Journal of the American College of Cardiology
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The purpose of this study was to investigate the effects of lightning strikes on the cardiovascular system. ⋯ Unless both entrance and exit sites are limited to the lower limbs, direct and splash lightning strikes cause myocardial damage as assessed by abnormal serum enzyme determinations or abnormal echocardiographic findings. Only direct hits resulted in echocardiographic abnormalities or a prolonged QTc interval. The degree of myocardial injury can be severe with left and right ventricular ejection fraction < 15% and can be reversible.
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The present investigation compared and contrasted steady and pulsatile pulmonary hemodynamics at rest and during exercise in patients with primary pulmonary hypertension and normal control subjects. ⋯ In addition to the expected abnormalities in steady measures of pulmonary artery hemodynamics at rest in patients with primary pulmonary hypertension, rest and exercise measures of oscillatory behavior (characteristic impedance and pulse wave reflection) are perturbed. Measures of steady and pulsatile behavior, particularly wave reflection, appear to have an important role in the exercise response of these patients.
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J. Am. Coll. Cardiol. · Feb 1993
Extent of jeopardized viable myocardium determined by myocardial perfusion imaging best predicts perioperative cardiac events in patients undergoing noncardiac surgery.
This study was undertaken to test the hypothesis that the risk of perioperative cardiac events is not simply determined by the presence of myocardium at risk, but is directly related to the extent of myocardium at risk as reflected in thallium-201 myocardial imaging. ⋯ The probability of important cardiac events in patients undergoing noncardiac surgery is best predicted by the extent of myocardium at risk as reflected on thallium-201 myocardial perfusion imaging. A history of diabetes mellitus also has a significant influence on perioperative risk.
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J. Am. Coll. Cardiol. · Jan 1993
Multicenter Study Clinical TrialPercutaneous balloon pericardiotomy for the treatment of cardiac tamponade and large pericardial effusions: description of technique and report of the first 50 cases.
This study describes the technique, clinical characteristics and results of the first 50 patients undergoing percutaneous balloon pericardiotomy as part of a multicenter registry. ⋯ Percutaneous balloon pericardiotomy is successful in helping to manage large pericardial effusions, particularly in patients with a malignant condition. It may become the preferred treatment to avoid a more invasive procedure for patients with pericardial effusion and a limited life expectancy.
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J. Am. Coll. Cardiol. · Jan 1993
Comparative StudyUsefulness of transesophageal echocardiography in identifying small left ventricular apical thrombus.
The aim of this study was to determine whether transesophageal echocardiography could clarify the nature of equivocal echodense structures in the left ventricular apical region frequently found on transthoracic echocardiography by directing the ultrasound beam from the left ventricular base to the apex and achieving better image quality. ⋯ 1) Transesophageal echocardiography is useful in identifying left ventricular apical thrombus in patients with unclear echogenic structures on transthoracic apical images; and 2) the high incidence of arterial embolism in patients with transesophageal echocardiographically detected left ventricular thrombus indicates the clinical importance of such thrombus.