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Biomedical subjects

S F Seides

Publications and source records attributed to S F Seides.

13 recordsLinked to original sources
PubMed1979

Congenital cardiac abnormalities in monozygotic twins. Report and review of the literature.

A pair of monozygotic twin girls is reported with concordance for 3 congenital cardiac abnormalities: (1) secundum atrial septal defect, (2) aneurysm of the membraneous ventricular septum, and (3) electrocardiographic frontal plane left axis deviation. A review of the published materials shows a 9.5 per cent incidence of concordance for congenital heart disease among monozygotic twins. In those in whom a precise cardiological diagnosis was made, 15/16 pairs (95%) were concordant for a specific defect, 2 had an additional defect, and only 1 pair had completely dissimilar defects. Concordance for congenital heart disease in monozygotic twins is uncommon, but when it occurs the defects will most often be identical.

Child↗
PubMed1979

Prevalence of arrhythmias during 24-hour electrocardiographic monitoring and exercise testing in patients with obstructive and nonobstructive hypertrophic cardiomyopathy.

Many patients with hypertrophic cardiomyopathy die suddenly and unexpectedly, a significant number perhaps due to arrhythmia. Of 100 patients initially evaluated for signs or symptoms suggestive of heart disease or a family history of hypertrophic cardiomyopathy, 51 were selected solely because they met the echocardiographic criteria for the disease, and 49 patients were selected primarily because they had: 1) normal sinus rhythm despite left atrial enlargement, 2) a history of syncope, 3) a family history of premature death, or 4) a history of paroxysmal atrial fibrillation. All 100 patients were studied by 24-hour ambulatory electrocardiographic monitoring and 74 of them also underwent treadmill exercise testing. More than 50% of patients in repetitive ventricular premature depolarizations, including 19% who had ventricular tachycardia. Monitoring was superior to exercise testing for exposing these arrhythmias. Two patients experienced cardiac arrest within 2 months of monitoring; in each, monitoring had revealed ventricular tachycardia. Two patients with paroxysms of supraventricular tachycardia during monitoring developed fixed atrial fibrillation within 1 year. These preliminary observations suggest that monitoring may help identify patients at increased risk for significant arrhythmic events.

Adolescent↗
PubMed1979

Effect of septal myotomy and myectomy on left ventricular systolic function at rest and during exercise in patients with IHSS.

Patients with idiopathic hypertrophic subaortic stenosis (IHSS) have supernormal left ventricular systolic function at rest. Septal myotomy/myectomy reduces outflow obstruction and symptoms. However, it has been proposed that operation causes myocardial damage, with consequent reduction in left ventricular function and potentially deleterious long-term consequences, despite relief of symptoms. To evaluate the effect of myotomy and mylectomy on left ventricular function, we employed noninvasive radionuclide cineangiography at rest and during maximal exercise in21 consecutive patients with IHSS, before and 6 months after operation. In 30 normal subjects, the ejection fraction (EF) was 57 +/- 2% at rest and 71 +/- 2% during exercise. Before operation in patients with IHSS, the EF was supernormal at rest (76 +/- 2%, p less than 0.001), and normal during exercise (71 +/- 3%, NS). All patients improved from NYHA functional class III-IV preoperatively to class I-II postoperatively; the maximal provocable gradient invariably diminished (average, 100 +/- , mm Hg preop, 33 +/- 9 mm Hg postop, p less than 0.001). Postoperatively, the EF at rest was 67 +/- 2%, still supernormal, but less than that noted preoperatively (p less than 0.001). During exercise, the EF was 66 +/- 4%, only mildly diminished (p less than 0.01) from that preoperatively. We conclude that muscle resection during myotomy and myectomy usually does not cause any important impairment of global left ventricular function at rest or during exercise stress.

Adolescent↗
PubMed1979

Verapamil therapy: a new approach to the pharmacologic treatment of hypertrophic cardiomyopathy. I. Hemodynamic effects.

