Angiology
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We report here a young patient who developed an acute transmural anterior wall myocardial infarction secondary to blunt chest trauma in an automobile accident. At angiography we demonstrated that this patient had sustained a left anterior descending branch intimal tear (Figure 1). Closed chest wall injury with myocardial contusion is a common occurrence in automobile accidents. However, the occlusion of the coronary artery from blunt chest trauma is rare in itself.
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Case Reports
Cardiac tamponade from central venous catheters. Report of a case and review of the English literature.
A case of acute cardiac tamponade caused by an internal jugular central venous catheter which was successfully treated is reported. The English literature is reviewed and shows that tamponade can occur up to 37 days after insertion and has a 65% mortality. The tamponade is usually caused by the actual infusate and not by blood.
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In the present study the technique and the reliability of indirect blood pressure measurement at the common femoral level was described. The blood pressure was measured by using a long cuff, which encircled the hips at the level of the groin, and determining the flow signals by Doppler technique applied at the ankle. In order to transmit the cuff pressure to the artery, a slender bag with air, which was a blood pressure cuff used in children, was placed over the common femoral artery under the cuff. ⋯ In patients with collateral vessels around the groin due to the iliac disease, the blood pressure could be measured by placing the Doppler flat probe over the common femoral artery or the collateral vessel. In observation of 24 subjects, a close correlation was obtained between the femoral cuff pressures and common femoral intra-arterial pressures. Furthermore, blood pressure values at the common femoral level measured indirectly showed similar reproducibility as those at the ankle and toe levels.
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Extracardiac sounds secondary to cardiac pacing are well known, but the murmurs originating in the heart after pacemaker insertion are rare. A patient who developed musical systolic murmur following temporary transvenous endocardial pacemaker insertion is described. It is concluded that the murmur was produced by vibrations caused by the pacing catheter and the tricuspid valve or some other intracardiac structure.