The American journal of cardiology
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The application of quantitative morphometric techniques to evaluation of the lungs of nine children who died with a ventricular septal defect between the ages of 3 months and 4 years showed that the presence of pulmonary hypertension interferes with the growth and development of the pulmonary circulation. In all cases the preacinar arteries were of normal size and not dilated, and arterial size and number within the acinus were reduced and similar to those seen in the normal child at birth. ⋯ Elevation of resistance was associated with failure of the intraacinar pulmonary circulation to develop normally rather than to obliterative pulmonary vascular disease. In view of the rapidity with which impairment of growth and elevation of resistance can develop, closure of a large defect is recommended before age 2 years.
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Two patients had a typical sounding cardiac friction rub after placement of a temporary transvenous pacemaker. Absence of myocardial perforation was documented in one patient during thoracotomy for placement of an epicardial electrode and in the other with an electrogram recorded from the pacemaker as it was being withdrawn. The rubs disappeared during pacemaker removal. These cases are believed to represent endocardial friction rubs resulting from contact of the pacing wire with the endocardium.
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A prospective study was carried out to evaluate accuracy of a real time computer system for arrhythmia monitoring in a coronary care unit. QRS complexes in 57 continuously recorded 30 minute electrocardiographic rhythm strips from 30 patients were classified by the computer. Blinded interpretation of each beat was made by a cardiologist. ⋯ This approach combines major elements of cross correlation of QRS signals as well as grouping of complexes into families. Normal and abnormal templates are stored and newly detected QRS complexes are matched. The program appears to be sufficiently accurate to warrant further applications.