The hemodynamic effects of intravenous verapamil administration were examined in 27 patients with hypertrophic cardiomyopathy. Increasing doses of verapamil produced small increases in heart rate and cardiac output and a significant decrease in systolic blood pressure, but had no significance effect on mean pulmonary artery wedge pressure or left ventricular end-diastolic pressure. The highest dose of verapamil increased heart rate from 72 +/- 3 to 81 +/- 6 beats/min and reduced systolic blood pressure from 118 +/- 8 to 99 +/- 5 mm Hg (p less than 0.005). This dose decreased the basal left ventricular outflow tract gradient from 94 +/- 14 to 49 +/- 14 mm Hg and the average left ventricular outflow tract gradient during the Valsalva maneuver from 76 +/- 5 to 63 +/- 13 mm Hg, during amyl nitrite inhalation from 69 +/- 15 to 39 +/- 13 mm Hg, and during isoproterenol infusion from 108 +/- 29 to 70 +/- 21 mm Hg (p less than 0.01). These results indicate that verapamil can significantly decrease left ventricular outflow obstruction in patients with hypertrophic cardiomyopathy and thus may provide an important new therapeutic agent in the treatment of this disorder.

Adult↗
PubMed1978

Long-term anatomic fate of coronary-artery bypass grafts and functional status of patients five years after operation.

To assess long-term results, coronary and graft angiography was performed 53 to 84 months after operation in 22 of 30 consecutive patients who had undergone coronary-artery bypass grafting before 1973, and who had at least one graft patent at an early (three to nine months) postoperative study. Of the 33 grafts, 31 were patent at late study. All patients had severe symptoms before operation. Of 16 who became asymptomatic early after operation, angina pectoris later redeveloped in 11. Progression of disease in ungrafted vessels accounted for symptomatic deterioration in nine of these 11 patients. We conclude that most grafts patent several months after operation remain so for at least 4 1/2 years, and that although most patients improve symptomatically after operation, symptomatic deterioration is common in the succeeding years and is most often due to progression of disease in ungrafted vessels.

Angina Pectoris↗
PubMed1978

Exercise-induced left ventricular dysfunction in symptomatic and asymptomatic patients with aortic regurgitation: assessment with radionuclide cineangiography.

In patients with aortic regurgitation,, left ventricular dysfunction at rest, which is associated with a poor long-term prognosis, often develops before severe symptoms. To determine whether evidence of left ventricular dysfunction could be detected before it appeared at rest, 43 patients with severe aortic regurgitation were studied using radionuclide cineangiography during exercise. In 30 normal subjects, left ventricular ejection fraction increased during exercise (57 +/- 1 percent [mean +/- standard error] at rest, 71 +/- 2 percent during exercise, P less than 0.001). In contrast, among 21 symptomatic patients, ejection fraction was normal at rest in 14 patients (average 47 +/- 2 percent) but normal during exercise in only one patient (average 38 +/- 2 percent, P less than 0.001). Ejection fraction was normal at rest in 21 of 22 asymptomatic patients (average 62 +/- 2 percent) but was normal during exercise in only 13 (average 57 +/- 3 percent, P less than 0.001). Thus, exericse-induced left ventricular dysfunction can precede symptoms and dysfunction at rest. Radionuclide assessment of left ventricular function during exercise may prove valuable in sequentially following the state of left ventricular function in patients before the onset of symptoms or of irreversible left ventricular failure.

Adolescent↗
PubMed1978

Electrocardiographic findings in patients with obstructive and nonobstructive hypertrophic cardiomyopathy.

