PubMed Health⌕ Search

Biomedical subjects

R Vilhelmsen

Publications and source records attributed to R Vilhelmsen.

15 recordsLinked to original sources
PubMed1989

[Radiographic examination of the thorax, fluoroscopy and echocardiography in cardiac calcification].

The value of radiographic examination of the thorax, fluoroscopy and echocardiography in demonstration and localization of intracardiac calcifications were compared in an investigation of 40 patients with valvular heart disease prior to planned cardiac catheterization or operation. Radiographic examination of the thorax revealed only the most severe calcifications. By means of echocardiography it proved possible to undertake a simple semi-quantitative characterisation of the calcified tissue with acceptable intra- and inter-observer variation. Echocardiography and fluoroscopy were found to be of equal value in demonstration of the degree of calcification of the heart. Echocardiography was, however, superior to fluoroscopy in fine localization of the calcifications. The relative and additive values of the methods could be illustrated employing Bayes' theorem and could be represented graphically provided that the observations carried out with the three methods could be considered independent of one another. It is concluded that radiographic examinations of the thorax is unsuitable for screening for cardiac calcifications. Fluoroscopy can no longer be considered to be the method of choice in assessing lesions of this type but should be employed in cases where echocardiography does not provide sufficient information or is not available. The greatest certainty in demonstration of calcifications is obtained with combined employment of fluoroscopy and echocardiography.

Adult↗
PubMed1988

Atrial natriuretic peptide in atrial fibrillation before and after electrical cardioversion therapy.

In eight patients with atrial fibrillation of less than 3 months duration and without congestive heart failure the plasma concentration of atrial natriuretic peptide was determined one day before, the day after and again 30 days after electrical cardioversion therapy. The pretreatment plasma concentration of the peptide was 99 pg mg-1 (23-480, median and range). The day after cardioversion to sinus rhythm the peptide concentration had normalized to 36 pg ml-1 (18-151). The plasma concentration of atrial natriuretic peptide remained stable in all but one patient for a period of 30 days (46 pg ml-1, 16-695) (P = 0.03). In conclusion, the plasma concentration of atrial natriuretic peptide in patients with atrial fibrillation was significantly reduced after electrical cardioversion to sinus rhythm and remained stable for a period of 30 days.

Adult↗
PubMed1983

Non-pharmacological provocation of coronary vasospasm. Experience with prolonged hyperventilation in the coronary care unit.

Results are reported of prolonged hyperventilation as a provocation test in a consecutive series of six patients with a clinical diagnosis of Prinzmetal's variant angina (PVA) and a control series of eight patients. All the patients with PVA responded to the hyperventilation test (HVT) with significant ST deviation (five with elevation, one with depression) and typical anginal pain. None of the eight patients in the control series were positive responders. Sustained attacks of serious arrhythmias were recorded in one patient with PVA. Sensitivity to HVT showed circadian variations; the tests were positive only in the early morning at the time of the reported spontaneous attacks. Beta blockade changed a negative HVT response to a positive one in one case. Treatment with calcium channel blockers suppressed the positive response in all patients. After cessation of long-term treatment with calcium channel blockers, HVT suggested spontaneous remission in spasm tendency in three out of four patients with PVA from a previous series of 12 patients. It is concluded that HVT as a non-pharmacological provocation test may prove an effective and comparatively safe procedure with potential for controlling the efficacy of drug treatment and confirming spontaneous remission of vasospastic disease. Optimal facilities for resuscitation should be at hand during the test due to risk of provoking life-threatening arrhythmias.

Adult↗
PubMed1982

Development of aortic stenosis in a patient with formerly pure aortic incompetence.

A 42 year old man with severe aortic incompetence and hypertension, but no aortic stenosis, responded so well to medical treatment that the planned operative treatment was postponed. 8 years later he was re-admitted with severe aortic stenosis and only minimal aortic incompetence. It is concluded, that a short trail of medical treatment may be warranted even in patients with severe aortic incompetence, before surgery is performed, especially if the patient is hypertensive.

