Annales de cardiologie et d'angéiologie
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Ann Cardiol Angeiol (Paris) · Feb 2003
Comparative Study[Prognostic significance of second and third degree atrioventricular block in acute inferior wall myocardial infarction].
High degree atrioventricular block complicates inferior wall acute myocardial infarction in 10 to 15% of cases. Its significance is still controversial. In this study, we have analysed 152 observations of acute inferior wall myocardial infarction during hospitalisation period. ⋯ It appears that the infracted mass of myocardium is larger in case of atrioventricular block, this is assessed by comparing the average value of the peak of creatine Kinase in the two groups with and without atrioventricular block (1534 IU versus 1096 IU, p < 0.02) and by considering the rate of low ejection fraction (EF < 40%) in each group (44.6% versus 16%, p < 0.01). In our study, we note that thrombolysis does not affect the incidence of atrioventricular block (19% and 24% in thrombolyed and not thrombolyzed patients respectively) but it seems that thrombolysis improves the outcome of these patients. The occurrence of atrioventricular block in acute inferior wall myocardial infarction is related to the presence of an important right coronary artery that is occluded, the recanalisation of this vessel leads often to rapid regression of the block that is no longer pejorative.
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Ann Cardiol Angeiol (Paris) · Nov 2002
[Validation of a diagnostic algorithm in non severe pulmonary embolism at the Annecy general hospital. D-dimers, venous lower limb ultra-sound and spiral CT scan].
We have evaluated the sensitivity of a diagnostic algorithm for all patients suspected of pulmonary embolism using: D-Dimer, lower limb venous ultrasonography and helical computed tomography. To validate this approach, a lung scan is systematically carried out if the pulmonary embolism diagnosis is not withheld as a result of the algorithm. Clinical tests are organised between the 3rd and 6th month. ⋯ This diagnostic approach therefore seems satisfactory but would require further investigation on a wider scale.
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Ann Cardiol Angeiol (Paris) · Jan 2002
Comparative Study[Beneficial effects of direct call to Emergency Medical Services on time delays and management of patients with acute myocardial infarction. The RICO (obseRvatoire des Infarctus de Côte-d'Or) data].
The influence of direct calls to specialized Emergency Medical Services in case of suspected myocardial infarction has not been extensively studied. The RICO registry is an exhaustive registry implemented in all six institutions participating in primary care of patients with acute myocardial infarction in one French administrative department (Côte-d'Or). From January 2001 to October 2001, 322 patients were admitted for acute myocardial infarction, among whom only 57 (18%) had directly called emergency medical services after the onset of symptoms. ⋯ This resulted in a significant increase in the use of reperfusion therapy (70% versus 38%, p = 0.003), including a higher proportion of primary angioplasty (33% versus 20%, p = 0.04). This study documents the beneficial effect of a direct call to the Emergency Medical Services by the patients themselves. Too few patients, however use this opportunity and actions should be taken for informing the lay public of the benefits of this medical service.
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Ann Cardiol Angeiol (Paris) · Sep 2001
[Surgery of active-phase infective endocarditis: report of 13 cases].
Infective endocarditis is always a disease at the present time. In this work we report our initial experience of infective endocarditis surgical treatment during the acute phase. ⋯ This work emphasises the interest of the surgical treatment in the active phase of the infective endocarditis.