OBJECTIVE: To measure the prevalence of cardiac sequelae 1 y after the onset of Kawasaki disease and determine the risk factors associated with these cardiac sequelae. MATERIAL AND METHODS: 1594 patients who initially visited one of the 87 target hospitals in 1996 for Kawasaki disease participated. Selection of the target ...

Myotonic dystrophy (MD) is a multisystem disease affecting numerous organs and systems. Cardiac involvement is frequent. Sudden death, due to fatal cardiac rhythm and conduction disturbances occurs in 30% of patients with MD. The aim of this study was to assess the possibilities and methods of early detection of myocardial ...

BACKGROUND: Patients with acute neurologic illness often manifest findings suggestive of cardiac injury. Their proper interpretation is unclear. Accordingly, we conducted a blinded evaluation to assess the incidence of cardiac injury determined by elevations of cardiac troponin I (cTnI) in patients presenting within 24 hours of a neurologic event and ...

OBJECTIVE: To evaluate cardiac findings in 31 Noonan syndrome patients. METHODS: Thirty-one (18 males and 13 females)patients from 26 families affected with Noonan's syndrome were evaluated from the cardiac point of view with electrocardiography and Doppler echocardiography. RESULTS: Twenty patients had some type of cardiac abnormality. The most frequent was ...

We reviewed the prevalence and severity of pruritus in 85 patients after cardiac surgery. EloHAES, a long-lasting hydroxyethylated starch, was given to 59 of these patients. None of the patients who did not receive EloHAES developed pruritus, compared with 22% of those who did (P = 0.007). The timing of ...

OBJECTIVE: To compare the results of cardiac output measurements obtained by lithium dilution and transpulmonary thermodilution in paediatric patients. Design: A prospective study. SETTING: Paediatric intensive care unit in a university teaching hospital. PATIENTS: Twenty patients (age 5 days-9 years; weight 2.6-28.2 kg) were studied. INTERVENTIONS: Between two and four ...

Myotonic dystrophy (MD) is associated with a wide spectrum of cardiac abnormalities, but only a few longitudinal studies have investigated the natural course of heart disease in MD. To assess whether neuromuscular involvement significantly predicts cardiac disorders in MD, 83 patients with various grades of disease severity were enrolled in ...

STUDY OBJECTIVES: A high incidence of nocturnal cardiac rhythm disturbances among patients with obstructive sleep apnea (OSA) syndrome has been described in some reports, but not in others. We wished to examine the prevalence of significant cardiac rhythm disturbance in patients with established moderate to severe OSA syndrome and, in ...

BACKGROUND: The aim of this study was to evaluate the ability of dipyridamole thallium scintigraphy and dobutamine stress echocardiography to predict cardiac complications following elective reconstruction of the abdominal aorta in patients with a stable preoperative cardiac condition and to compare this with information obtained from the medical history, ECG ...

BACKGROUND: A major outbreak of epidemic dropsy occurred in Delhi, India, in August-September 1998, due to the consumption of contaminated mustard oil. METHODS: The clinical data of 212 adult patients of epidemic dropsy who presented to our hospital is analysed. RESULTS: Pitting pedal oedema (100%), skin erythema (75%), limb tenderness ...

STUDY OBJECTIVES: During isovolemic hemodilution, healthy individuals maintain oxygen consumption VO2 by identical increases in cardiac index (CI) and oxygen extraction ratio (O(2)ER). In critically ill patients, the relationship between CI and O(2)ER may be different. Patients with an altered cardiac function may have a decreased CI/O(2)ER ratio, whereas patients ...

Upper airway obstruction is a prevalent feature in patients with Down syndrome. However, these patients may be completely asymptomatic in the early months of life. The recognition of a problem within the airway quite often occurs when these children present for cardiac surgery, diagnostic radiography with sedation, or during the ...

PURPOSE: A previous study of healthy female volunteers suggested that deep inspiratory breath holding can reduce the cardiac volume in the treatment portals for left-breast cancer treatment. The reduction of irradiated cardiac volume may be important considering the reported late cardiac morbidity and mortality and the frequent coexistent use of ...

