[Detection using scintigraphy with monoclonal anti-myosin in recurring myocarditis treated with cyclosporin A in a heart transplant candidate].
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Biomedical subjects
Publications and source records attributed to M Cladellas.
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Paradoxical septal motion of the interventricular septum and right ventricular enlargement constitute diagnostic features of right ventricular volume overload. A diastolic septal displacement toward the left ventricle and its systolic normalization explain this phenomenon. A thick septum would, theoretically, impede such movement. One patient with a cardiac allograft and gross tricuspid regurgitation is described who, in the context of a rejection episode and in a very short interval, showed two septal motion patterns related to two different septal thicknesses. It is concluded that in a patient with large right ventricular dimension and increased septal thickness, lack of paradoxical septal motion does not rule out severe right ventricular volume overload.
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The ECG phenomena in 20 outpatients (121 episodes) suffering from variant angina with transient ST segment elevation greater than 1.5 mm. (Prinzmetal angina) were studied by Holter monitoring. The most important changes in the ECG morphology were: a) increased height of the R wave in all cases, b) the S wave decreased or disappeared, c) the ST segment elevation varied from 1.5 to 38 mm, d) the TQ interval was ascending in 78 episodes, e) there was a double alternance of ST-TQ in 20 episodes and f) the first modification of the ECG was an increase of the T wave height. Arrhythmias were seen in 19 patients (44 episodes). The most frequent were premature ventricular contractions. The prevalence and importance of the ventricular arrhythmias were statistically related to the duration of the episodes (p less than 0.005), the degree of the ST segment elevation (p less than 0.005), the presence of ST-TQ alternance (p less than 0.005) and the presence of increased R wave greater than 25% (p less than 0.025).
A patient with severe isolated right-sided cardiac failure of unknown origin is presented in whom three right ventricular endomyocardial biopsies obtained in different bioptome positions disclosed a yellowish material which was confirmed at histological examination as fat. At operation, a complete replacement of atrial and ventricular myocardium by fat was noted. this previously unreported use of endomyocardial biopsy is emphasized, especially when the differential diagnosis of isolated right-sided heart failure is considered.
A case is described of a 50 year-old man with an acute prosthetic dysfunction due to valve thrombosis and cardiogenic shock, on a prosthesis in the mitral position (Bjork-Shiley). The patient was promptly treated with a streptokinase in two infusions 1.5 x 10(6) UI over 180 and 90 minutes, respectively. Early clinical, fluoroscopy and echocardiography improvement was observed. The authors comment the present role of the thrombolytic therapy in front of surgery of prosthetic valve thrombosis.
Pulmonary function studies were performed in 10 patients undergoing surgery for heart transplantation. The study was repeated 6 to 12 months after surgery. The comparison between data before and after transplantation showed an overall improvement in lung function indices, except for the lung diffusing capacity (DLCO). A mean 14% reduction (p less than 0.01) of DLCO was observed. In the absence of evidence of other lung disease or rejection reaction in these patients, this finding may be related to a side effect of cyclosporine on the lung and deserves further investigation.