International journal of cardiology
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Eighty patients (43 M, 37 F), aged 23-89 years who were referred for emergency echocardiography over a 12-month period were prospectively studied in order to determine the reasons for emergency echocardiography and the influence of its results on patient management. The most frequent emergency request was to clarify whether the basis for cardiomegaly in a haemodynamically unstable patient was pericardial effusion or left ventricular dilatation. ⋯ As a consequence of the emergency echocardiography, management was immediately influenced in 19 patients. This study has provided information on the specific settings in which emergency echocardiography can be justified.
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We present two patients who were admitted to our Hospital because of repetitive syncopal attacks. The study previous to their admission included electrocardiograms in which the QT interval was normal. During their admission, an striking lengthening of the QT interval, in addition to other criteria of the long QT syndrome, was observed in both patients. We suggest that one normal measurement of the QT interval should not rule out this diagnosis.
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Randomized Controlled Trial Clinical Trial
The effect of lorcainide on arrhythmias and survival in patients with acute myocardial infarction: an example of publication bias.
Ninety-five patients with suspected acute myocardial infarction were randomly allocated on admission to hospital on a double blind basis to treatment with lorcainide, a Class 1C anti-arrhythmic drug, or matching placebo. Treatment was continued for 6 weeks. Twenty-four-hour ECG tape recordings were made immediately on admission, on the sixth or seventh day after admission, and again just before the end of the treatment period. ⋯ The study was not designed to evaluate the effect of lorcainide on survival, but there were nine deaths among the 49 patients treated with lorcainide compared with only one in the patients given placebo. These findings are consistent with the results of the First and Second Cardiac Arrhythmia Suppression trials (CAST and CAST-II). This study was carried out in 1980 but was not published at the time: it now provides an interesting example of 'publication bias'.
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Case Reports
Unilateral pulmonary artery agenesis: a rare cause of haemoptysis and pleuritic chest pain.
Haemoptysis and pleuritic chest pain are common presentations of cardiopulmonary disease. While a number of common disorders may explain these symptoms, occasionally unusual causes may emerge which should be considered in the differential diagnosis especially if pulmonary embolism is unlikely; so that inappropriate anticoagulation or thrombolytic therapy is avoided. We present a case of unilateral pulmonary artery agenesis, who presented with pleuritic chest pain and haemoptysis, and was initially treated as a case of pulmonary thromboembolism.
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Comparative Study
Peripartum versus idiopathic dilated cardiomyopathy in young women--a comparison of clinical, pathologic and prognostic features.
Clinicopathologic features of 13 women with peripartum cardiomyopathy were compared to 13 women aged 19 through 38 with idiopathic dilated cardiomyopathy. No presenting clinical or pathologic variable distinguished either group. However, the clinical course differed between the groups. ⋯ Patients in this group succumbed one year or more after disease onset. Five of 13 patients with peripartum cardiomyopathy had poor outcome, with death occurring 9 months or less after disease onset. The clinical course of peripartum cardiomyopathy appears distinct from that of idiopathic dilated cardiomyopathy in young women.