PubMed Health⌕ Search

Biomedical subjects

M Y Flugelman

Publications and source records attributed to M Y Flugelman.

62 records · Page 4Linked to original sources
PubMed1983

Survival after sudden obstruction of the left main coronary artery.

Left main coronary artery (LMCA) stenosis occurs in 10% of patients undergoing coronary arteriography, but total occlusion is rare. Goldberg et al reported 6 cases of complete obstruction of the LMCA among 2,200 patients studied arteriographically. Sudden obstruction of the LMCA should be lethal, and we found no report describing survival with sudden obstruction of the LMCA. The present report describes such a patient.

Coronary Angiography↗
PubMed1983

Prediction of in-hospital ventricular fibrillation from admission data in acute myocardial infarction.

We studied retrospectively 26 readily obtainable clinical and electrocardiographic variables in 22 consecutive patients who experienced primary ventricular fibrillation in association with an episode of acute myocardial infarction. Twenty-eight consecutive patients who had an uncomplicated course after acute myocardial infarction served as controls. The clinical profile of the two groups was similar except that patients who had primary ventricular fibrillation smoked more and had a higher peak creatinine phosphokinase level at the time of infarction. The data was evaluated using univariate and stepwise logistic regression analysis. This analysis demonstrated that patients who developed primary ventricular fibrillation had, on admission (1) more evidence of congestive heart failure (Killip classification), (2) a lower diastolic blood pressure, (3) greater ST-segment elevation, (4) a longer QTc interval, and (5) a less distinguishable J point on the electrocardiogram. This method of logistic analysis that utilizes easily obtainable hospital admission data serves as a preliminary model for prediction of the relative risk of primary ventricular fibrillation in a patient with acute myocardial infarction. The ability to identify patients at risk has important therapeutic implications.

Aged↗
PubMed1983

Beta blockade in asymptomatic diabetics with abnormal rest electrocardiograms.

Diabetic patients without evidence of vascular disease often reveal non-specific ST-T changes and prolonged QTc intervals in their ECGs. In an attempt to elucidate the role of autonomic dysfunction in the etiology of these changes, we compared the ECGs and beat to beat variations in 22 patients with changes in repolarization before and one hour after beta blockade. None had clinical evidence of ischaemic heart disease or peripheral vascular disease. In 19 patients (86%) the ST-T changes persisted after beta blockade. Heart rate was 75.6 +/- 15.3/min before and 64.3 +/- 9.6/min after beta blockade, while the QTc interval was 0.43 +/- 0.02 sec before and 0.41 +/- 0.02 sec after propranolol. Beat to beat variation during deep breathing is diminished in diabetic patients. Beta blockade reversed this phenomena. We conclude that while beat to beat variations and prolongation of QTc are likely to be consequent to autonomic neuropathy, the ST-T changes do not appear to be due to increased sympathetic tone and their etiology is yet to be determined.

Adolescent↗
PubMed1983

Recurrent obstruction and thrombolysis of the right coronary artery.

A patient presented twice with the hyperacute phase of inferior wall myocardial infarction. Emergency coronary angiography was undertaken on each occasion and the occluded right coronary artery reopened by intracoronary thrombolysis using urokinase. The patient subsequently underwent successful percutaneous transluminal coronary angioplasty to dilate the underlying subtotal obstructive lesion in the proximal right coronary artery. The sequence of events in this patient demonstrates that (1) acute coronary thrombolysis can preserve ventricular myocardium, (2) recurrent thrombolysis can be performed successfully in the same artery in the same patient, and (3) coronary angioplasty may be an effective method of dilating the underlying coronary narrowing after coronary thrombolysis.

Adult↗
PubMed1982

Congenital prolongation of Q-T interval: a family study of three generations.

Three generations of a family with the Romano-Ward syndrome are described. Of all the affected members, only 1 was symptomatic, experiencing episodes of syncope proven to be due to polymorphous ventricular tachycardia (PMVT) induced by chlorimipramine treatment for depression. During treatment of an episode of PMVT with lidocaine, the patient developed the 'torsade de pointes' variant of ventricular tachycardia, which progressed to ventricular fibrillation and was successfully treated with electroversion. The hazards of treating these patients with commonly used drugs, the possible etiologies for the Romano-Ward syndrome and its mode of inheritance are discussed.

Aged↗