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Results 301 - 350 of 400
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Marsch S C - - 1992
Continuous peri-operative three-channel Holter monitoring in a 70-year-old patient undergoing elective hip arthroplasty failed to show onset and progression of a lethal postoperative myocardial infarction, which was clearly visible in a 12-lead electrocardiogram. The modified bipolar leads used for Holter monitoring differed from the corresponding leads of the 12-lead electrocardiogram. ...
Hanisch P J - - 1991
The nature and severity of an acute myocardial infarction may be related to the region of myocardial involvement. Four possible sites of infarction are inferior, anterior, posterior, and lateral. Knowledge of ECG tracings common to each of these areas, the coronary artery source of each, clinical complications, and signs and ...
Braunwald E - - 1991
Severe myocardial ischemia, when sustained, leads to a predictable sequence of events, including myocardial necrosis, expansion of the infarct, and later its replacement by scar tissue. The nonischemic tissue sustains ventricular function, but it frequently adapts to the extra load placed on it by dilating. The enlargement and remodeling of ...
Gaspoz J M - - 1991
For emergency room patients with a low probability of acute myocardial infarction, we established a new short-stay coronary observation unit, a 2-bed nonintensive care unit with telemetry monitoring adjacent to the emergency room. Of 512 consecutive admissions to the coronary observation unit, 425 (83%) were discharged home without evidence of ...
Gidding S S - - 1991
This article briefly reviews the role of ultrasound scanning in the diagnosis and management of fetal cardiac disease. Currently, the potential exists for the accurate identification of a wide range of cardiac defects and for the diagnosis and successful management of many cardiac rhythm disturbances. Considerable benefit is derived for ...
Frenkel Y - - 1991
The safety of pregnancy after myocardial infarction remains a significant dilemma for both the obstetrician and the cardiologist. Only 20 cases of pregnancy after myocardial infarction have been reported. To clarify this problem, we add our experience of four such cases in which conception occurred 9 months to 9 years ...
Johnston D W - - 1991
The use of simple relaxation-based stress management procedures in the treatment of mild primary hypertension has been the subject of extensive study. Stress management appears to lead to reliably greater reductions in pressure than a variety of control procedures. The mechanisms underlying these effects are obscure, and research has not ...
Van Meter C H CH - - 1991
Advances in the surgical management of ventricular tachyarrhythmias have been dramatic in recent years. Seriously ill patients, with or without ventricular aneurysms, who have medically refractory ventricular tachyarrhythmias may be candidates for intraoperative electrophysiologic mapping with surgical excision and/or cryoblation of the foci of their arrhythmias. In properly selected patients ...
Pearlman N W - - 1990
Pelvic exenteration has a high complication rate due, in large part, to the extensive raw surfaces and dead space it creates. Numerous techniques have been used to control this space and line these surfaces, but none, to date, has proven to be a reliable solution. We investigated the use of ...
Rencken R K RK Department of Urology, Medical University of Southern Africa, - - 1990
Acute epididymo-orchitis occasionally responds poorly to conservative measures. Testicular infarction may be one reason for this complication. Ultrasonography and radionuclide scanning can elucidate the cause. A patient with this complication is described.
Aglio L S - - 1990
Myocardial infarction is encountered rarely during pregnancy, but when it occurs the event is life-threatening to both mother and fetus. Data on maternal and fetal outcome are limited, but overall maternal mortality approaches 35%, and 40% of deaths occur during the third trimester. We present a case of myocardial infarction ...
Carroll G - - 1990
Recent studies on pathogenetic mechanisms, supplemented by findings in clinical trials point the way to a logical approach to acute evolving myocardial infarction. This is designed in the earliest stage to limit infarction through reduction in myocardial oxygen demands, improvement in collateral blood supply and dissolution of coronary thrombus, to ...