AIM: We describe the detection of right sided cardiac abnormalities by Doppler ultrasonography of the lower limb veins. We also attempt to quantify the degree of tricuspid regurgitation (TR) by analysis of the femoral vein Doppler waveform (DW). MATERIALS AND METHODS: The DWs of the lower limb veins were examined ...

Two hundred fourteen consecutive male cardiac surgery patients were retrospectively evaluated for the incidence of adhesive capsulitis of the shoulder and were assessed for risk factors. Only male patients were included, as the study took place at a Veteran's hospital. Patients who had no shoulder problems prior to cardiac surgery ...

A patient developed acute severe hemodynamic compromise during a transjugular intrahepatic portosystemic shunt (TIPS) procedure for intractable ascites. Rapid clinical and radiographic evaluation of the patient disclosed pericardial blood and cardiac tamponade as the cause, probably due to right heart perforation from guidewire and catheter manipulation. The tamponade was successfully ...

OBJECTIVE: To evaluate the clinical relevance of cardiac arrhythmias during rehabilitation after coronary artery bypass graft (CABG) surgery. DESIGN: Survey of consecutive patients admitted to an inpatient cardiac rehabilitation center. SETTING: A rehabilitation center acting as a reference for cardiology clinics lacking this facility. The program was performed in the ...

A retrospective chart review was performed for identification of patients with isolated internuclear ophthalmoplegia (INO) postcardiac catheterization from two neuro-ophthalmology units. Of the 110 patients with a diagnosis of INO who were evaluated during the observation period, five patients (4.5%) demonstrated relatively isolated INO occurring in the perioperative period of ...

BACKGROUND: Pulmonary embolism (PE) is a possible noncardiac cause of cardiac arrest. Mortality is very high, and often diagnosis is established only by autopsy. METHODS: In a retrospective study, we analyzed clinical presentation, diagnosis, therapy, and outcome of patients with cardiac arrest after PE admitted to the emergency department of ...

PURPOSE: We assessed whether the American College of Cardiology/American Heart Association (ACC/AHA) task force guidelines for perioperative cardiac evaluation could reliably stratify cardiac risk before aortic surgery. METHODS: We retrospectively applied the guidelines to a closed database, set up prospectively. The setting was a referral center in an institutional practice ...

OBJECTIVES: Cardiac involvement is frequently observed in HIV-infected patients, especially in those in the late stage of the disease. This study was designed to evaluate the impact of highly active antiretroviral therapy (HAART) in patients with cardiac involvement. METHODS: A retrospective study of 1042 patients admitted to a Division of ...

Cardiac diseases are well known among patients on maintenance hemodialysis (HD), and carnitine deficiency may be an important factor in cardiac morbidity. We studied the effects of low-dose L-carnitine treatment (500 mg/day) on chest symptoms (dyspnea on exertion, chest pain, palpitation), cardiac function, and left ventricular (LV) mass in 9 ...

OBJECTIVES: To evaluate the efficacy of open chest cardiac compressions for the resuscitation of pre-hospital cardiac arrest patients presenting with non-shockable rhythms on arrival at the emergency department. DESIGN: Prospective observational study of outcomes and physiological parameters during open chest cardiac compressions for non-traumatic pre-hospital cardiac arrest. SETTING: Large accident ...

OBJECTIVE: To assess the incidence of acute renal failure (ARF) developing perioperatively in adult patients requiring cardiopulmonary bypass surgery (CPB) and to make comparisons with data from the same institution published earlier. DESIGN: Prospective, observational. SETTING: Tertiary referral centre for cardiopulmonary medicine. PATIENTS AND PARTICIPANTS: All patients admitted to the ...

Propofol, a central-acting sedative agent, has been implicated in the development of rhabdomyolysis in children. We describe two adults who developed rhabdomyolysis after receiving high rates of propofol infusion. Rhabdomyolysis of both skeletal and cardiac muscle was suggested in both patients by marked increases of creatine kinase (>170 000 U/L) ...

