Sudden cardiac death during ambulatory ECG monitoring. A report of 2 cases.

Two cases of sudden cardiac death during ambulatory ECG monitoring, each with an episode of torsade de pointes as part of the terminal dysrhythmia, are reported. In the first case, pause-dependent changes of the TU waves favour early after-depolarisations and triggered activity as the initiating mechanism of torsade. Quinidine therapy was probably an aggravating factor.

Quantitative ECG changes and patency of infarct-related arteries after intravenous streptokinase.

Thirty-three patients with acute inferior myocardial infarction (MI), who were treated with intravenous streptokinase, were studied by serial 12-lead ECGs for 48 hours to determine the relationship between early changes in the sum of elevations above the baseline 40 ms after the end of the QRS complex in leads II, III and AFV (SumST), the sum of amplitude of R waves in leads II, III and AVF, the sum of the Q waves in leads II, III and AVF, the sum of ST-segment depression in leads V1-V4 as measured from the baseline to 80 ms after the J point (SumST (V1-V4] and the patency of the infarct-related artery at angiography after MI. Patients with patent arteries had a faster rate of decline in the SumST during the first 2.5 hours; reached the steady state earlier; had a more pronounced decrease in the SumST at 1.

Intravenous streptokinase in acute myocardial infarction.

The safety and efficacy of streptokinase (STK) (Kabikinase; Keatings) in restoring vessel patency in 70 patients with acute myocardial infarction are reported. Return of vessel patency occurred more frequently (76%) in patients receiving STK than in patients in a control group (12%) (P = 0.001).

Spontaneous multivessel coronary vasospasm documented by coronary arteriography. A case report.

A case of spontaneous multivessel coronary artery spasm documented by coronary arteriography is reported. The patient was also resistant to sublingual nitrates and nifedipine and required intracoronary nitroglycerine to alleviate the spasm.

Echophonocardiographic estimation of pulmonary capillary pressure in acute myocardial infarction.

Non-invasive estimation of pulmonary capillary wedge (PCW) pressure by an echophonocardiographic technique is reported. The ratio of time interval from the Q-wave to the C-point (echocardiogram) (Q-C) and from aortic closing (A2) to the E-point (A2-E) correlated well with the measured PCW pressure (r = 0.89; P = 0.

Torsade de pointes induced by sotalol and hypokalaemia.

The problem of a sotalol-induced ventricular arrhythmia (torsade de pointes) is presented and the contributory role of hypokalaemia is emphasized. It is concluded that sotalol may not be a suitable beta-blocker to use with a diuretic.