Lavie C J CJ Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, - - 1990
Although much of the current enthusiasm in the management of acute myocardial infarction is related to revascularization strategies, mechanical and electrical complications continue to pose a major threat to recovery in some patients. Some of the major complications of acute myocardial infarction are cardiogenic shock, rupture of the free wall ...
Berns E - - 1990
The prognostic significance of ventricular and supraventricular tachyarrhythmias after infarction varies with type and timing. In some cases intervention may be appropriate, and in others not. Management of peri-infarction and of later arrhythmias is reviewed. To avoid proarrhythmic consequences, pharmacologic treatment should be rigorously guided by carefully defined end points.
Njoh J - - 1990
A one-year prospective study of the complications of hypertension was carried out in the Medical Wards of the John F. Kennedy Hospital in Monrovia, Liberia. Of all medical admissions 15.6% (105 out of 672) were due to hypertension with its complications. Of the hypertensives, 72.4% (76 of 105) came from ...
Burnett D A - - 1990
The nonoperative management of acute variceal hemorrhage can control acute hemorrhage and allow stabilization of the patient prior to definitive therapy to prevent further bleeding episodes. Balloon tamponade, endoscopic sclerotherapy, and pharmacotherapy can stop acute variceal bleeding. Endoscopic sclerotherapy has the highest reported success rate, decreases the incidence of early ...
Charlson M E - - 1989
Among hypertensive and diabetic patients undergoing elective noncardiac surgery, preoperative status and intraoperative changes in mean arterial pressure (MAP) were evaluated as predictors of postoperative ischemic complications. Of 254 patients evaluated before operation and monitored during operation, 30 (12%) had postoperative cardiac death, ischemia, or infarction. Twenty-four per cent of ...
Sweeney M S - - 1989
Cardiac surgical emergencies are broken down into three categories: cardiac trauma, aortic dissection, and surgery for acute myocardial infarctions. Emphasis is given to describing the presentation of patients with such problems, and to the salient aspects of the clinical strategies for managing each problem. An important goal of each section ...
Domingo E - - 1989
We prospectively studied 110 patients with a first acute myocardial infarction with cross-sectional echocardiography, between 7-10 days post-infarction, to assess the value of semiquantitative segmental contractility score for the first year post-AMI risk stratification. 87 patients had acceptable recordings (40 anterior and 47 inferior infarction). Twelve patients had severe complications ...
Ettles D F - - 1989
We describe a case of fatal left ventricular outflow obstruction detected by intraoperative transoesophageal echocardiography. This resulted from acute haematoma formation within the interventricular septum following internal mammary artery grafting to the left anterior descending coronary artery. This unusual case highlights the emerging role of transoesophageal echocardiography in the diagnosis ...
Golden W E - - 1989
Perioperative consultations may play a major role in the care of surgical patients in an era of prospective payments. Since insurance reimbursement policy favors limitations in the number of consultants on a case, general medicine ("holistic") consultation services may become preferred perioperative consultants in the future. To focus curriculum planning ...
Rosenlund R C - - 1988
An increasing number of parturients suffering from ischaemic heart disease require anaesthetic care for labour and vaginal delivery. We present the case of a 42-year-old gravida who had previously suffered a myocardial infarction and undergone coronary artery bypass grafting. Management was directed toward prevention of haemodynamic instability by alleviation of ...
Ferdinand K C - - 1988
Acute transmural myocardial infarction is usually caused by a coronary thrombus along with fixed coronary artery stenosis. Myocardial necrosis can be interrupted by the prompt use of pharmacologic and mechanical thrombolysis. Intravenous streptokinase and urokinase have been associated with approximately a 45 percent recanalization rate while the newer agent, recombinant ...
Macdonald R L - - 1988
An unusual case of sphenoethmoidal sinusitis complicated by cavernous sinus thrombosis, meningitis and pontine and cerebellar infarction is described. The patient presented with advanced intracranial complications which in retrospect caused delay in recognition and treatment of the underlying sphenoethmoidal sinusitis. Surgical drainage of the sinusitis was ultimately required. The pathogenesis ...
