Angiology
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The purpose of this study is to examine how frequently myocardial ischemia was manifested on the surface electrocardiogram (ECG) during percutaneous transluminal coronary angioplasty (PTCA) and to select the most sensitive leads for the duration of ischemic ST changes. The study population consisted of 126 patients (pts), 116 men and 10 women, who underwent PTCA for one-vessel coronary artery disease. A 12-lead ECG was recorded in all patients before inflations and at ten-second intervals during each inflation. ⋯ The most sensitive ECG leads for detection of ST elevation were V2 or V3, V4 and V1 for the LAD, leads a VF and II for RCA, and leads III, aVF, or II, and V6 for LCX. The best leads for detection of ST depression were III, aVF and II for LAD, V2 or V3 and aVL for RCA, and V2 or V3, V1, and V4 for LCX. In conclusion, surface ECG represents a simple and very sensitive method for myocardial ischemia monitoring during PTCA.(ABSTRACT TRUNCATED AT 250 WORDS)
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Case Reports
Reversal of gangrenous lesions in the blue toe syndrome with lovastatin--a case report.
A seventy-six-year-old man with ischemic heart disease, peripheral vascular disease, and chronic renal failure developed bilateral cyanotic toes, which upon muscle biopsy, were shown to be caused by atheromatous emboli. The probable source was atheromatosis of the abdominal aorta. ⋯ With lovastatin therapy there was complete healing and except for transient cyanosis related to temporary cessation of therapy, there has been no recurrence for the past thirty months. The possible role of lovastatin in the conservative treatment of this disorder is discussed.