Clinical cardiology
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Clinical cardiology · Aug 1982
Case ReportsProlonged persistence of a large pericardial effusion and hemodynamic evidence of cardiac tamponade during treatment of myxedema.
We describe clinical, echocardiographic, and catheterization findings that were present initially and during therapy in a myxedematous patient with a large pericardial effusion and tamponade. Treatment with thyroxine resulted in a marked improvement of most of the clinical features of hypothyroidism and some improvement in cardiac function. ⋯ These findings are consistent with evidence of an abnormality of pericardial drainage that persists for months after other thyroid hormone dependent functions are normalized by thyroxine replacement. Therefore prompt surgical drainage rather than dependence on medical therapy alone is indicated in myxedematous patients who have cardiac tamponade.
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Clinical cardiology · Aug 1982
Influence of ipratropiumbromide on heart rate and hemodynamics in patients with sinus bradycardia.
In 13 patients with sinus bradycardia, heart rate and hemodynamics were recorded before and 3, 30, 60, and 120 minutes following intravenous administration of 0.5 mg ipratropiumbromide (Itrop by C. H. Boehringer Sohn, Ingelheim, West Germany). ⋯ It increased by an average of 78% three minutes following the administration as compared to pretreatment control values. Mean heart rate still was markedly increased by an average of 26% at 120 min following the injection of the drug. This effect of ipratropiumbromide on heart rate was accompanied by an increase in cardiac index while stroke volume decreased due to a decrease in ejection fraction and diastolic filling time.