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S Vythilingum

Publications and source records attributed to S Vythilingum.

25 records · Page 2Linked to original sources
PubMed1984

Pulsatile hepatomegaly in constrictive pericarditis.

In a study of 30 consecutive patients with constrictive pericarditis diagnosed by clinical, radiological, and echocardiographic criteria 21 (70%) were found to have pulsatile hepatomegaly. The pulsations were felt clinically and confirmed by external hepatic recordings. These pulsations conformed almost identically to the jugular venous pulsations in the neck. The hepatic pulsations disappeared after successful pericardiectomy. Persistence of the hepatic pulsations was associated with poor postoperative relief suggesting that it is another useful sign in the assessment of the adequacy of pericardiectomy. Thus this poorly appreciated clinical finding appears to be present in a high proportion of patients with constrictive pericarditis.

Adult↗
PubMed1983

Abnormal glucose tolerance and lipid abnormalities in Indian myocardial infarct survivors.

Glucose tolerance and lipid levels in a random sample of 103 Indian patients (96 males and 7 females) with coronary artery disease (CAD) aged between 20 and 55 years were compared with those in a healthy Indian control group matched as regards age and sex. Previous episodes of myocardial infarction were taken as evidence of CAD. Of the patients 44% were overweight. Glucose tolerance was abnormal in 55% of the patients. Both cholesterol and triglyceride values in the patients with CAD were significantly higher than those in the control group. Serum cholesterol levels were over 6,5 mmol/l in 62% of the patients with CAD and serum triglyceride levels were over 2,0 mmol/l in .53%. Males with CAD tended to have lower plasma high-density lipoprotein (HDL) cholesterol levels than the control group (P less than 0,01). There was a significant negative correlation between body mass index and HDL cholesterol, and no correlation was demonstrated between body mass index and total cholesterol or triglyceride levels. Furthermore, when the patients were sub-grouped according to their glucose tolerances it was found that only the triglyceride levels were significantly different (values were higher in those with abnormal glucose tolerance). Our data suggest that abnormal glucose tolerance and lipid aberrations are significant risk factors in Indian patients with CAD.

Adult↗
PubMed1981

Valve replacement in active infective endocarditis.

To assess the role of emergency valve replacement in patients with active infective endocarditis (IE), we reviewed 30 patients who underwent valve replacement within 3 months of the diagnosis of IE. Eighteen patients fulfilling the criteria for active IE underwent emergency surgery. The aortic valve was involved in all cases and was previously thought to be normal in 12 (67%). There were 5 early deaths (27,7%), 4 due to circulatory failure and 1 due to rupture of a mycotic cerebral aneurysm. Prosthetic valve dehiscence (paravalvular leak) developed in only 1 patient, and prosthetic valve endocarditis did not occur. The results confirm the place of early valve replacement in otherwise moribund patients with IE. We recommend immediate valve replacement for active IE in the presence of: (i) progressive haemodynamic deterioration; (ii) failure to obtain early control of infection; (iii) significant emboli; and (iv) conduction disturbances.

Adult↗
PubMed1981

Problems encountered during insertion of permanent endocardial pacing electrode.

Case reports of two potential problems arising during permanent endocardial pacemaker electrode insertion are described. They are cannulation of a persistent left-sided superior vena cava, and unsuspected subclavian vein thrombosis. A left-sided superior vena cava may be recognized clinically and avoided; but, if necessary, it can be employed as a route to the right ventricular endocardium. Subclavian vein thrombosis appears to be a complication of previous cephalic vein pacemaker insertion and prohibits further access on the implanted side. It may present with a painful, swollen arm or with the symptoms of multiple pulmonary emboli; occasionally it is not clinically suspected unless abnormal venous distension is sought.

Aged↗
PubMed1980

Insertion of permanent endocardial pacing electrodes via the infraclavicular subclavian vein.

A technique of insertion of permanent endocardial pacing electrodes via the infraclavicular subclavian vein is described. Twenty-eight electrodes have been inserted without a displacement or any of the recognized complications occurring. The method is quicker and more reliable than more conventional approaches. We feel the low displacement rate is the result of the relatively proximal catheter fixation to the fascia pectoralis and the use of tined electrodes.

Electrodes↗
PubMedDate not supplied

Sex hormone levels in young Indian patients with myocardial infarction.

The finding of abnormal levels of sex hormones in men with coronary artery disease has led to the hypothesis that alterations in sex hormones may represent an important risk factor for myocardial infarction. In this study, the sex hormone profile of 28 young men (aged less than 40 years) with myocardial infarction was compared with 28 age- and weight-matched normal men. Although the mean total serum estradiol levels and the free estradiol index of the patients and controls were similar, the mean serum total testosterone level and the free testosterone index were significantly lowered in the patients with myocardial infarction (p less than 0.01). The ratio of serum estradiol to testosterone was significantly increased in the patients (p = 0.0005) and correlated with serum cholesterol, triglycerides, and plasma glucose. A significant inverse correlation was also demonstrated between total testosterone and serum cholesterol and triglycerides. Hence, the results of this study support the hypothesis that low plasma testosterone and an increased estradiol-to-testosterone ratio may be important risk factors for myocardial infarction.

Adult↗