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Biomedical subjects

T R Daskalov

Publications and source records attributed to T R Daskalov.

11 recordsLinked to original sources
PubMed1989

A comparison of the haemodynamic effect of isosorbide-5-mononitrate and isosorbide dinitrate administered in intravenous injection to patients with acute myocardial infarction.

The haemodynamic effects of 10 mg of isosorbide-5-mononitrate (IS-5-MN) and 10 mg of isosorbide dinitrate (ISDN), administered in intravenous injection, were compared in 16 patients with acute myocardial infarction. The study, using the balloon thermodilution catheter, took 4 hours to complete. Both drugs produced a decrease in pulmonary and peripheral arterial pressure, cardiac index, stroke and stroke work indexes; the effect was present immediately after administration to reach a maximum 3-15 minutes later, after which the values gradually returned to baseline levels. While IS-5-MN resulted in an increase in peripheral arterial resistance, heart rate rose briefly following the administration of ISDN. After IS-5-MN, pulmonary diastolic pressure decreased by 15% and peripheral arterial pressure by 5%, and stroke work index by 12%; the magnitude of decrease was double following the administration of ISDN (30%, 15% and 23%, respectively). The decrease in cardiac and stroke indexes was likewise less pronounced after IS-5-MN than after ISDN, the difference, however, was not statistically significant. Duration of the haemodynamic effect of both drugs was about the same--approximately 3 hours.

Aged↗
PubMed1987

Application of a combination of sublingually administered vasodilating drugs for rapid action on pulmonary hypertension in patients with cardiac asthma and with pulmonary oedema.

Eight patients with pulmonary oedema and 6 patients with cardiac asthma (primary disease: in 7 patients acute myocardial infarction, in 6--hypertension, in 1--mitral defect) were given sublingually a combination of 0.5 mg nitroglycerin, 10 mg Isodinit (isosorbid dinitrate) and 4 mg Sidnofarm (molsidomine) in powder form. This resulted in a rapid, pronounced and protracted reduction of dyspnoea, pulmonary congestion, respiration rate, and heart rate in the course of a four-hour observation rate, in more than 80% of cases. In patients with high blood pressure it dropped by 27% vs. the initial level; in patients with hypotension the change was only minimal. Pulmonary diastolic pressure began to drop from the 3rd minute after administration of the agents and the maximal decrease was attained after 30 min (34% of the initial value); even 4 hours after administration the values were below the initial level. The mentioned drug combination appears to be valuable especially in the first stage of treatment of cardiac asthma and pulmonary oedema.

Administration, Oral↗
PubMed1986

[Familial idiopathic congestive cardiomyopathy in 2 brothers with a similar course].

The course of idiopathic congestive cardiomyopathy in two full brothers is described. The diagnosis was made on the base of the existing cardiomegaly, gallop rhythm and congestive cardiac insufficiency, in the absence of any connection with some of the well known causes for hypertrophy and dilation of the heart. It was confirmed at necropsy in one of the brothers. A similarity was established in their case history, namely: considerable physical activity until the first signs of cardiac insufficiency, advancement of decompensation at the same age (20 years) with an already existing cardiomegaly, identical complaints--rhythm disturbances and pulmonary thromboembolism, similar electrocardiographic changes with formation of "pseudoinfarct" image, ventricular flutter--immediate cause for the death of one of the brothers, sudden death--for the other. The origination of the disease cannot be associated with the effect of exogenous morbid factors. There are no data on advancing of autoimmune process. With the genealogical study, covering four generations, the family was established to have a stillborn child, no other sick members of the family, no data about multiple deaths. The cytogenetic analysis showed no chromosomal aberrations. The possibility the disease to be transmitted via autosomal recessive mode or via autosomal-dominant gene with a low penetration is discussed.

Adult↗
PubMed1986

[Acute myocardial infarct in embolizing abacterial thromboendocarditis (2 cases)].

