British heart journal
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The treatment of pain in acute myocardial infarction varies with local practice. Narcotic analgesics are still the usual treatment in many hospitals. Knowledge of optimal doses, duration of pain relief, and time between drug administration and pain relief is inadequate. ⋯ Large randomised studies consistently show that beta blockade, initially given intravenously and then orally, relieves pain and reduces the need for analgesics. Studies also indicate that early administration of streptokinase and glyceryl trinitrate relieves pain. There is evidence that drugs that limit ischaemic damage also relieve pain.
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British heart journal · Jun 1988
Reproducibility of cardiac output measurement by cross sectional and Doppler echocardiography.
The variability of Doppler echocardiographic estimation of cardiac output at the aortic orifice was investigated in eight healthy subjects. Cross sectional echocardiograms of the aortic orifice and aortic Doppler velocities were recorded and measured by four echocardiographers. Between subject variability was significantly larger than within subject variability for all variables. ⋯ The coefficient of variation for cardiac output was 8.8% and the 95% confidence interval for measurement of cardiac output by the Doppler method was 4.45 to 6.35 l/min. One echocardiographer reanalysed all the recordings and the results showed that recording the echocardiograms introduces a significantly larger source of error than measuring them. Thus serial measurements of cardiac output by the Doppler method can be performed with acceptable reproducibility; this indicates that the technique can be accurately applied in clinical practice.
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British heart journal · Jan 1988
Case ReportsMarfan's syndrome and isolated aneurysm of the abdominal aorta.
A 43 year old woman presented with an aneurysm of the abdominal aorta. Marfan's syndrome was diagnosed as the underlying cause of the aneurysm. An isolated aneurysm as presenting sign of Marfan's syndrome is rare. In a review of published reports about 30 cases were found.
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British heart journal · Nov 1987
Continuous arteriovenous haemofiltration in children with postoperative cardiac failure.
Six children with refractory heart failure were treated by continuous arteriovenous haemofiltration. The cause of the failure was postoperative fluid overload or low cardiac output with anuria or oliguria. This produced a mean (2 SD) negative fluid balance of 1.4 (0.6) ml/kg/h and reduced mean (2 SD) body weight from 4.7 (2.2) to 4.2 (2.3) kg over a period of 57.5 (31.1) hours. ⋯ All but one was weaned from artificial ventilation and catecholamine treatment. No adverse haemodynamic effects were noted. One child need operation for a femoral artery thrombosis after 12 days of continuous arteriovenous haemofiltration.
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British heart journal · Oct 1987
Comparative StudyA comparison of bepridil with amiodarone in the treatment of established atrial fibrillation.
Fourteen patients with established atrial fibrillation (longer than three months) that was refractory to treatment were studied to compare the clinical and electrophysiological effects of amiodarone and bepridil. All patients initially received bepridil for three weeks (200-600 mg/day), followed by amiodarone for two to three months (100-400 mg/day). Bepridil seemed to be slightly more effective than amiodarone in converting the fibrillation to sinus rhythm (nine of fourteen compared with four of ten). ⋯ These arrhythmias seemed to be associated with bepridil induced prolongation of the QTc interval. No ventricular arrhythmias were seen during amiodarone treatment. Although bepridil seems to be an effective antiarrhythmic agent for the management of atrial fibrillation, its arrhythmogenic actions make it unsuitable for this purpose.