BACKGROUND AND STUDY AIMS: Gastrointestinal endoscopy is an invasive examination. The aims of this study were to elucidate the effects and risks of upper gastrointestinal endoscopy with regard to cardiopulmonary functions in patients with heart disease, and to establish safety guidelines for use during endoscopy in this particular group of ...

AIMS: We evaluated echo-guided pericardiocentesis with contrast study in cardiac tamponade management. PATIENTS AND METHODS: From 1982 to 1998 we performed pericardiocentesis in 110 patients (56 +/- 14 years old). Subxiphoid approach was used in 109. Cardiac tamponade was idiopathic (n = 16), secondary to malignant disease (n = 50) ...

The present study summarizes the results of 12 cardiac surgical procedures performed in a carrier of Haemophilia B and in six patients with Haemophilia A at a single centre from 1979 to 1998. The median age of the patients at the time of intervention was 56 years ranging from 18 ...

OBJECTIVE: To determine whether patients with cardiac tamponade are subject to delays and clinical deterioration before undergoing echocardiography and pericardial drainage. DESIGN: Retrospective study. SETTING: The Montreal Heart Institute, Montreal, Quebec, a cardiology referral centre. PATIENTS: The charts of 50 patients who presented with tamponade were reviewed. Intervals between the ...

BACKGROUND: beta-blockers are routinely prescribed in congenital long-QT syndrome (LQTS), but the effectiveness and limitations of beta-blockers in this disorder have not been evaluated. METHODS AND RESULTS: The study population comprised 869 LQTS patients treated with beta-blockers. Effectiveness of beta-blockers was analyzed during matched periods before and after starting beta-blocker ...

The prognostic value of wall motion score index (WMSI), assessed at predischarge after a first acute myocardial infarction (AMI) in the thrombolytic era, is still not well known. One-hundred forty-four consecutive patients with a first AMI treated with thrombolytic therapy underwent exercise testing and echocardiography at rest before discharge and ...

In patients with the long QT syndrome (LQTS), the occurrence of cardiac events (syncope or cardiac arrest) is frequently associated with acute arousal caused by exercise, swimming, emotion, or noise. However, cardiac events may also occur during sleep or with ordinary daily activities. The purpose of this study was to ...

OBJECTIVE: To determine the usefulness of systematic intraoperative transesophageal echocardiography in a cardiac surgical unit. DESIGN: Open prospective observational survey. SETTING: University Hospital. PARTICIPANTS: Consecutive adult patients (n = 203) undergoing elective or urgent cardiac operations. MEASUREMENTS AND MAIN RESULTS: Pre-cardiopulmonary bypass imaging yielded unsuspected findings in 26 patients (12.8%) ...

OBJECTIVE: To evaluate the safety and efficacy of ketamine in pediatric patients undergoing interventional cardiac procedures. DESIGN: A retrospective clinical study. SETTING: A single, tertiary referral center. PARTICIPANTS: Patients (n = 107) undergoing interventional cardiac procedures between July 1996 and July 1998. INTERVENTIONS: Each patient received a bolus of ketamine, ...

Sudden, severe bradycardia/asystolic cardiac arrest are considered infrequent, but are certainly the most serious complications of spinal anaesthesia. We report four cases of primary asystole and one of severe bradycardia in young to middle-aged, healthy patients scheduled for minor surgery at the day surgery unit. Bradycardia/asystole were not related to ...

This study was performed to determine the value of dipyridamole-99m Tc-methoxy-isobutyl isonitrile perfusion (99mTC-MIBI) tomographic scintigraphy in the assessment of cardiac risk in patients being evaluated prior to combined pancreas-kidney transplantation (PKT). We performed perfusion tomographic scintigraphy using single photon emission computed tomography (SPECT) on 77 patients. The tomographic images ...

To evaluate the relationship between myocardial scintigraphic abnormalities based on (123)I-radioiodinated 15-(p-iodophenyl)-3(R, S)-methylpentadecanoic acid (BMIPP) uptake and cardiac function and the relationship between these abnormalities and long-term prognosis in patients with hypertrophic cardiomyopathy (HCM), 27 patients with nonobstructive HCM underwent BMIPP myocardial scintigraphic study, echocardiography, and exercise radionuclide study. Based ...