One hundred and thiry-four patients with hypertrophic cardiomyopathy were evaluated by standard 12-lead electrocardiography. Normal electrocardiograms were extremely uncommon, occurring in less than 7% of each subgroup of patients (i.e., those with or without either symptoms or obstruction to left ventricular outflow), with the exception of those who were both asymptomatic and had no left ventricular outflow obstruction. Even in this subgroup, however, normal electrocardiograms occurred in only 27% of patients. Repolarization abnormalities and left ventricular hypertrophy were the most common abnormalities, occurring in 81% and 62%, respectively, of the total population. A broad spectrum of other electrocardiographic abnormalities was found, but none was unique to hypertrophic cardiomyopathy. Patients with vs those without electrocardiographic left ventricular hypertrophy or left atrial abnormality had significantly (P less than 0.005) greater mean ventricular septal thickness (22 +/- 0.6 vs 19 +/- 0.6 mm) and left atrial dimension (48 +/- 1 vs 40 +/- 1 mm) measured by echocardiography, and signficantly (P less than 0.01) higher mean pulmonary capillary wedge pressure (16 +/- 1 vs 10 +/- 1 mm Hg) and left ventricular end-diastolic pressure (20 +/- 1 vs 15 +/- 1 mm Hg). The high prevalence and diverse nature of electrocardiographic abnormalities suggest that any patient with an unusual and unexplained electrocardiogram should be suspected of having hypertrophic cardiomyopathy even if the physical examination is normal, as is often the case in patients without obstruction.

Cardiomyopathy, Hypertrophic↗
PubMed1976

Wolff-Parkinson-White syndrome with 1:2 atrioventricular conduction.

The QRS complex of the Wolff-Parkinson-White syndrome is thought to represent a fusion beat resulting from conduction over the normal pathway and an anomalous pathway. This report demonstrates utilization of both of these pathways resulting in two ventricular responses from a single supraventricular impulse. The presence of "1:2" atrioventricular conduction in this case firmly supports the fusion beat theory of the Wolff-Parkinson-White syndrome.

Adult↗
PubMed1975

Sinus node re-entrant tachycardia in man.

Sinus node re-entry (SNR) usually appears as a single beat. Tachycardias (SNRT) consistent with sustained SNR were seen in six patients and were initiated by premature stimulation of the high right atrium (six patients) and coronary sinus (four patients), and after continuous pacing from the high right atrium (four patients) or right ventricle (one patient) at rates of 130 to 200 per minute. During SNRT: (1) atrial beats exhibited a high-to-low atrial activation sequence, (2) the P-waves were similar in morphology to P-waves during sinus rhythm, and (3) re-entry in the A-V node or at the site of stimulation could be excluded. The cycle length of SNRT ranged from 625 to 320 msec. and SNRT either terminated spontaneously (six patients) or after premature atrial capture and/or vagal maneuvers (two patients). The electrophysiologic characteristics of SNRT and differentiation of SNRT from A-V nodal re-entry are discussed.

Aged↗
PubMed1975

Echocardiographic findings in isolated, surgically created tricuspid insufficiency.

The effects of surgically created tricuspid insufficiency on the right ventricular dimension and the motion of the interventricular septum were determined by serial echocardiography in a patient with a hemodynamically normal heart who underwent tricuspid valvulectomy and later tricuspid valve replacement for medically intractable bacterial endocarditis. Initially, both the right ventricular dimension (1.8 cm) and motion of the interventricular septum were normal. After valvulectomy interventricular septal motion became distinctly paradoxical (pattern A, later pattern B), and the right ventricular dimension progressively increased to 3.5 cm. After successful tricuspid valve replacement interventricular septal motion promptly returned toward normal as did the right ventricular dimension (2.2 cm). The rapid changes in these echocardiographic variables with creation and relief of acute right ventricular volume overload correspond well with results of previous work in experimental animals but differ from findings in man with chronic right ventricular volume overload.

Adult↗
PubMed1975

Echocardiographic findings of ventricular septal rupture in acute myocardial infarction.

Echocardiograms were recorded both before and after the clinical appearance of an autopsy-confirmed interventricular septal rupture in a patient with an acute myocardial infarction. The major findings were related to the upper portion of the interventricular septum. Before rupture, this portion of the septum was relatively akinetic with a slight anterior motion during systole, whereas after rupture there was a marked increase in the amplitude of septal motion with abrupt posterior motion occurring with the onset of ventricular diastole.

Acute Disease↗
PubMed1975

Propranolol-induced urticaria: successful therapy with tolamolol.

Urticaria with systemic effects occurred in a patient being treated with propranolol and was reproducible upon rechallenge with the drug; Successful beta-adrenergic blocking therapy was achieved using a new agent, tolamolol, with no evidence of any adverse effects.

Female↗