Japanese heart journal
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Although there are many reports on sudden cardiac arrest occurring outside the hospital, little is known about the precise prognostic factors that determine the outcome after cardiopulmonary resuscitation. Clinical information before and immediately after sudden cardiac arrest is frequently incomplete because the event occurs outside the hospital. We studied 90 consecutive patients with sudden and unexpected cardiac arrest who were resuscitated in the general ward of our hospital. ⋯ In the group of 25 patients in our study, there have been a total of 10 deaths (40%). Five of the 10 deaths resulted from recurrent cardiac arrest and 1 was a noncardiac death. There was a high rate of recurrence of cardiac arrest in the first year following resuscitation, especially among the cardiomyopathy patients.
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Japanese heart journal · Sep 1989
Congenital coronary artery fistulas. Diagnostic and surgical considerations.
Between 1974 and April, 1988, 9 patients with congenital coronary artery fistulas underwent surgical repair. Of these, 4 were female and 5 male, ranging in age from 6 to 50 years (mean 28.2 +/- 18.9). Seven patients were symptomatic (congestive heart failure and/or angina), whereas in 2 patients the diagnosis was established through the investigation of an asymptomatic continuous murmur. ⋯ There was no operative mortality and long term follow-up was uneventful after a mean follow-up of 5.4 +/- 5.2 years, with 8 patients still completely asymptomatic. Surgical therapy is recommended for patients having coronary artery fistulas in order to prevent fistula-related complications. In those cases requiring CPB, closure of the fistula from the involved chamber only is suggested.
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The difficulty in making an accurate diagnosis of acute pulmonary embolism is well known. To clarify the role of echocardiography, including Doppler echocardiography, in acute pulmonary embolism, we examined hemodynamic and echocardiographic parameters in 9 patients with acute pulmonary embolism just before and after treatment with urokinase. ⋯ Doppler echocardiography quantitatively evaluated the grade of tricuspid regurgitation, and accurately estimated systolic pulmonary artery pressure. We conclude that echocardiography, including Doppler echocardiography, sensitively reflects the right ventricular pressure and volume overload of acute pulmonary embolism, is quite useful for its diagnosis which is often difficult, and is suitable for noninvasive follow up of these patients.