disease. Report of a case].

A case of aneurism of the left ventricle, confirmed by ventriculogram, associated to an inactive rheumatic cardiopathy with a pure mitral stenosis is presented. Since none of the usual causes that have been reported were found to explain the aneurism of the left ventricle; the possibility of the aneurism resulting from residual myocardiac fibrosis produced by the rheumatic myocarditis is suggested.

Adult↗
PubMedDate not supplied

[Familial occurrence of Wolff-Parkinson-White syndrome. Report of a family group and review of the literature].

A family group of nine members was studied, two of which had W-P-W syndrome; the father type A; and the son type B. These two patients were studied from the clinical electrocardiographic and vectocardiographic point of view; and they were subject to hisian electrogram recordings. The atrial-ventricular conduction under basal conditions and during atrial stimulation is analyzed. In the first case, potential H is registered after the beginning of delta wave of the ventricular complexes in lead II. In th second case, atrial-ventricular conduction can only occur through the abnormal via (no H potential and register of delta wave in the periferial simultaneous lead), or only through the normal via (evidence of potential H with a normal H-V interval and no delta wave in the periferial line of control). The bibliography of the observation that in most family groups described up until now, there is a good correlation concerning sex. This gives the impression to be a genetic disorder linked to sex.

Adult↗
PubMedDate not supplied

[Aneurysm of the pulmonary artery. Analysis of 7 cases].

Aneurysms of the pulmonary artery are very rare, very few have been reported in medical literature. It is the purpose of this paper to present and discuss 7 cases. The etiology was congenital in 2, syphilitic in 2, cystic medionecrosis in 1, and mycotic in 2. The diagnosis was confirmed by necropsis in 3, and by angiography in 4. The basic clinical aspects are hemoptysis, pulmonary ejective murmur, and the radiological findings. The evolution depends on the etiology. The mycotic aneurysms ruptured and the patient with cystic medionecrosis died in heart failure. One of the syphilitic aneurysms died from an unrelated cause, and the others are alive and asymptomatic. The medical treatment is determined by the etiology.

Adolescent↗
PubMedDate not supplied

[Hemodynamic effects of various doses of a new inotropic: amrinoma].

The hemodinamic effects of Amrinone, bipiridine derivate with positive inotropic effects in animals, were studied on eight patients under right and left heart catheterization. The cardiac index, stroke volume, dP/dt and stroke work index were increased; the pulmonary pressure and the left ventricle end diastolic pressure were decreased all with statistical significant values. There were no changes in mean aortic pressure. These effects are mainly due to an increase in contractility and, partially, to vasodilation and tachycardia. The intrinsic mechanism of action of this compound is not known. Its place in cardiac therapy must be established with additional clinical investigations.

Adult↗
PubMedDate not supplied

[The long-term follow-up of 1000 patients with a valve replacement by the prosthesis of the Instituto Nacional de Cardiología Ignacio Chávez].

The long-term follow-up of patients with bioprosthetic valves manufactured at the Instituto Nacional de Cardiología Ignacio Chávez is presented. From February 1983 to May 1990, 1068 patients were operated and 1252 valves were replaced. Eighty two percent had rheumatic heart disease with one or more injured valves. In 17% it was a replacement of a failing valve. Seventy three percent of the patients had a low or medium-low socioeconomical status. There were 176 perioperative deaths in the first month after the operation and 150 patients were lost to follow-up. The rest (740) are the subject of this report. Mortality associated with valve related complications had a probability of 0.74 +/- 0.05, it had a significative increase after month 70th, with a 88% survival at that time. The functional class in the whole group improved 90%, with confidence limits for binomial distribution between 85 and 97%. There was also a significant reduction in heart enlargement. There were 161 prosthesis dysfunctions due to valve calcification or rupture, 50 were replaced. Twenty-three patients had hemolysis, and 19 infective endocarditis. There were 6.5% with systemic embolism in spite that only one half of those in which there was an indication, different of the valve replacement, received anticoagulant medication. The use of this prosthesis is on economical and medical satisfactory solution for the problem of a great number of our population of patients.

Academies and Institutes↗
PubMedDate not supplied

[Short and long term hemodynamic effects of amiodarone in patients with hypertrophic obstructive myocardiopathy. Combined evaluation using invasive and noninvasive methods].

Amiodarone is an antiarrhythmic drug with negative inotropic effect; therefore an study of hemodynamic effects of this drug in obstructive hypertrophic cardiomyopathy was performed. Seven consecutive patients with hypertrophic cardiomyopathy were studied prospectively. Intraventricular pressure gradient was determined at rest and during the Valsalva manoeuver during left heart catheterization; traces were obtained before (control) and at 10, 20 and 40 minutes after amiodarone, 10 mg/kg of body weight, was given IV. Simultaneously a mode M echocardiogram and carotid pulse were registered, Internal diameters, ejection time, percentual shortening, systolic anterior motion of the mitral valve, and mesosystolic aortic closure were measured. Afterwards oral amiodarone was administered to the same patients for 3 months. In this chronic phase the same phono-echocardiographic parameters and isovolumetric relaxation time were measured at 6 and 12 weeks. Parenteral administration of amiodarone reduced intraventricular gradient from 48.3 to 6.2, 8.7, and 1.3 mmHg. at 10, 20 and 40 minutes (p less than 0.001); mean pressure with Valsalva decreased from 78 to 19.6, 20.4, and 22.5 mmHg. (p less than 0.001). In four patients there was a reduction of left ventricular end diastolic pressure, Ejection time percent shortening and aortic closure intensity were reduced, systolic diameter and the distance septum, forward movement increased. The maximal effect was found 40 minutes after the injection of amiodarone. In the chronic phase the negative inotropic effect returns to near control values, but there is an increase in ventricular volumes with a significant shortening of the isovolumetric relaxation time. Amiodarone IV, decreases the intraventricular gradient in obstructive hypertrophic cardiomyopathy probably by a negative inotropic influence. This action almost disappears with oral amiodarone but there is a notorious improvement of left ventricular compliance.

Adult↗
PubMedDate not supplied

[Rupture of the interventricular septum in acute myocardial infarct].

Ventricular septal rupture in patients with acute myocardial infarction is not a common complication. It was found in 20 patients of 4298 admitted to the coronary care unit of the Instituto Nacional de Cardiología Ignacio Chávez from January 1980 to March 1991. The diagnosis was made by right heart catheterization if 85%, by echocardiography in 35% and by postmortem study in 15% of the patients. Mortality was 70%. In all patients the functional class worsened after the rupture, from class I to III or IV. There were not significant differences in mortality in relation to risk factors, or hemodynamic findings. Mortality was higher in older patients, females and patients with anterior myocardial infarction. Angiographic studies did not increase mortality and are necessary to establish an early surgical treatment.

Age Factors↗
PubMedDate not supplied

[Frustration and body image in children with and without congenital cardiopathy].

The aim of the present study was to determine the existence of differences on the type of response to frustration and disintegration of body image among children with congenital heart diseases (hospitalized and out patients) with or without symptomatology and children without heart disease. The study was performed in the outpatient clinic and the pediatric cardiology ward of the Instituto Nacional de Cardiología "Ignacio Chávez". Two tests were used: The Rosenzweig picture frustration test for children (PFT) and the human figure drawing (HFD) of Elizabeth Koppitz. No differences were found regarding the type of response to frustration, differences between groups were present in only two emotional items of the HFD. We conclude that children with congenital heart disease have special capabilities that enable them to respond to illness in adaptative ways.

Analysis of Variance↗