Zeitschrift für Kardiologie
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Comparative Study
[Comparison of invasive blood pressure measurement in the aorta with indirect oscillometric blood pressure measurement at the wrist and forearm].
Indirectly measured blood pressure at the wrist or upper arm was compared with directly measured values in the aortic arch during routinely performed diagnostic cardiac catheterization in 100 patients (31-80 years, mean 59.3 years, 60% males). The noninvasive measurements were carried out by oscillometric devices, NAiS Blood Pressure Watch for measurements at the wrist, and Hestia OZ80 at the upper arm. Systolic blood pressure measured at the wrist was 4.3 +/- 14.1 mm Hg, and the diastolic value 6.0 +/- 8.9 mm Hg higher than when measured at the aortic arch; the difference was significant in both cases. ⋯ The correspondence between wrist and upper arm values was better for diastolic blood pressure, the values differing by less than +/- 10 mm Hg in two-thirds of patients. Self-measurement of arterial blood pressure with an oscillometric device at the wrist can be recommended only in individual cases with a difference of simultaneously measured values at the upper arm of less than +/- 10 mm Hg for systolic and diastolic blood pressures. The standard method for indirectly measuring arterial blood pressure remains the measurement at the upper arm site, which nevertheless showed a systolic pseudohypertension (deviation of more than 10 mm Hg) in comparison to the invasively measured values in 15% of our selected patients and a diastolic pseudohypertension (deviation of more than 15 mm Hg) in 23% of the patients.
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Case Reports
[The aortic arch as source of thromboembolism events--significance of echocardiography diagnosis].
A 43-year-old woman presented with acute embolic occlusion of the left brachial artery. She was immediately treated by surgical embolectomy. ⋯ There-upon an aortotomy and thrombectomy was performed and showed a normal wall structure of the thoracic aorta except for a minimal ulcerated lesion of the intima at the aortic arch. This case confirms that transthoracic and transesophageal echocardiography are the diagnostic methods of choice for detecting thromboembolic sources originating in the heart or thoracic aorta.