Med Klin
-
Clinical signs of an acute penetrating wound of the heart not always are clear. Because of hemorrhage and reduced cardiac output during heart tamponade venous pressure not necessarily must be increased. If by pericardiocentesis an aspiration of blood is possible, diagnosis of a penetrating heart wound is of high probability; otherwise there is no diagnostic value of a negative pericardiocentesis. ⋯ Attention is necessary because of an injury of a coronary artery. Following this principle prognosis is good if the patient is reaching clinical treatment alive. Lethal outcome in 2 of our 12 reported cases in one of them is caused by refusing immediate surgical intervention by the patient himself, in the other by development of ischemic cardiac necrosis involving a papillary muscle after suturing a cardiac wound.
-
Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical Trial
[On the action of antihypotensive agents in sympathicotonic orthostatic hypotension in geriartric patients: comparison between placebo and etilefrin (author's transl)].
The action of etilefrin (Effortil Depot Perlongets) was compared with placebo in a double-blind study in 24 female geriatric patients with sympathicotonic orthostatic hypotension. After determining the basic values, all patients were treated with the active substance in a titration phase lasting one week (dosage 2-3 Perlongets/day). The decrease in systolic blood pressure and the increase in pulse rate while standing were then statistically significant lower (p less than (p less than 0.001) when compared with the basic values. ⋯ The symptomatology, particulary episodes of collapse increased again. There was a statistically significant difference between the action of etilefrin and placebo for all criteria (both objective and subjective parameters). Side-effects were not observed.
-
The effect of dopamine was tested in 20 patients with cardiogenic shock. 14 patients suffered from acute myocardial infarction, 6 patients from severe heart failure. In the beginning the dosis of dopamine was 200 to 300 microgram/min. 4 patients with an acute myocardial infarction died in shock. ⋯ Hemodynamic studies showed a sigificant increase of the arterial mean pressure and a decrease of the diastolic arterial pulmonary pressure. During dopamine a statistically not significant increase of cardiac index and stroke volume was observed.
-
Report about a case of relapsing polychondritis in a woman aged 60 years, which was proofed through autopsy. There was involvement of the trachea, the bronchial system and the cartilages of the ribs. ⋯ The pecularities of the clinical picture and the pathohistological findings are reported in detail. It seems that the polychondritis is related in it's pathogenesis to the rheumatic disorders. tthe etiology, however, remains obscure.