Disk embolism to left atrium. Dislodgment of disk of Beall prosthetic mitral valve into left atrium.
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Heart Valve Prosthesis↗
Biomedical subjects
S B Arvan
Publications and source records attributed to S B Arvan.
Diastolic intervals in cardiomyopathy and abnormal thyroid states: alterations in isovolumic relaxation time and rapid filling time of depressed and enhanced myocardial contractility.
Diastolic and systolic time intervals were measured in 11 control subjects, 11 patients with cardiomyopathy, 7 hyperthyroid patients, and 5 hypothyroid patients. The isovolumic relaxation time (IVRT), rapid filling time (RFT), preejection period (PEP), left ventricular ejection time (LVET), and PEP/LVET ratio were found by simultaneously recording the ECG, phonocardiogram, external carotid pulse, and apexcardiogram. In cardiomyopathy the IVRT and RFT were prolonged (107.4 +/- 21.1 msec [P less than 0.01] and 111.0 +/- 10.0 [P less than 0.01] respectively) in comparison to the control subjects. (In the controls the IVRT was 85.7 +/- 18.4 msec and the RFT was 94.5 +/- 12.8 msec). In altered thyroid states the RFT was most affected; in hypothyroidism it increased to 123.9 +/- 25.2 (P less than 0.01) and in hyperthyroidism it decreased to 71.5 +/- 21.3 msec (P less than 0.01). In hyperthyroid patients the IVRT, although shorter than in control subjects, was not significantly altered, but it showed a significant increase after treatment. The RFT also returned toward normal after therapy in both groups (116.7 +/- 14.6 msec in hypothyroid patients and 89.0 +/- 23.1 msec in those with hyperthyroidism).
Adolescent↗
Systolic time intervals in the syndrome of midsystolic click and late systolic murmur.
Left ventricular function, as measured by systolic time intervals, was studied in 30 subjects with the syndrome of midsystolic click and late systolic murmur (ages, 20 to 53 years; mean, 34 +/- 9 years). Twenty-one were asymptomatic, six had chest pain, two had palpitations, one had shortness of breath, and one had hypotensive episodes. Each patient had the typical auscultatory and echocardiographic findings of the syndrome of midsystolic click and late systolic murmur. In the study the values for the interval between the onset of the QRS complex (Q) and the aortic component of the second heart sound (A2) (377 +/- 42 msec), the Q-A2 index (532 +/- 39 msec), the preejection period (PEP) (97 +/- 17 MSEC), THE PEP index (127 +/- 16 msec), the left ventricular ejection time index (403 +/- 26 msec) and the ratio of PEP to left ventricular ejection time (0.35 +/- 0.01) were not significantly different from the values in 17 controls matched for age. Out study, then, supports the contention that left ventricular function remains well preserved in most patients with the syndrome of midsystolic click and late systolic murmur.
Adult↗
Exercise testing in young asymptomatic diabetic patients.
The cardiovascular response to submaximal bicycle exercise was studied in a group of 19 asymptomatic diabetic patients aged 18 to 39, including 11 males and 8 females and 18 control subjects (9 males and 9 females, aged 20 to 34 years). The maximum heart rate achieved by the control subjects (group I), 175.9 +/- 8.9 beats/min, was greater than that achieved by the diabetic patients (group II), 159.4 +/- 17.8 beats/min, (P less than 0.01). The work load at which the maximum heart rate was reached was lower in diabetic males, 681 +/- 155.4 kg m/min, than in healthy males, 866.7 +/- 139.9 kg m/min, (P less than 0.02). Although systolic blood pressure elevations were comparable during exercise and the postexercise period, the increase in diastolic blood pressure during exercise in the diabetic patients was greater than in control subjects (P less than 0.001). This difference, however, was only observed in the males and not in the females. The difference in diastolic blood pressure was again noted between the groups in the postexercise period; that of group II was higher than that of group I (P less than 0.01). This was particularly notable in the older diabetics (aged 31 to 40 years). One patient in group II developed ischemic ST segment changes, and 1 subject in each group was found to have J junction depression of 1.0 mm or more. The implications of these findings are discussed in relation to the possible pathophysiology of the diabetic patients.
Adult↗