British heart journal
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British heart journal · Feb 1990
Ambulatory pulmonary arterial pressure in primary pulmonary hypertension: variability, relation to systemic arterial pressure, and plasma catecholamines.
The variability of pulmonary arterial pressure, the relation of pulmonary pressure to systemic pressure, pulmonary pressure responses to stimuli (exercise, hypoxia, smoking, free ambulation), and plasma catecholamine responses were assessed in five patients with primary pulmonary hypertension. Ambulatory monitoring techniques provided data for the computerised analysis of continuous, beat-to-beat, direct recordings of both pulmonary and systemic arterial pressures for 8 to 10 hours. ⋯ The variability of systemic pressure was similar to that in healthy volunteers. Basal and stimulated plasma catecholamine values were normal, suggesting preservation of normal sympathetic nervous system activity in primary pulmonary hypertension.
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British heart journal · Feb 1990
Comparative StudyNon-invasive determination of cardiac output by Doppler echocardiography and electrical bioimpedance.
Cardiac output measured by thermodilution in 25 patients within 24 hours of acute myocardial infarction was compared with cardiac output measured by Doppler echocardiography (24 patients) and electrical bioimpedance (25 patients). The mean (range) cardiac outputs measured by Doppler (4.03 (2.2-6.0) 1/min) and electrical bioimpedance (3.79 (1.1-6.2) 1/min) were similar to the mean thermodilution value (3.95 (2.1-6.2) 1/min). Both non-invasive techniques agreed closely with thermodilution in most patients. ⋯ Both non-invasive techniques were reproducible and accurate in most patients with acute myocardial infarction. Doppler echocardiography was time consuming and technically demanding. Electrical bioimpedance was simple to use and had the additional advantage of allowing continuous monitoring of the cardiac output.
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British heart journal · Jan 1990
Case ReportsReversible impairment of myocardial function in hypoparathyroidism causing hypocalcaemia.
A 25 year old woman presented with severe myocardial dysfunction. Laboratory tests showed hypocalcaemia caused by hypoparathyroidism. After the restoration of normal concentrations of serum total and free ionic calcium indices of left ventricular function returned to normal and her symptoms disappeared.
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British heart journal · Dec 1989
Integration of ambulance staff trained in cardiopulmonary resuscitation with a medical team providing prehospital coronary care.
Ambulance staff with advanced training in cardiopulmonary resuscitation and equipped with monitor/defibrillators were used as the initial responders to collapse calls within a medically based prehospital coronary care system. During 21 months, in a population of approximately 120,000, ambulance staff successfully resuscitated six patients from ventricular fibrillation; there were four long term survivors. The median response time of emergency ambulances to collapse calls was eight minutes compared with 20 minutes for the medically manned mobile coronary care unit. ⋯ Nineteen other patients with important arrhythmias were referred for earlier medical management which in some cases may have saved lives. An additional eight long term survivors of out of hospital ventricular fibrillation were resuscitated by medical staff. The integration of paramedical with medical prehospital coronary care improved survival after out of hospital cardiac arrest.
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British heart journal · Apr 1989
Diagonal earlobe creases and fatal cardiovascular disease: a necropsy study.
The association between diagonal earlobe creases and fatal cardiovascular disease was investigated in a consecutive series of 303 coroner's necropsies. Those studied all died outside hospital in the Brighton Health District. Data were analysed on the cause of death and on the type of earlobe, the presence or absence of diagonal creases, age, sex, height, and any previous history of cardiovascular disease or diabetes mellitus. ⋯ Diagonal creases were present in 123 (72%) of 171 men and 88 (67%) of 132 women. A previous history of cardiovascular disease was present in 90 (30%) of the total of 303 and 74 (35%) of the 211 with diagonal creases. A cardiovascular cause of death was present in 154 (73%) of 211 with and 41 (45%) of 92 without diagonal creases and was associated with an increased risk of a cardiovascular cause of death of 1.55 in men and 1.74 in non-diabetic women.