Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Aug 1993
Randomized Controlled Trial Multicenter Study Clinical TrialShort-term effects of early intravenous treatment with a beta-adrenergic blocking agent or a specific bradycardiac agent in patients with acute myocardial infarction receiving thrombolytic therapy.
This study was conducted to explore mechanisms that could explain the possible clinical benefit of early administration of a beta 1-selective adrenoreceptor blocking agent or a bradycardiac drug as adjunct to thrombolysis in acute myocardial infarction. ⋯ In the absence of contraindications, the administration of a beta-blocker or a specific bradycardiac agent together with thrombolytic therapy was safe. In this limited number of patients, these agents did not appear to enhance myocardial salvage or preservation of left ventricular function or to reduce the incidence of major arrhythmias in the early phase of infarction.
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This study was designed to determine the diagnostic value of chest radiography for pericardial effusion. ⋯ A predominant left-sided pleural effusion and a pericardial fat stripe are chest radiographic signs that are suggestive, but not diagnostic, of pericardial effusion. Because these signs cannot reliably confirm or exclude the presence of pericardial effusion, we conclude that chest radiography is poorly diagnostic of this condition.
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J. Am. Coll. Cardiol. · Aug 1993
Planimetry of orifice area in aortic stenosis using multiplane transesophageal echocardiography.
The purpose of this study was to investigate whether the orifice area in aortic stenosis can be determined accurately and reliably by multiplane transesophageal echocardiography. ⋯ Multiplane transesophageal echocardiography is a practical and accurate clinical tool for the assessment of the severity of aortic stenosis.
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J. Am. Coll. Cardiol. · Jul 1993
Intravenous amiodarone for life-threatening tachyarrhythmias in children and young adults.
The purpose of this study was to evaluate the efficacy of intravenous amiodarone in young patients. ⋯ Intravenous amiodarone was well tolerated in this small series of patients. Postoperative ventricular tachycardia was responsive to intravenous amiodarone in 80% (8 of 10) of the patients (95% confidence interval 40% to 99%). Use of this drug in acute, postoperative tachyarrhythmias may be lifesaving in some patients when standard intravenous therapies fail.
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J. Am. Coll. Cardiol. · Jul 1993
Bolus intravenous nitroglycerin predominantly reduces afterload in patients with excessive arterial elastance.
We hypothesized that bolus intravenous nitroglycerin would be an afterload-reducing agent in patients with excessive initial afterload for their level of left ventricular systolic function. Conversely, bolus intravenous nitroglycerin should be a preload-reducing agent in patients without excessive initial afterload. ⋯ Patients with normal arterial elastance and ventricular function respond to nitroglycerin with a predominant preload reduction, whereas patients with either excessive arterial elastance or abnormal ventricular function respond with a predominant afterload reduction.