Arquivos brasileiros de cardiologia
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Arq. Bras. Cardiol. · Jul 1994
Case Reports[Diagnosis of papillary muscle rupture in acute myocardial infarction by transesophageal Doppler echocardiography].
Three patients, two females, ages ranging from 62 to 78 years were studied, evolving with hypotension, acute pulmonary edema and cardiogenic shock. One had anterior myocardial infarction, and in two, infero-posterior. Due to severe hemodynamic instability and necessity of vasoactive drug therapy to maintain adequate arterial pressure, coronary angiography was performed in two, showing total occlusion of the circumflex artery and severe mitral regurgitation. ⋯ The third patient died before operation. Differential diagnosis of acute mitral regurgitation due to papillary muscle dysfunction or rupture was not possible by left ventriculography or by transthoracic echo. Transesophageal echo was the only exam to clearly confirm papillary muscle rupture, as should be done promptly after clinical suspicion of this severe condition arises.
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Arq. Bras. Cardiol. · Mar 1994
[Thiocyanate toxicity arising from prolonged use of sodium nitroprusside in severe heart failure].
To evaluate the toxicity of thiocyanate induced by the infusion of sodium nitroprusside in patients with severe congestive failure. ⋯ Sodium nitroprusside is potentially toxic, especially when the renal function is abnormal. Thiocyanate dosage is useful in diagnosing nitroprusside induced toxicity and then it contributes to an adequate treatment and prevention of clinical toxicity.
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Arq. Bras. Cardiol. · Aug 1993
Comparative Study[Artificial respiration with extracorporeal membrane oxygenator in arteriovenous position without pump. Experimental study].
To test the hypothesis of respiratory support and to study the consequent hemodynamic alterations, we performed pumpless A-V ECMO using a 1.2m2 polipropylene hollow fiber membrane oxygenator, specially adapted from conventional model utilized in routine cardiac surgery. ⋯ In both groups pumpless A-V ECMO was able to maintain gasimetric parameters within acceptable patterns and compatible with life, with few hemodynamic alterations. However, an adequate mean arterial blood pressure is needed to provide flow through membrane oxygenator.
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Arq. Bras. Cardiol. · Nov 1992
Case Reports[Pheochromocytoma. Its diagnostic and therapeutic characteristics].
Pheochromocytoma is a cause of hypertension that frequently can be cured by surgery. The aim of this paper, based on 5 cases of pheochromocytoma, is to relate our experience in diagnosis and treatment in this pathology. In four of 5 patients with pheochromocytoma we observed unusual characteristics of the disease. ⋯ Computed tomography and I-131 meta-benzylguanidine for radioisotopic imaging, displayed not only all tumoral masses but also bone metastases in the malignant case. During the follow-up period, from the sixth month to the fourth year after surgery, four patients were asymptomatic, and have normal urinary catecholamine metabolite levels. The patient with a malignant form of pheochromocytoma continued to show elevated catecholamines release and remained hypertensive in spite of adrenal mass resection.