Cor et vasa
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Ten patients with severe pulmonary hypertension due to Toxic Oil Syndrome (TOS) (3 men, 7 women; mean age 27.9 +/- 11.23 yrs.) are presented. The pulmonary vessels were examined with a micromorphometric technique. All patients had intimal fibrosis of the arteries and veins. ⋯ Plexiform lexions were found in eight cases. It is concluded that TOS can produce severe pulmonary hypertension histologically undistinguishable from the primary form. TOS can be added to the list of diseases causing plexogenic arteriopathy.
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Data on the epidemiology of sudden cardiac death from several regions of the People's Republic of China are presented. The average annual incidence varied from 7.3 to 29.5 per 100,000, being greater in the north and north-east part of the country than in the south-east China. Ischaemic heart disease and acute myocardial infarction were the underlying causes in more than half of the autopsied cases of sudden cardiac death. In most cases, multiple severe stenoses of the coronary arteries were found.
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Five patients in cardiogenic shock due to acute myocardial infarction were examined by two-dimensional echocardiography. In one patient, cardiogenic shock developed only after rupture of the interventricular septum, four subjects had "primary" cardiogenic shock. In these four persons there were found extensive disturbances of left ventricular wall motion (the mean extent of the akinetic or dyskinetic zone amounted to 41% of the left ventricle (LV). ⋯ The basic difference between the two groups consisted in the fact that in patients in cardiogenic shock the remaining part of the left ventricle exhibited severe hypokinesis, whereas in other infarcts it was normokinetic or hyperkinetic. Autopsy findings in all patients revealed severe diffuse involvement of all coronary arteries. In the discussion, it is pointed out that the above-mentioned phenomenon (hypokinesis of the "intact" part of the left ventricle) may be both one of the causes of shock as well as merely its consequence.
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In 18 patients with the Lown-Ganong-Levine syndrome and in 11 control subjects the response of the atrioventricular conduction system to heart rate acceleration by right atrial pacing, and, with the aid of His bundle electrogram, the behaviour of individual levels of the atrioventricular conduction system were studied. At spontaneous sinus rhythm A-H interval was shorter in the patients with the Lown-Ganong-Levine syndrome than in the controls. In the latter the A-H interval became markedly prolonged, up to a Wenckebach-type IInd-degree AV block, already at a minor pacing-induced acceleration of the heart rate, whereas in the patients with the Lown-Ganong-Levine syndrome the atrioventricular propagation of excitation at a 1:1 ratio remained preserved even at substantially higher heart-rate values. On the basis of the responses of the A-H interval to pacing the patients with the Lown-Ganong-Levine syndrome were classed into four types.