Adult↗
PubMed1981

Prinzmetal's variant angina.

A series of 12 consecutive patients with Prinzmetal's variant angina is presented. There was a preponderance of males (eight/12) and individuals less than 60 years of age (nine/12). Delay in diagnosis was frequent, primarily due to difficulty in achieving a proper 12 lead ECG recording of the attack which often occurred late at night or in the early morning, subsiding within minutes. In some cases, moreover, ST-depression was observed in the ECG monitoring lead as a reciprocal manifestation of subepicardial ischaemia or due to incorrect polarity in the monitoring lead. The incidence of serious arrhythmias, AV-block and ventricular tachycardia was high (eight/12); two patients had to be DC-converted. Coronary arteriography revealed a spectrum from normal or nearly normal coronary arteries to single vessel disease. Nitroglycerin was well suited for treatment of acute attacks. Long-term treatment with calcium antagonists was effective and without serious side-effects. The follow-up time was from 8 months to 5 years (mean 2 years). It is concluded that Prinzmetal's variant angina as such is a rare disease, but that coronary artery spasm is most likely an important contributory factor in the clinical manifestations of coronary artery disease: arrhythmias, sudden death and myocardial infarction.

Aged↗
PubMed1981

Prinzmetal's variant angina)(PVA). Circadian variation in response to hyperventilation.

The study reports on the outcome of hyperventilation tests in a 57-year-old male with Prinzmetal's variant angina, formerly often complicated by ventricular fibrillation. It was found that hyperventilation for a period of 6 min after a delay of 4 to 6 min was followed by the development of ST-elevation and pain, but only when the test was performed in the morning, whereas the outcome of tests performed later in the day were negative. Pretreatment with calcium blockers, nifedipine or verapamil proved effective in preventing the anginal response to the test, also when it was performed in the morning. It is concluded that hyperventilation performed in the early morning, but not later in the day, may prove to be an effective and safe procedure for provoking Prinzmetal's variant angina, and that hyperventilation may be useful in the evaluation of the efficacy of drug therapy.

Angina Pectoris↗
PubMed1980

Infradiaphragmatic arteriosclerosis in the 5th decade: an angiographic comparison between sexes.

Ninety consecutive arteriographies performed on patients in the age group 40-50 years (45 men and 45 women) because of signs and symptoms of peripheral vascular disease were analyzed for severity and distribution of obliterative or occluding arterial lesions. A marked difference in the arteriosclerotic pattern was found between the two sexes. Women presented with aortoiliac changes and slight peripheral changes, while men more frequently had severe peripheral changes and few severe aortic changes. In 22 premenopausal and 23 postmenopausal women there was no difference in the localization or degree of the arteriosclerotic changes. It was not possible to draw conclusions from gynecological-obstetrical information. In this study all but six patients were smokers, but no differences in the extent of arteriosclerotic changes were observed between the heavy smokers and the other patients.

Adult↗
PubMedDate not supplied

Blood and tissue silicone in extracorporeal circulation.

A new method for the determination of blood and tissue contents of silicone by atomic absorption spectrophotometry is described. Silicone was found in the blood, probably as droplets, in each of 14 patients undergoing open-heart surgery with the aid of a bubble oxygenator. In five fatal cases the brains and kidneys contained silicone. Although the clinical significance of the silicone embolization is unclear precautions should be taken to reduce the release of silicone from the extracorporealoxygenating devices.

Aged↗
PubMedDate not supplied

Continuous suture technique in prosthetic aortic valve replacement.

Among 80 patients having aortic valve replacement using a continuous suture technique the occurrence of periprosthetic leak was 8.8%. There is a statistically significant difference in the occurrence of the periprosthetic leak in patients having pure stenosis (o) of combined stenosis and insufficiency, and patients having pure insufficiency (26%). Continuous suture technique reduces cross clamp time and by-pass time significantly but should be used routinely only in stenotic lesions. In pure insufficiency the method of suture should be considered separately in each case. Interrupted suture technique should be used if one or more of the known factors predisposing to perivalvular leak are present.

Bioprosthesis↗