International journal of cardiology
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This study examines the use of conductance catheters to assess human right ventricular volume. Ten patients undergoing diagnostic cardiac catheterisation underwent right heart catheterisation with a conductance catheter and micromanometer, and a thermodilution catheter before and after fluid loading. Parallel wall conductance (Vc), and the multiplication factor relating conductance and thermodilution derived stroke volumes (å) were derived at each steady state. ⋯ D. 0.16). Serial cycles recorded during volume loading defined an end systolic pressure-volume relation more reliably than a stroke work end diastolic volume relation. Thus, a conductance derived volume signal can be obtained in the human right ventricle which can be interpreted as a continuous and instantaneous index of right ventricular volume, allowing the construction of real time pressure-volume cycles.
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In inferior wall acute myocardial infarction, maximal ST-segment depression in left precordial leads (V4-V6) has been shown to be associated with increased in-hospital mortality, presumably due to coronary artery disease involving the left anterior descending coronary artery system. ⋯ In patients with inferior wall acute myocardial infarction, maximal precordial ST-segment depression in leads V4-V6 is suggestive of severe coronary artery disease involving the left anterior descending coronary artery or its diagonal branch.
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I describe a patient with bilateral trapezius myalgias as a presenting manifestation of group B streptococcal endocarditis. Diffuse myalgias occur in association with bacterial endocarditis. However, localized trapezius myalgias have not been reported. Physicians should consider the diagnosis of endocarditis in patients with this compliant.