[Hospital epidemiology of ST-segment elevation myocardial infarction and feasibility of primary percutaneous coronary intervention in an interhospital network: data from a multicenter, prospective and observational study VENERE (VENEto acute myocardial infarction REgistry].

Background: Primary percutaneous coronary intervention (pPCI) is the most effective reperfusion treatment of acute ST-segment elevation myocardial infarction (STEMI), but logistic- and organization-related problems affect its feasibility. The aim of this study was to investigate a) the requirements of reperfusion therapies, and b) the feasibility of pPCI as suggested by the current guidelines, in the Veneto Region.

Methods: With the aim to treat with pPCI most of the patients with high-risk STEMI regardless of the type of admitting hospital, a single treatment protocol was developed and shared by the majority of Cardiology Departments in the Veneto Region.

[Papillary fibroelastoma of the septal leaflet of the tricuspid valve. Report of a case and review of the literature].

Papillary fibroelastoma is a rare benign cardiac tumor typically attached to the cardiac valves. The tumor is recognized during life, more often in patients evaluated for embolic events of unclear pathology, but sometimes also in totally asymptomatic patients. There is a general agreement that left-sided fibroelastomas must be removed to avoid systemic complications.

Large infero-posterior wall pseudoaneurysm of the left ventricle: an unusual presentation.

Post-myocardial infarction left ventricular pseudoaneurysm resulting from free wall rupture is a rare finding and its recognition during life is uncommon. The diagnosis is difficult since symptoms, clinical evaluation and electrocardiographic and X-ray findings are usually non-specific. We herein present a case of a pseudoaneurysm manifesting after a silent myocardial infarction and diagnosed at echocardiography in a patient who, at the time of hospitalization, had a history and clinical and laboratory findings suggestive of pulmonary embolism.

[Carcinoid heart disease and primary ovarian tumor].

Carcinoid heart disease occurs in about one third of patients with carcinoid syndrome, especially in those with ileal carcinoid and hepatic metastases. Patients with primary ovarian carcinoid tumor are extremely rare. In these circumstances, typical carcinoid cardiac lesions may develop unassociated with hepatic metastases, due to the venous drainage from the ovaries into the inferior vena cava of vasoactive released substances such as serotonin.

[Company Wide Quality Control (total quality): methodological principles and intervention techniques for step-by-step improvement].

The concept of Quality is particularly up to date and not a new one for the Journal. The need for better Quality is a must also in Medical care. Quality doesn't mean additional costs and excessive burden for the co-workers.

[Revision and optimization of processes: a fundamental timing for adequate use of the resources and technological innovation. An example of intervention in the cardiology field and considerations on "total quality" in medicine].

Unlabelled: The Cardiology Unit of the Este General Hospital began its activity in 1988. We soon identified a mismatch between a good, up-to-date diagnostic instrumentation with growing customers' demand and an inadequate utilization of the instruments. Waiting lists were getting longer, customers were not satisfied, no-shows at the appointments increased and we had a progressive loss in image.

[A case of double-chamber right ventricle operated on in adulthood].

A 49-year-old patient suffering from recurrent effort lipothymia and palpitation was referred for cardiac catheterization. A diagnosis of marked hypertrophy of right ventricular outflow tract and double chamber right ventricle with intraventricular gradient of 50 mm Hg was made. Operation was delayed until age 49 when an anomalous intraventricular hypertrophic band was resected.

Left ventricular function in thalassemia major: protective effect of deferoxamine.

Objective: To test the hypothesis that chelation therapy with deferoxamine would prevent alterations in left ventricular systolic and diastolic function due to transfusional iron overload in patients with thalassemia major.

Design: A consecutive series of patients receiving chronic transfusional and chelation therapy were studied by two-dimensional and Doppler echocardiography.

Setting: Primary clinic.

[Pseudo-normalization of diastolic filling in severe aortic stenosis].

We report the case of a 79-year-old woman with severe aortic stenosis and alteration of left ventricular diastolic filling demonstrated by Doppler echocardiography, with inverted early/end diastolic flow profile. A sixteen month prospective follow-up study demonstrated progression of the illness, with further augmentation in transvalvular gradient and increased wall hypertrophy, but with apparent concomitant normalization of transmitral flow velocity profile. We conclude that a "normal" velocity pattern does not exclude an altered diastolic filling pattern, and must be interpreted with caution, in the light of all clinical and technical data.

[Results of emergency aortocoronary bypass in complicated coronary angioplasty].

Sixteen out of 293 (5.4%) procedures for percutaneous transluminal coronary angioplasty, performed between 1985 and 1988, were complicated by acute closure and required emergency revascularization surgery. The injured vessel was the left anterior descending artery in 14 cases and the right coronary artery in 2 cases.

[Coronary angioplasty in unstable angina. Immediate and short-term results].

We report the results of percutaneous transluminal coronary angioplasty (PTCA) in 67 consecutive patients with unstable angina. Twenty patients had new onset (less than 2 months) angina, 33 patients had crescendo angina and 14 had early postinfarction angina. Fifty-one patients had one-vessel disease, 12 patients had two-vessel disease and two patients had three-vessel disease; two patients had a stenosis of a venous graft.

Sensitivity, specificity and predictive accuracy of Q wave, QX/QT ratio, QTc interval and ST depression during exercise testing in men with coronary artery disease.

One hundred forty-three subjects (107 with coronary artery disease [CAD], 23 without CAD [evaluated by coronary angiography] and 13 athletes) were selected for this study. All subjects underwent exercise testing to evaluate sensitivity, specificity and predictive value of Q wave, QX/QT ratio, QTc interval and ST depression. The Q-wave analysis revealed less sensitivity (49%) and less specificity (83%) than ST depression (71% and 97%, respectively).

[Heart rupture as a complication of myocardial infarct in the acute stage. Case contributions and clinical course of survivors].

Heart rupture was found in 25 (4.4%) of 560 patients with myocardial infarction admitted to the Coronary Care Unit of the Department of Cardiology, Padua Medical School. Ten (40%) of them had a breaking of the free wall, 10 the interventricular septum, 4 (16%) a papillary muscle and 1 (4%) the ventricular wall with formation of a pseudoaneurysm.

Natural and post-surgical history of mitral stenosis and mitral stenosis and insufficiency: an observational study.

Natural and post-surgical history has been investigated in 410 pts with mitral stenosis and 209 pts with mixed mitral stenosis and regurgitation. They had undergone cardiac catheterization in the years 1968-1980. Hemodynamic data and clinical status (NYHA class) have been statistically analyzed in order to obtain prognostically useful parameters.