BACKGROUND: Chronic cyanosis with its associated rheologic changes is a known risk factor for glomerular nephropathy. Therefore, contrast-induced nephrotoxicity should be an important consideration for angiographers comparable to diabetics. On the other hand, progressions in diagnostic and interventional techniques have led to expanded indications and a more widespread use of ...

This study was carried out to compare cardiac output measurements determined by thermodilution and by Portapres, a non-invasive system. Eighty-seven non-invasive blood pressure measurements were performed in 46 patients in our critical care unit utilising the new, non-invasive Portapres system. Cardiac output values were obtained from these blood pressure values ...

To help guide physicians in their evaluation of patients with acute coronary syndromes, we investigated whether elevated cardiac troponin I in patients presenting with unstable angina predicts ischemia on stress testing. Elevated cardiac troponin I in patients who present with chest pain and normal creatine kinase levels is associated with ...

BACKGROUND: Patients with penetrating cardiac injuries may be stable or only mildly shocked, especially if the laceration has sealed off and the patient has been aggressively resuscitated. Clinical signs, chest roentgenograms, pericardiocentesis, and subxiphoid window are not always helpful in establishing the diagnosis. We reflect on the current evaluation based ...

BACKGROUND: The cause of inflammation in cardiac mucosa at the gastro-oesophageal junction (GOJ) is unclear, both gastro-oesophageal reflux disease (GORD) and Helicobacter pylori having been implicated. AIMS: To describe patterns of gastritis in patients with symptomatic GORD. METHODS: In 150 patients (126 normally located Z-line, 24 Barrett's oesophagus) with symptoms ...

A new chromogenic peptide substrate assay kit was used to measure factor XII (FXII) levels in plasma samples from 115 male patients with heart disease awaiting cardiac surgery, 40 age-matched normal healthy male blood donors and 20 patients before, during and after cardiopulmonary bypass surgery (CPB). Kallikrein-like and FXIIa-like activities ...

We studied 695 patients with spina bifida over 16 years old. 56 of these are deceased. The cause of death of 30 of these patients could be ascertained from the records kept at the unit. The leading cause of death was renal failure secondary to complications of the renal tract ...

BACKGROUND: Advances in surgical and medical management have greatly improved long-term survival rates in patients with congenital heart disease (CHD). As these patients reach adulthood, myocardial dysfunction can occur, leading to cardiac transplantation. METHODS AND RESULTS: We reviewed the pretransplantation and posttransplantation courses of 24 patients >18 years old (mean ...

OBJECTIVE: To evaluate a model describing postoperative hypoxemia after cardiac surgery by using two variables, i.e., shunt and resistance to oxygen diffusion (Rdff). DESIGN: Estimation of these two variables in normal subjects and postoperative cardiac patients. SETTING: The pulmonary function laboratory for the normal subjects and the intensive care unit ...

The safety and efficacy of transradial cardiac catheterization in patients with prior ipsilateral brachial cutdown is not known. Using standard techniques we performed transradial catheterization in 278 consecutive patients, of which 63 had prior brachial cutdown. All patients had a strongly palpable radial pulse and a negative Allen's test. Although ...

BACKGROUND: Cardiac catheterization is a common procedure that involves the introduction of a small sheath (5F-8F) into the femoral artery for insertion of other diagnostic catheters. After cardiac catheterization, local compression of the femoral artery is required to prevent bleeding and to achieve hemostasis. Traditional methods of achieving hemostasis require ...

Acute auditory stimuli and swimming activities are frequently associated with syncope, aborted cardiac arrest, and death in the long QT syndrome (LQTS). We investigated the clinical and genetic findings associated with cardiac events precipitated by these arousal factors. The study population involved 195 patients with an index cardiac event associated ...

The creation of arteriovenous fistula is an established form of therapy for patients with chronic renal failure. Anesthetic management in such patients is governed by the presence of risk factors such as hypertension, ischemic heart disease, diabetes, chronic pulmonary disease, anemia, coagulopathy, metabolic acidosis and/or hyperkalemia. In an attempt to ...