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R M Norris

Publications and source records attributed to R M Norris.

150 records · Page 9Linked to original sources
PubMedDate not supplied

Predictors of late hospital death in acute myocardial infarction.

Although death from ischemic heart disease occurs in the majority of cases within 24 hr of a new clinical event, study of patients selected by admission to hospital shows a mortality pattern in which most deaths from myocardial infarction happen after the first day. In one hospital, over the last 2 yr, 46% of deaths from infarction have happened from the fourth day onwards. Introduction of a coronary-care unit in this hospital has reduced hospital mortality in patients under 70 yr of age from approximately 21% in 1966-1967 to 13% in 1977-1979, mainly because of improved treatment of arrhythmias. With the decline of cardiac arrhythmias as a mode of dying in hospitals, mechanical complications of shock and cardiac failure now account for up to two-thirds of hospital deaths, with cardiac rupture probably next in importance, accounting for 15%-20% of deaths. Of these 3 mechanisms, death from cardiac failure is most likely to be "late" (from the fourth day onwards). Shock and cardiac failure are directly related to massive destruction of left ventricular myocardium. Therefore, major efforts aimed at reduction of late hospital mortality should be directed towards therapeutic measures, initiated very early after the onset of infarction, which might protect the threatened myocardial tissue and restrict infarct size.

Bundle-Branch Block↗
PubMedDate not supplied

Plasma propranolol concentration in patients with angina and acute myocardial infarction.

1. Plasma levels of propranolol were measured fluorometrically in patients with angina pectoris and in patients admitted to the Coronary Care Unit with acute myocardial infarction. 2. In thirty patients with stable angina pectoris, plasma propranolol levels varied almost linearly with doses between 10 and 120 mg during 6-hourly chronic oral administration. Plasma levels greater than 100 ng/ml produced 70-80% reduction in the tachycardia induced by strenous exercise on a treadmill. 3. In nineteen patients with acute myocardial infarction given oral propranolol, 20 mg 6-hourly, peak as well as trough plasma levels of the drug increased progressively but remained below 100 ng/ml in all except two patients during the first 24 h after their admission to the Coronary Care Unit. 4. The data suggest that the use of low and fixed doses of propranolol may not produce adequate plasma levels or significant beta-adrenoceptor blockade in the early stages of acute myocardial infarction in man.

Adult↗
PubMedDate not supplied

Changes in severity of myocardial infarction and three year survival rates after myocardial infarction in Auckland, 1966-7 and 1981-2.

Mortality from coronary heart disease has been declining steadily over the past 20 years in Auckland. The possibility that improved survival contributed to this decline was examined in patients who survived four weeks after myocardial infarction, changes in the severity of the disease being controlled for. Patients who had had myocardial infarction in 1966-7 (191 patients) or 1981-2 (203) were compared to determine whether three year survival rates had changed and the severity of the disease altered. With a coronary prognostic index taken as the measure of severity the 1981-2 group had significantly more severe myocardial infarctions than the 1966-7 group, but despite this the three year survival was significantly better (86% in the 1981-2 group v 75% in the 1966-7 group). These findings suggest that improved survival after myocardial infarction contributed to the decline in mortality.

Cardiomegaly↗