Annales de cardiologie et d'angéiologie
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Among the various anticancer drugs, used alone or in combination during courses of chemotherapy, anthracyclines (leader: doxorubicin) are responsible for direct myocardial toxicity, which can exceptionally be acute, but more often chronic with a delayed onset. This cardiotoxicity is directly proportional to the cumulative dose administered and the recommended total dose for doxorubicin is 550 mg/m2. The risk factors able to potentiate cardiotoxicity must be analysed before starting chemotherapy and follow-up by ultrasonography and/or isotope ejection fraction must be repeated before each course. ⋯ The incidence of this toxicity is low, but it can be fatal. Exceptional examples include the cardiotoxicity induced by high-dose cyclophosphamide responsible for acute haemorrhagic myocarditis, potentiation of the cardiotoxic effect of anthracyclines by dacarbazine and plicamycin, and serious ventricular and supraventricular arrhythmias induced by amsacrine. Among the various cytokines used in oncology, interferon is responsible for heart failure, reversible after stopping treatment, but also for ventricular arrhythmias, or even sudden death, the pathophysiology of which still remains unclear.
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Ann Cardiol Angeiol (Paris) · Feb 1995
Case Reports[Pulmonary embolism associated with right auricular thrombus. Apropos of 2 cases].
The authors report two cases of serious pulmonary embolism, derived from venous thrombus (inferior vena cava in one case, superficial femoral vein in the other), associated with mobile thrombus of the right auricle, with a very rapidly favourable course after intravenous fibrinolysis. This treatment was extremely effective, allowing rapid haemodynamic improvement and resolution of the thrombus in less than 24 hours. No major haemorrhagic complications or recurrent emboli were observed. Fibrinolysis, in serious pulmonary embolism associated with thrombus of the right auricle, therefore appears to be a useful treatment, particularly in patients admitted to centres in which emergency embolectomy cannot be performed.
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Ann Cardiol Angeiol (Paris) · May 1994
Review[Aortic coarctation and pregnancy. Apropos of 3 cases followed-up during a period of 10 years].
Classically, coarctation of the aorta is poorly tolerated during pregnancy or at least is associated with a risk of rupture of the aorta, rupture of a cerebral aneurysm or, more rarely, cardiac failure or bacterial infection. The authors turned their attention to this association of coarctation of the aorta and pregnancy in the light of 3 cases of pregnancy brought to term in the Department of Cardiology of the Ibn Rochd Teaching Hospital Group, Casablanca, Morocco. During a 10 year period, 20 patients were hospitalised in the department with coarctation of the aorta. ⋯ One patient was lost to follow-up at 7 months and was seen again only after delivery at home, i.e. without supervision but equally without complications. The 3 newborn infants had an Apgar of 10/10 and a birth weight of 3.2-3.5 kilos. There were no spontaneous abortions and no premature deliveries.(ABSTRACT TRUNCATED AT 250 WORDS)
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Ann Cardiol Angeiol (Paris) · Jan 1994
Review[Doppler echocardiography of tricuspid insufficiency. Methods of quantification].
Evaluation of tricuspid incompetence has benefitted considerably from the development of Doppler ultrasound. In addition to direct analysis of the valves, which provides information about the mechanism involved, this method is able to provide an accurate evaluation, mainly through use of the Doppler mode. In addition to new criteria being evaluated (mainly the convergence zone of the regurgitant jet), some indices are recognised as good quantitative parameters: extension of the regurgitant jet into the right atrium, anterograde tricuspid flow, laminar nature of the regurgitant flow, analysis of the flow in the supra-hepatic veins, this is only semi-quantitative, since the calculation of the regurgitation fraction from the pulsed Doppler does not seem to be reliable; This accurate semi-quantitative evaluation is made possible by careful and consistent use of all the criteria available. The authors set out to discuss the value of the various evaluation criteria mentioned in the literature and try to define a practical approach.
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Ann Cardiol Angeiol (Paris) · Sep 1993
[Ambulatory arterial blood pressure monitoring in the management of hypertension in pregnancy].
Ambulatory blood pressure monitoring (ABPM) completes the diagnostic approach to hypertension of pregnancy, by providing a dynamic study of the blood pressure status of the pregnant woman. It corrects certain erroneous diagnoses of hypertension of pregnancy, in particular those related to the "White coat" effect, especially common in pregnant women. ⋯ Finally, while loss or reversal of circadian rhythm appears to be of good predictive value regarding the onset of eclampsia, it is above all blood pressure load which appears to be harmful to fetal growth and maturity. ABPM also facilitates management by improving the compliance of pregnant women with regular monitoring and with treatment, by more accurately guiding the surveillance of drug treatment.