Green L - - 1988
This study investigated the applicability in a primary care setting of two decision-support tools for evaluating the necessity of admitting patients with suspected acute cardiac ischemic disease to a cardiac intensive care unit. The heart disease predictive instrument (HDPI) of Pozen et al and the electrocardiogram scoring method of Brush ...
Pitchumoni C S - - 1988
The multisystem involvement in acute pancreatitis (AP) is a reflection of the pancreatic gland's capacity to produce a number of potent vasoactive peptides, hormones, and enzymes. The various prognostic criteria are early evaluations of these metabolic derangements. The pathogenesis of hypocalcemia, long recognized as an indicator of severity of AP, ...
Jones E - - 1988
A 56 year old man with ischaemic heart disease and known allergy to wasp venom was stung in the mouth by a wasp and within four hours sustained an acute myocardial infarction. This complication has been described on only three previous occasions. Possible pathogenic mechanisms include the anaphylactic reaction itself, ...
Timberlake G A - - 1988
Myocardial contusion is becoming more frequently recognized as a concomitant of blunt chest and abdominal trauma. Thromboembolism is an infrequent, but serious, complication of myocardial contusion and management is controversial. We report a case and review the literature of thromboembolism complicating blunt heart injury, and suggest a protocol to prevent ...
Berk W A - - 1988
Management of infective endocarditis includes early recognition of complications and prompt intervention when necessary to avert an untoward result. Among the most serious potential complications of this disorder are those that involve the heart itself. Although the ECG is often normal or nearly so in patients with endocarditis, at other ...
Charlson M E - - 1987
When prognostic indexes have been tested in a second population, they have often performed less well. Since this is believed to be inevitable, methodologic differences that may explain the discrepancies have been overlooked. Data from a prospective study of 232 patients undergoing noncardiac surgery were used to examine the effect ...
Thompson D R - - 1987
Anxiety was studied on four occasions over one year in 76 men under 66 years of age, who were admitted to hospital with a first acute myocardial infarction. Anxiety was measured by the Spielberger State-Trait Anxiety Inventory, and by a self-rating questionnaire. Average levels of State and self-rated anxiety fluctuated ...
Goldberg R J - - 1987
Over the past decade, the management of patients with acute myocardial infarction has undergone remarkable change due in part to the availability of new diagnostic and therapeutic modalities. Many of these techniques have gained widespread acceptance and use without the benefit of studies demonstrating efficacy. A survey of 391 members ...
Jaroch M T - - 1986
Our experience at the Cleveland Clinic and that in the literature with splenic infarction were reviewed to describe the natural history of splenic infarction and provide guidelines for management. Data for this review included 75 patients identified by clinical studies or at autopsy during a 10-year period and a review ...
Kay G N - - 1986
Great strides have been made in the management of patients with acute myocardial infarction since the advent of coronary care units. However, congestive heart failure continues to be the major cause of in-hospital mortality. The accurate diagnosis and classification of hemodynamic abnormalities allow the application of specific therapies for each ...
Lindpaintner K - - 1986
The authors report a case of focal myocardial necrosis, presenting clinically as an acute myocardial infarction during the administration of the antineoplastic drug, amsacrine, in a patient without coronary artery disease. In addition to the recognized arrhythmic complications, the authors emphasize myocardial necrosis as a possible further manifestation of amsacrine-related ...
Matjasko J - - 1985
Because controversy exists regarding continued use of the seated position for neurosurgical procedures, this prospective (1981-1983) and retrospective (1972-1981) analysis of 554 seated patients was done to establish the incidence and severity of venous air embolism (VAE) related to type of surgical procedure and anesthetic technique; to examine the impact ...
Nienaber C A - - 1985
The coronary patient after the striking experience of a myocardial infarction faces a completely new situation possibly affecting lifestyle, occupation and life expectancy. A dedicated post-infarction diagnostic strategy for the evaluation of the individual risk of suffering from a future coronary event, or of dying, requires profound knowledge of the ...
