Echocardiographic abnormalities following cardiac radiation.

Five years or more after receiving cardiac radiation, 41 patients with Hodgkin's disease and seminoma in remission were subjected to echocardiography. The abnormalities detected included pericardial thickening in 70%, thickening of the aortic and/or mitral valves in 28%, right ventricular dilatation or hypokinesis in 39%, and left ventricular dysfunction in 39%. In the 23 patients treated by an upper mantle technique with shielding, the incidence of right ventricular abnormalities and valvular thickening was significantly lower than in patients treated with modified techniques.

Propafenone for the treatment of severe ventricular arrhythmias.

Twenty-one patients whose severe ventricular arrhythmias were not controlled by other currently used antiarrhythmic agents or who were intolerant of those drugs were treated with a new antiarrhythmic agent, propafenone. This therapy was associated with complete or nearly complete suppression of premature ventricular beats in 15 (71%) of the patients, satisfactory control in 4 (19%) and no control in 2 (10%). The majority reported no adverse effects.

Clinically unrecognized ventricular dysfunction in young diabetic patients.

Left ventricular function at rest and during supine bicycle exercise was assessed by gated radionuclide angiography in 20 diabetic patients and 18 normal control subjects without clinical evidence of heart disease. The diabetic patients were aged 21 to 44 years and all except one used insulin. No subject developed chest pain or electrocardiographic changes during exercise.

Radionuclide angiography and endomyocardial biopsy in the assessment of doxorubicin cardiotoxicity.

Thirty-eight patients with a mean age of 53.2 years (19 to 75 years of age), who were receiving doxorubicin (D) for malignant disease, were studied in order to determine the relationship between functional and morphologic myocardial changes at different dose levels. Serial patient evaluations included physical examination, chest x-ray, electrocardiogram (ECG), endomyocardial biopsy (EMB), and rest-exercise gated nuclear angiography (GNA), at doses of D ranging from 144 to 954 mg/m2 (mean, 426 mg/m2).

Detection of radiation cardiomyopathy by gated radionuclide angiography.

Twenty-one asymptomatic adults underwent rest and exercise gated radionuclide angiography seven to 20 years after having received mediastinal radiation (2,000 to 7,600 rads) for Hodgkin's disease. None of these patients received cytotoxic chemotherapy. Twelve patients (57 percent) had abnormal left (less than 53 percent at rest and/or greater than 5 percent decrease at peak exercise) and/or right (less than 27 percent at rest and/or greater than 5 percent decrease at peak exercise) ventricular ejection fractions.

Rest and exercise ventricular function in adults with congenital ventricular septal defects.

Rest and exercise right and left ventricular function were compared using equilibrium gated radionuclide angiography in 19 normal sedentary control subjects (mean age 28 years, range 22 to 34) and 34 patients with hemodynamically documented congenital ventricular septal defect (VSD) (mean age 27 years, range 20 to 40). The 34 patients with VSD were divided into 3 groups: those in Group 1 (17 patients) had pulmonary to systemic blood flow ratios of less than 2 to 1; those in Group 2 (12 patients) had prior surgical closure of VSD (mean interval from surgery 17 years, range 9 to 22), and those in Group 3 (5 patients) had Eisenmenger's complex. Gated radionuclide angiography was performed at rest and during each level of graded supine bicycle exercise to fatigue.

Left ventricular function in trained and untrained healthy subjects.

Left ventricular function was compared in 18 normal sedentary controls (mean age 28 years, range 22 - 34 years) and nine endurance-trained athletes (mean age 19 years, range 15 - 25 years) at rest and during supine bicycle exercise. Gated radionuclide angiocardiograms were performed at rest and at each level of graded maximal supine bicycle exercise. Heart rate, blood pressure, left ventricular ejection fraction and the relative changes in left ventricular end-diastolic and end-systolic volumes were assessed.

Acute coronary occlusion following blunt injury to the chest in the absence of coronary atherosclerosis.

A 35-year-old man suffered transmural diaphragmatic wall infarction immediately after receiving a nonpenetrating trauma to his chest. During subsequent months crippling angina pectoris developed and coronary arteriography was performed. A complete obstruction of the left circumflex coronary artery was demonstrated 2 cm.