Clinical cardiology
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The relationship between QT interval and serum calcium concentration (s-Ca) was examined in 9 hypercalcemic (s-Ca greater than 11 mg/dl) patients. Three QT intervals corrected by Bazett's formula were used for the analysis: the intervals from the beginning of the QRS to the onset (QoTc), the apex (QaTc), and the end of T wave (QeTc). The measurements of s-Ca and other electrolytes were made on the blood sample taken on the same day of the electrocardiogram (ECG) recordings. ⋯ Sensitivity of QoTc, QaTc, and QeTc in predicting high s-Ca was 83%, 57%, and 39%, respectively, and specificity was 100%, 100%, and 89%. The PQ interval tended to be prolonged in the case of hypercalcemia, but the change was statistically insignificant. These observations suggest that QT intervals can serve as an indicator of high s-Ca and that the QoTc seems to be a good indicator of the three QTc's.
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Clinical cardiology · Apr 1987
Pericardial effusion: diagnostic value of the subcostal acoustic window (inferior vena cava-right atrial projection).
To validate the usefulness of the subcostal acoustic window (inferior vena cava-right atrial projection) for the echocardiographic diagnosis of pericardial effusion we studied 40 patients with pericardial effusion detected through the parasternal approach. A group of 100 patients without evidence of effusion constitutes the control group. ⋯ Therefore, moderate and severe pericardial effusions can be detected in most cases (95.4%) below the right atrial wall through the subcostal inferior vena cava-right atrial projection. The echocardiographic criteria for its diagnosis is the lack of contact through the cardiac cycle between right atrial wall and the diaphragm.
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Isolated pulmonary valve prolapse may be a sign of pulmonary hypertension. Three patients with pulmonary hypertension as a result of left ventricular failure, chronic obstructive pulmonary disease, and primary pulmonary hypertension, respectively, are described in the case reports. ⋯ Present methods to detect pulmonary hypertension by two-dimensional echocardiography rely on remote findings of right heart abnormalities or changes in systolic time intervals. Pulmonic valve prolapse is the first direct sign of pulmonary hypertension found on two-dimensional echocardiography.
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Clinical cardiology · Oct 1985
Cardiac arrhythmias during sleep in morbidly obese sleep-apneic patients before and after gastric bypass surgery.
Fourteen morbidly obese patients scheduled for gastric bypass surgery were diagnosed preoperatively as suffering from sleep apnea syndrome. There were 13 males and 1 female aged 24 to 59 years. Mean preoperative excessive body weight was 222 +/- 38%; mean apnea index prior to surgery was 84 +/- 44. ⋯ In a consecutive sleep study performed 6 months postoperatively most cardiac arrhythmias disappeared. Marked sinus arrhythmia persisted in only two patients and severe ventricular premature beats (Lown's grade III-IV), found preoperatively in all patients, were still present postoperatively in only two, although in a much milder form. Surgical weight reduction, therefore, is a valuable method in the abolishment of life-threatening cardiac arrhythmias of the morbidly obese sleep-apneic patient.