[Giant aneurysm of the interventricular septum. Value of imaging techniques].

A pseudosubaortic left ventricular aneurysm was discovered in a 32 year old African presenting with pyrexia after a long history of chest pains and dyspnea. Echographic and radiological techniques showed a large pulsatile mediastinal mass and the patient was referred for aneurysmorrhaphy. The actiology of this pseudo-aneurysm is discussed with reference to data in the literature.

[Is plasma lipoprotein (a) level a reliable indicator predicting restenosis after angioplasty?].

Lipoprotein (a) [Lp(a)] is an independent genetically determined marker of coronary artery disease. It is present in the atheromatous plaque with a molecular structure similar to that of plasminogen. Its role in postangioplasty restenosis is a possibility but is controversial.

[Left ventricular filling and left bundle branch block: an echocardiographic and radionuclide study].

Left bundle branch block changes the activation and haemodynamics of the left ventricle. In order to evaluate its consequences on left ventricular filling, the duration of the isovolumic relaxation period, the velocities and the integrals of the rapid and slow filling waves were recorded by Doppler echocardiography and the ejection fraction, the peak filling rate and its time of apparition were measured by gamma angiocardiography in 18 patients aged 55 +/- 9 years and 18 control subjects aged 53 +/- 9 years. Left bundle branch block was associated with a prolonged isovolumic relaxation period (104 +/- 14 vs 88 +/- 11 ms) a delayed and reduced peak filling rate and an increased atrial filling velocity at a heart rate comparable to that of control subjects (69 +/- 9 vs 72 +/- 8 beats/mn).

[Contribution of transesophageal echocardiography in the investigation of the atrium in systemic embolism].

Transesophageal echocardiography (TEE) is a semi-invasive examination that provides better images of the atrium than classical transthoracic echocardiography (TTE) due to the anatomical positioning of the captor and the high frequency Doppler apparatus used. We used TEE and TTE to evaluate the incidence of the cardiac origin of emboli in 46 patients with unexplained stroke or transient ischemic attack (TIA): 23 had documented heart disease (mean age 60 years) and 23 had no cardiac disease (mean age 43 years). Among those with existing heart disease, 4% of the anomalies certainly or probably responsible for the emboli in addition to the underlying cardiopathy were detected by TTE versus 37% by TEE (as compared to values reported in the literature: 25% by TTE and 51% by TEE).

[Mechanism of clinical onset and outcome of coronary disease before 40 years of age. 148 cases].

This study reviewed the clinical histories of 148 coronary patients aged 34 +/- 5 years (20-40 years) documented in the same cardiology unit. Myocardial infarction was the presenting condition in 114 patients (77%): inaugural 65%, with prodrome 7%, asymptomatic 4%. The presentation was angina pectoris in 32 patients (22%): effort angina 15%, unstable angina 7%.

Effect of xamoterol on haemodynamics and plasma catecholamines in chronic heart failure.

The effects of xamoterol on haemodynamics and plasma catecholamines were studied at rest and after exercise in patients with mild to moderate heart failure, using a symptom-limited exercise test. Exercise duration and myocardial efficiency were significantly increased, and heart rate on maximal exercise was reduced despite increased catecholamine levels.

[Coronary endarterectomy using an excimer laser. Preliminary peroperative results].

From experimental and clinical experience, safe coronary angioplasty cannot be performed with CW lasers. The excimer laser does present a number of advantages in vitro: non-thermal ablation of plaques and a linear relationship between the number of pulses and the depth of the crater, so that tissue ablation is quantitatively predictable. A 308 nm, 20 ns pulse duration, 1 to 5 repetition rate laser was specifically designed for clinical application.

[Traumatic tricuspid insufficiency. 5 cases].

Five men (mean age 39 years) were followed up for 6 to 60 months for tricuspid valve regurgitation caused by a front-to-back injury (in a car in four cases, in an aircraft in one case). The time elapsed between the accident and the signal symptoms varied from 28 days to 20 years. The condition was diagnosed on clinical data (stage 2) and on the results of echocardiography and cardiac catheterization.

[Right biventricular and atrial thrombi: echocardiographic diagnosis and peroperative verification].

An exceptional case of triple intracardiac thrombosis (right atrium and right and left ventricles) is reported. The 21-year old male patient without significant previous history was admitted in a state of acute circulatory failure, with blood pressure 80/45 mmHg and a left ventricular end-diastolic diameter of 74 mm. Echocardiography showed dilated cardiomyopathy with low output pattern and demonstrated the presence of three large intracavitary thrombi: the first one was attached to the lateral wall of the right ventricle and occupied most of the apex; the second one, with multiple lobes, was located in the left ventricle, and the third thrombus was appended to the roof of the right atrium.

[Quantitative study of the pulmonary uptake of thallium 201 during exercise and redistribution in the coronary patient].

In some patients with coronary disease hyperactivity of the lungs is commonly observed when the myocardial scintigraphic images are recorded during exercise. Pulmonary activity of radionuclide tracers has been reported in the literature and quantified in different ways. The present study contributes to this quantification by suggesting a new index: the pulmonary activity to cardiac activity percentages ratio during exercise and blood redistribution.

[Acute myocardial infarct during sports practice: a preventive approach based on 40 cases with a non-fatal outcome in a military environment].

A retrospective study of 40 non-lethal myocardial infarctions occurring during physical exercise (average age 38 years) compared with 100 controls (average age 41 years) showed that the coronary artery disease which was identical after 40 years of age, differed in the youngest age subgroups. Juvenile exercise-induced infarction (N = 20) was characterised by a high incidence of normal coronary vessels (N = 8 compared with 6 in 39 controls of comparable age). The cardiovascular risk factors were qualitatively and quantitatively the same with a high incidence of smoking (85 to 95 p.

[Use of specific photo-markers in experimental laser coronary angioplasty].

Research into improving the efficacy of laser in the vaporisation of atheromatous plaques has led to the study of their modes of emission and to attempts at changing the natural absorption properties of the target lesion. This was achieved in vitro by incubation with solutions of derived haematoporphyrin and in vivo by oral administration of therapeutic doses of tetracycline. The selective nature of the coloration produced having been proved, the use of appropriate lasers allowed reduction of 50 to 100 p.

[Acute myocardial infarction during athletic activity. 38 cases in the military milieu].

38 observations of myocardial infarction (M.I.) (group A), remarkable by their occurrence immediately (31 cases) or with a delay (less than 12 hours, 7 cases) after the onset of chest pain and/or lipothymia during (30 cases) or a the end (7 cases) of a non unusual physical effort, have been documented with a 60 items questionnaire for the analysis of exercise, mesologic and personal data.

[Changes in HBs antigen and anti-HBs antibody in 77 patients with acute B-virus hepatitis].

Serum HBs antigen (HBs Ag) and anti-HBs antibody (anti-HBs), as determined by radioimmuno-assay or ELISA methods, were studied in a group of 77 patients with acute icterogenic viral hepatitis over a period of at least three months and correlated to the evolution of the disease either to return to good health or to a chronic state. The cumulative rate of patients in whom HBs Ag had disappeared (n = 53) was a linear function of time during the first sixteen weeks. Correlation seemed even stronger in the subgroup of patients restored to good health before the third month.