The Canadian journal of cardiology
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To determine the prevalence of cardiac abnormalities in patients with systemic lupus erythematosus. ⋯ Cardiac abnormalities can be identified noninvasively in 47% of patients with systemic lupus erythematosus.
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A prospective study was conducted of all cases of attempted resuscitation following cardiac arrest occurring over a period of one year in a tertiary care teaching hospital. Analysis was made of the effects on survival of preselected variables of patients and circumstances of arrest. In 125 cases for which resuscitation was attempted, 49 attempts (39%) were initially successful. ⋯ The most potent predictors of successful resuscitation were early successful resuscitation (less than 20 mins), age less than 75 years, and cardiac arrest in proximity to an acute ischemic cardiac event (less than 48 h). Survival to discharge was extremely poor when the arrest was unwitnessed (zero of 20 cases) or when the arrest occurred on medical or surgical wards (two of 62 cases). Such low efficacy indicates that reassessment of policy regarding the administration of cardiac resuscitation to patients in hospital is warranted.
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Multicenter Study Clinical Trial
A Canadian multicentre study of a 48 h infusion of milrinone in patients with severe heart failure.
Milrinone is a nonglycoside, nonsympathomimetic bipyridine with positive inotropic and systemic vasodilator properties. In order to evaluate the efficacy and safety of a short term infusion of milrinone, 105 patients with stable New York Heart Association (NYHA) class III or IV heart failure received a loading dose (50 micrograms/kg) and a 48 h continuous infusion (0.5 micrograms/kg/min). Administration of the loading dose resulted in a 28% decrease in pulmonary capillary wedge pressure (PCWP) (P less than 0.001), a 38% increase in cardiac index (P less than 0.001), and a 34% increase in stroke volume index (P less than 0.001) within 15 mins. ⋯ Of the 105 patients entered, one died of an acute myocardial infarction after premature termination of the infusion, and the infusion rate was decreased in two others because of supraventricular arrhythmias. In patients with severe heart failure, intravenous milrinone has significant beneficial hemodynamic effects. ECG monitoring for arrhythmias is recommended during milrinone infusion.
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Primary cardiac tumours are uncommon entities, and myxoma is the most common, comprising about 50% of all these neoplasms. A case of a 43-year-old woman with right atrial myxoma and a shunt through a patent foramen ovale producing severe cyanosis is reported.