European heart journal
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European heart journal · Mar 1995
Pre-hospital triage of patients with suspected myocardial infarction. Evaluation of previously developed algorithms and new proposals.
To evaluate previously developed algorithms for the improvement of pre-hospital triage of patients with suspected acute cardiac disease. ⋯ The hospital-based algorithms were unsuitable as a predictor for pre-hospital acute cardiac pathology. A new practical hospital admission model was developed, based on six clinical predictors, including analysis of an electrocardiogram. Following appropriate validation, this out-of-hospital protocol may lead to better triage decisions by the general practitioner.
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European heart journal · Mar 1995
Characteristics of infective endocarditis in France in 1991. A 1-year survey.
To update data on incidence and characteristics of infective endocarditis in France. ⋯ Despite medical and surgical advances, infective endocarditis remains frequent and severe in France.
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European heart journal · Dec 1994
Survival in patients found to have ventricular fibrillation after cardiac arrest witnessed outside hospital.
Since 1980 an Emergency Medical Service (EMS) system with a two-tier ambulance service has been operating in Göteborg. During this 12-year period, all cardiac arrests outside hospital have been monitored. Cardiopulmonary resuscitation (CPR) training for the general public began in 1985 and, by the end of 1992, 125 000 persons had been trained. ⋯ The study group comprises all patients with cardiac arrest witnessed outside hospital in Göteborg between 1980 and 1992, in whom CPR was initiated by our EMS and ventricular fibrillation observed at the first ECG recording. In a multivariate analysis of age, sex, time of collapse, interval between collapse and first defibrillation, bystander-initiated CPR, the following factors were associated with an increased chance of being discharged from hospital: (1) Short interval between collapse and first defibrillation (P < 0.001); (2) Bystander-initiated CPR (P < 0.001); and (3) Age (P < 0.05). Among patients with an out-of-hospital cardiac arrest who were found by the EMS personnel to have ventricular fibrillation, the predictors of survival were: interval between collapse and defibrillation, bystander-initiated CPR and age.
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European heart journal · Oct 1994
Volume loading in predominant right ventricular infarction: bedside haemodynamics using rapid response thermistors.
Intravenous fluid loading is commonly used for the treatment of low cardiac output (CO) syndrome complicating severe right ventricular infarction (RVMI). We prospectively evaluated the effectiveness of this method in 11 consecutive patients (age 66 +/- 14 years) with severe RVMI, using a newer thermodilution method with rapid response thermistors. Volume loading was performed until pulmonary wedge pressure (PWP) reached 18 to 24 mmHg. ⋯ The end-diastolic RV volume increased from 95 +/- 26 to 113 +/- 24 ml.m-2 (P < 0.001); however, RV end-systolic volume increased from 65 +/- 28 to 83 +/- 29 ml.m-2 (P < 0.01), thus SV did not change significantly (30 +/- 6 vs 30 +/- 8 ml.beat-1.m-2, P ns). RVEF decreased from 32 +/- 11 to 28 +/- 11% (P < 0.001). CO did not improve significantly (2.3 +/- 0.42 vs 2.4 +/- 0.62 l.min-1.m-2, P ns) neither did the clinical status.(ABSTRACT TRUNCATED AT 250 WORDS)
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European heart journal · Sep 1994
Review Case ReportsImpending paradoxical embolism: a case report and literature review.
Paradoxical embolism occurs following the passage of embolic material from the venous to the arterial circulation through a right to left shunt--frequently a patent foramen ovale. The diagnosis is usually presumptive when arterial emboli occur in the appropriate clinical setting. ⋯ Transoesophageal echocardiography revealed a thromboembolus straddling a patent foramen ovale. The patient underwent emergency removal of the intracardiac clot with closure of the patent foramen ovale.