European heart journal
-
European heart journal · Jun 1986
Case ReportsLeft coronary artery aneurysm and anteroseptal acute myocardial infarction following blunt chest trauma.
After a suicide attempt (fall from the ninth floor) a 28-year-old man presented with a blunt chest trauma. Electrocardiographic and enzymatic changes were characteristic of an acute anteroseptal myocardial infarction. ⋯ The other left and right coronary arteries were normal. The patient remained asymptomatic 8 months later under medical treatment.
-
The efficacy of intraaortic counterpulsation (IABP) in severe cardiogenic shock after acute myocardial infarction is questioned because of the lack of a large controlled series. Out of 52 patients treated for severe, prolonged cardiogenic shock 3 improved with 'conventional' treatment. Forty-nine patients did not improve and were in 'intractable' shock for an average of 10.74 +/- 7.14 h (means +/- SD). ⋯ Ten survived longer than a month. Of the remaining 15 patients of similar age, severity and duration of shock, in whom the balloon could not be made to operate, none survived. It is suggested that intraaortic counterpulsation can save a number of patients with severe protracted cardiogenic shock after all other available treatment modalities have failed.
-
European heart journal · Mar 1985
Clinical significance of nonclinical ventricular tachycardia induced in amiodarone-treated patients.
The clinical significance of sustained nonclinical ventricular tachycardia (VT) induced during electrophysiologic studies was studied in 10 amiodarone-treated patients. Nine patients had previous myocardial infarction while 1 patient had right ventricular dysplasia. All patients had only a single morphologic type of VT recorded during the multiple spontaneous episodes of tachycardia. ⋯ Nonclinical VT was sustained, requiring cardioversion (7 patients) or rapid ventricular pacing (3 patients) for termination. After a mean follow-up period of 27 +/- 10 months (range 12 to 36 months), 4 patients did not exhibit recurrent VT, 3 patients with inducible clinical VT experienced a recurrent episode of clinical VT after 16, 27 and 49 months, respectively, 2 patients had nonarrhythmia related deaths after 11 and 12 months, and 1 patient died suddenly after 17 months. These results suggest that laboratory induction of sustained nonclinical VT in amiodarone-treated patients does not imply the likelihood of their future spontaneous occurrence and, therefore, their prevention may not be required.
-
European heart journal · Mar 1985
Randomized Controlled Trial Comparative Study Clinical TrialMetoprolol in acute myocardial infarction (MIAMI). A randomised placebo-controlled international trial. The MIAMI Trial Research Group.
The effect of metoprolol on mortality and morbidity after 15 days, was compared with that of placebo in a double-blind randomised international trial (the MIAMI trial) in patients with definite or suspected acute myocardial infarction (AMI). Treatment with intravenous metoprolol (15 mg) or placebo was started shortly after the patient's arrival in hospital within 24 h of the onset of symptoms, and then oral treatment (200 mg daily) was continued for the study period (15 days). Of the 5778 patients included, 2901 were allocated to placebo and 2877 to metoprolol. ⋯ There was no significant effect on ventricular fibrillation but the number of episodes tended to be lower in the metoprolol treated patients during the later phase (6-15 days; 24 vs 54 episodes). The incidence of supraventricular tachyarrhythmias, the use of cardiac glycosides and other antiarrhythmics, and the need for pain-relieving treatment were significantly diminished by metoprolol amongst all randomised patients. Adverse events associated with metoprolol were infrequent, expected, and relatively mild.