Giornale italiano di cardiologia
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We report on a patient with pulmonary thromboembolism, primarily diagnosed by urgent TEE. The thrombus was localized in the distal portion of the right pulmonary artery and was easily recognized by transversal plane TEE inspection. Pulmonary scintigraphy was subsequently performed and confirmed TEE findings.
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Hyperdynamic left ventricular function and increased left ventricular mass has been recently reported in the long-term follow-up of patients after successful repair of aortic coarctation (AoCo). ⋯ In the long-term follow-up of patients after successful coarctation repair there are persistent alterations of left ventricular function with hypertrophy, hyperkinesia and increased inotropic state. Hypertension at rest and after exercise could persist despite good surgical results.
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Clinical Trial
[An experimental model for the rational treatment of arrhythmias: a clinical study with quinidine].
Fourteen patients with supraventricular and/or ventricular ectopic beats selected by clinical, dynamic ECG and exercise test, underwent a basal continuous ECG recording (Holter) and then were given 400 mg of quinidine orally. The concentrations of the drug were determined in blood samples taken 30 minutes before, and 1, 2, 4, 6, 8, 12, and 24 hours after administration. On the same day patients were also monitored by continuous ECG recording (Holter). ⋯ Concentrations producing 50% of the effect (EC50) could be calculated from these curves. In spite of similar steady-state blood levels of quinidine, some patients after chronic therapy did not respond to treatment (non responders). Non responders could be predicted by the acute test because they had greater EC50 values of QTc increase: patients with EC50 greater than 2 mg/L were all non responders.
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The management of patients with isolated congenital complete heart block is controversial, and indications for cardiac pacing are not clearly defined. In the present study we report our long-term experience in the management of patients with this disease. ⋯ Our results confirm that patients with isolated congenital complete heart block often have symptoms and/or signs of electric instability without symptoms. Cardiac pacing relieves symptoms and improves working capacity. Although in this study we are not able to draw conclusions on the therapeutic value of prophylactic pacing, our favourable follow-up results suggest that this therapeutic approach may prevent complications.