Two patients are described, aged 60, with acute symptomless myocardial infarctions, diagnosed while still alive by electrocardiography, on the background of predominating neurological symptomatics, admitted as a manifestation of ischemic cerebral strokes, and in one of the patients--as embolization of peripheral artery, confirmed at operation. Multiple embolism and infarctions, with different duration, of brain and some other internal organs were established at necropsy, that originated from abacterial thromboendocarditis of aortic valve that developed in the absence of other diseases or data for the existence of disseminated intravasal coagulation. In the first case--extensive posterior-septal myocardial infarction was established and in the second--two not extensive infarctions, localized high anterior-septally and in the free anterior left ventricular wall. Though embolic deposits were not established in the large coronary arteries, the combination of acute myocardial infarctions and embolizing thromboendocarditis, in the absence of stenosing coronary atheromatosis, makes the embologenic origin of infractions most probable.

Endocarditis↗
PubMed1985

Haemodynamic effects of Isodinit (isosorbide dinitrate) in acute myocardial infarction.

In 26 patients with acute transmural myocardial infarction, the authors studied the effect of sublingual Isodinit (isosorbide dinitrate) on haemodynamic indicators: in 12 patients on heart rate, pulmonary and peripheral arterial pressure, in 14 (of whom 6 with normal and 8 with elevated diastolic pulmonary pressure) moreover on cardiac output and peripheral vascular resistance. The results showed a decrease in pulmonary arterial pressure by 35%, in peripheral arterial pressure by 10-14%, and a slighter fall in peripheral vascular resistance; the heart rate did not substantially change. In patients with normal diastolic pulmonary artery pressure, the cardiac and stroke index and the stroke work index decreased, whereas in patients with elevated pulmonary pressure these indicators did not significantly change. The effect of sublingual Isodinit occurs 5-7 min after its administration and reaches its maximum between the 15th--45th min; after 2 hrs the effect ceases. The preparation is suitable for the treatment of congestive heart failure in acute myocardial infarction.

Adult↗
PubMed1984

[Cardiological problems in pheochromocytoma patients].

The course of the disease of six cases with pheochromocytoma was analyzed in patients, aged from 19 to 65, with manifestations mainly of the cardiovascular system. The diagnosis was verified in five of them at necropsy and in one of them--intraoperatively. The arterial hypertension accompanied by distinct vegetative symptomatics were the basic clinical signs and in some of the cases--disturbances in the carbohydrate metabolism. In four patients the arterial hypertension was permanent, in two of them--with paroxysmal elevation opresf blood pressure. In the other two--with hypertonic crises on the background normal blood pressure. The duration of the hypertension--from a single hypertonic crisis during pheochromocytoma attack, had a lethal end, till the fifth year. In three of the patients rhythm disorders (supraventricular tachycardia or tachyarrhythmia) originated in a pheochromocytoma paroxysm and in three--acute left ventricular insufficiency (gallop rhythm, pulmonary edema). The clinical picture resembles heart defect, myocardial infarction with congestive cardiac insufficiency and rhythm disorders, renal insufficiency with symptomatic arterial hypertension and decompensated hypertonic heart, epilepsy, coggagenosis . The authors admit that the development of acute left ventricular failure in hypertonic patients, that could hardly be explained only by the increase of the heart afterloading (in advanced age, not enlarged and no data about grve heart lesions) or the origination of severe rhythm disorders, not coped by the modern antirhythm agents, are signs, indicating, the existence of pheochromocytoma. The catecholamine affection of myocardium, that was found in three of the deceased patients, very likely, contributes to the origination of left ventricular failure.

Adrenal Gland Neoplasms↗
PubMed1976

[Metabolic disorders in the acute stage of cardiac infarction].

The level of lactates and pyruvates in arterial blood of 35 patients with myocardial infarction without shock (17-without heart insufficiency and 18-with manifested but in various degrees) is higher as compared with the level of 18 healthy subject and the elevation is better manifested in the patients with cardiac insufficiency. The highest level of lactates and pyruvates is reached in the first 48 hours of the onset of the disease, after which they decrease progressively and in patients without cardiac insufficiency is normalized by the 5-6th day and in those with insufficiency-remains elevated. Slight to moderate correlation exists between the level of lactates and BE and PaCO2. Lacate and pyruvate level reoresents a more sensitive index for the existence of distrubances in the tissue metabolism as compared with the indices of alkaline-acid equilibtrium.

Acute Disease↗