Nitkin R S - - 1985
A cardiac transplant patient with rapidly progressive graft atherosclerosis is described. This case demonstrates the accelerated nature of this disease and problems in diagnosis, as well as an unexpected and previously unreported lack of sensitivity of exercise thallium scintigraphy in its investigation. This case also gives further support to the ...
McIlmoyle E L - - 1985
Some 262 general practitioners in the Belfast area were asked to complete a questionnaire about their attitudes and practice regarding the management of myocardial infarction at home. Of the 211 responders, only nine per cent would sometimes consider home care for patients under 65 years of age, although 55 per ...
Friedman M J - - 1985
Intracoronary streptokinase administration has been an effective procedure for establishing reperfusion of an evolving myocardial infarction by lysing the thrombus that is usually responsible for the infarction. After reperfusion is accomplished, appropriate management of the patient must be planned to provide the best chance for assuring continued vessel patency, and ...
Sulman J - - 1985
This paper describes a conceptual framework for identifying myocardial infarction patients in the acute care hospital who are at risk for medical and psychosocial complications that may impede recovery. Because of their precarious medical status, these patients present special issues for social work practice. Psychosocial factors affecting outcomes are reviewed ...
Hankins G D - - 1985
In the present review the world literature on pregnancy complicated by myocardial infarction is summarized, and two additional cases are presented. It is apparent that the majority of pregnant women who have died after myocardial infarction did so at the time of initial infarction, and maternal mortality was greatest if ...
Rowley J M - - 1984
Two hundred and sixty three general practitioners were offered the use of a hospital based service consisting of a medical senior house officer, a nurse attached to a coronary care unit, and a specially equipped ambulance estate car to help with the initial management of patients with suspected myocardial infarction ...
Silliman R A - - 1984
Purulent pericarditis is a serious but uncommon disorder which rarely complicates acute myocardial infarction. We have described a patient who had fatal purulent pericarditis subsequent to Swan-Ganz catheterization, which was done to facilitate the management of left ventricular failure complicating acute myocardial infarction. Although rare, purulent pericarditis should be considered ...
Vordermark J S JS - - 1984
The use of the ultrasonic Doppler flow detector in the management of acute testicular torsion is described. The Doppler can be used to diagnose torsion accurately and also to monitor manual detorsion. In this series detorsion was a reliable procedure which avoided emergency exploration in 5 of 8 patients with ...
Rude R E - - 1984
Acute myocardial infarction remains one of the most common clinical problems in internal medicine and cardiology. The development of the modern coronary care unit has been accompanied by an enhanced understanding of the pathophysiology and natural history of this variable clinical syndrome, and specific therapy for many complications of infarction ...
Chapman P H - - 1984
After surgery for posterior fossa or third ventricular tumors, hydrocephalus may persist or evolve. Proper management of this complication requires timely detection. Temporary external ventricular drainage has been suggested by some authors as an adjunct to clinical observations and radiographic studies for unshunted patients. As an alternative, the authors have ...
Chapman D W - - 1983
Decisions about early management of acute myocardial infarction require great care and astuteness, since the threat of sudden death is the greatest during the first few hours after onset of infarction. General measures of acute care include relief of pain and management of arrhythmia. Drug therapy with beta-adrenergic blocking agents ...
Khan M - - 1983
Eleven patients with large cerebellar infarctions were admitted recently to our service. Eight of them showed evidence of hydrocephalus on the CT scan examination. Five were treated with controlled external ventricular drainage and six were managed conservatively. One death, most likely due to progressive brainstem infarction, occurred. The outcome was ...
Hall S - - 1983
Status epilepticus is a medical emergency. Recent experimental studies have shown that permanent brain damage can occur after only 60 minutes of uncontrolled seizure activity. Cardiac arrhythmias are a common cause of death. Other complications include rhabdomyolysis, acute tubular necrosis and neurogenic pulmonary edema. Management is divided into three phases: ...
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