[Echocardiographic study of the R-on-T phenomenon (R-on-T echo and phenomenon)].
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Biomedical subjects
Publications and source records attributed to S Mondillo.
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A case of left ventricular myxoma diagnosed by echocardiography and successfully removed by left ventriculotomy is reported. This is a 21 year old male, with the few symptoms which simulating an hypertrophic cardiomyopathy in contrast to the large size of the tumour. It is possible that myxomas are responsible for sudden death. Therefore, in presence of new cardiac signs kind and relevance, the possibility of a myxoma should be considered. The diagnosis can be easily ruled out (or confirmed) by echocardiography, which represents a valuable tool in the diagnosis of myxomas.
We report a case of left ventricular myxoma in a 19-year-old man which presented as intermittent aortic valve obstruction. Echocardiography provided a comprehensive diagnosis, and excision through a left ventriculotomy was safely accomplished.
The anti-hypertensive action and tolerability of single daily doses of 80 mg nadolol, or 80 mg nadolol and 5 mg bendroflumethiazide were assessed in 30 subjects with mild or moderate hypertension. In both experiments a significant reduction in arterial pressure was observed, while no undesirable effects were noted. The association of nadolol and bendroflumethiaxide not merely proved to have a greater anti-hypertensive effect than treatment with the beta-blocking agent alone, but also led to the normalisation of blood pressure values in a higher percentage of hypertensive subjects than when nadolol alone was administered. This particular drug combination is thus the treatment of choice for most patients with hypertension. The fact that the beta-blocking agent and the diuretic can be administered in a single daily dose clearly enhances the patient's compliance with the prescribed treatment.
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By means of echocardiography, phonocardiography and jugular venous pulse recording, we have investigated 8 patients with atrio-ventricular conduction disturbances of various degrees: 4 with a first-degree AV block; 3 with complete heart block; 1 with type 1, 2nd degree AV block. The pattern of mitral valve motion at M-mode echocardiography suggests that the leaflets of the atrioventricular valves are definitively closed in diastole, only by the ventricular contraction. The simultaneous recording of echocardiogram and phonocardiogram in complete heart block seems to indicate that the increased intensity of the first heart sound is not always due to the increased velocity of valve closure, but also to the sudden vibration of the atrial floor, which is put under undue tension by the simultaneous atrial and ventricular contraction.
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In a study carried out on over 700 patients with three different manifestations of aterosclerosis (cerebrovascular, coronary and peripheral), we could not find any statistically significant difference between the total cholesterol and triglyceride concentration in these three groups. Also, there was o difference in cholesterol and triglyceride levels between these three groups and 200 normal subjects. The same held true when we compared a selected group of 76 patients with ischaemic heart disease who had no other risk factor, with a group of 80 control subjects. On the contrary, when we compared several fractions of serum lipoproteins and the ratios of apolipoprotein A to Apolipoprotein B, LDL Cholesterol to HDL Cholesterol, and total Cholesterol to HDL Cholesterol of the two groups, the differences were statistically significant. We conclude that when other risk factors are excluded, the protein component, rather than the lipid component of the plasma lipoproteins correlates the presence of coronary artery disease.
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