Angiographic study of coronary artery disease in diabetic patients in comparison with nondiabetic patients.

Diabetes mellitus is known to be a major risk factor for the development of coronary artery disease (CAD). The aim of this study was to investigate angiographically the coronary arteries of diabetic persons, focusing on the type and distribution of CAD, sex differences in CAD anatomy, and the size of the coronary vessels. This was a randomized study and included two groups of patients with angiographically demonstrated CAD.

Comparison of coronary collateral circulation in diabetic and nondiabetic patients suffering from coronary artery disease.

Background And Hypothesis: Although it is well established that diabetes mellitus (DM) induces more severe coronary artery disease (CAD), it is not known whether it contributes to the development of coronary collateral circulation. The present study examines coronary collateral circulation in diabetic and nondiabetic patients with angiographically verified CAD.

Methods: The study group consisted of 463 diabetic patients (382 men, 81 women) with a mean age of 60.

Comparison of angiographic findings, risk factors, and long term follow-up between young and old patients with a history of myocardial infarction.

We compared the angiographic findings, coronary risk factors and five years prognosis in 200 patients < or =45, and 260 patients >45 years old who where admitted with an acute myocardial infarction. We found that family history and smoking were the most common risk factors in patients < or =45 years old P<0.04, P<0.

Coronary-subclavian steal syndrome. Report of a case treated with subclavian angioplasty.

We describe the case of a man aged 42 who, five years before, had undergone aortocoronary bypass surgery using the internal mammary artery for the anterior and saphenous vein graft for the posterior descending arteries. Over the last one and a half years he had started to present angina pectoris as well as symptoms of vertebrobasilar insufficiency during exertion of the left upper extremity (recently during simple writing), whereas a full treadmill test was normal. Clinically, obstruction of the left subclavian artery was suspected with both coronary and subclavian steals.

Systolic segmental disappearance of internal mammary artery graft. Correlation with prolonged spasm of the graft.

Vasospasm of the saphenous vein and internal mammary grafts may develop spontaneously under several conditions. We present for the first time spasm of a left internal mammary artery bypass graft during coronary arteriography. A patient who underwent coronary artery bypass operation 4 years ago was recatheterized because he developed chest pain.

Percutaneous balloon pericardiotomy for management of cardiac tamponade in a patient with lung cancer and large pericardial effusion.

We describe the case of a 32-year-old man with lung cancer involving the pericardium on which we performed pericardiotomy, using a balloon dilating catheter, to create a non-surgical pericardial window. For the percutaneous creation of pericardial window we advanced into the pericardium by subxiphoid approach a 0.035 inch guide wire through a 7f.

Spontaneous left anterior descending coronary artery dissection. Case report presentation and review of the relevant literature.

Spontaneous coronary artery dissection is a rare incident occurring usually in young patients, predominantly in females. It is usually fatal and found postmortem. We present the case of a middle aged man with spontaneous left anterior descending coronary artery dissection found angiographically which caused an anterior wall myocardial infarction.

Colour Doppler echocardiography in the diagnosis of ruptured aneurysm of sinus of Valsalva.

In this report we present three cases of ruptured aneurysm of sinus of Valsalva which were detected by colour Doppler echocardiography. The diagnosis was confirmed by cardiac catheterization and at operation.

Hypertrophic peripheral neuropathy (Dejerine-Sottas disease) associated with heart block. Case report presentation and review of the literature.

We present a case of a male suffering from hypertrophic peripheral neuropathy (Dejerine-Sottas disease) and severe involvement of the cardiac conductive tissue causing syncopal attacks. It is the first time that an association of this neuromuscular disease with cardiac involvement is described.

Marfan's syndrome and coarctation. Coincidence or association? A case report.

The case of a patient with coexisting Marfan's syndrome and coarctation of the aorta is presented. The relevant literature is reviewed and the possible association between the two lesions is discussed.

The ST segment axis as a differential diagnostic feature between acute pericarditis and acute inferior myocardial infarction.

The ST segment electrical axis in the frontal plane was calculated in 20 patients with an acute inferior myocardial infarction (AIMI) and another 20 patients with the acute phase of pericarditis (AP). The ST segment axis of patients with AIMI ranged from 100 degrees-120 degrees (mean 114 degrees). The ST segment axis of patients with AP ranged from 30 degrees-60 degrees (mean 45 degrees).

The effects of long-term antithrombotic treatment on left ventricular thrombi in patients after an acute myocardial infarction.

Sixty patients (48 men and 12 women; aged 36 to 72 years, mean 48 +/- 9), who survived an acute anterior myocardial infarction and in whom left ventricular thrombus was detected by cross-sectional echocardiography 1 to 2 days before they were discharged from the hospital, were prospectively studied. All had evidence of left apical wall motion abnormalities. They were randomly divided into three groups of 20 patients each.

Exercise testing after acute myocardial infarction. How much? How soon?

Exercise testing shortly after acute myocardial infarction is considered safe and valuable for the determination of long-term prognosis. One point of discussion is whether a submaximal pre-discharge test or a maximal test at 6-8 weeks, which has a higher sensitivity for diagnosing multivessel disease should be preferred. The former is the authors' choice, since the submaximal predischarge test has excellent prognostic value for adverse effects, and because approximately 1.

The effective treatment of multifocal atrial tachycardia with amiodarone.

Multifocal atrial tachycardia (MAT) was observed in 9 patients aged 60-85 (mean 72.1 +/- 8.6) years during exacerbation of their chronic lung and/or cardiac disease.

Effect of nifedipine on the sick sinus syndrome.

The effect of nifedipine (N) on sinus node (SN) function was studied in 15 patients (9 males, 6 females) sixty-two to seventy-six (mean 68.1 +/- 11) years old, with sick sinus syndrome (SSS). SSS was characterized electrophysiologically by a prolonged corrected sinus node recovery time (CSNRT greater than 535 msec) and/or prolonged sinoatrial conduction time (SACT greater than 125 msec), assessed by applying premature atrial stimulation.

Atrial septal defect and constrictive pericarditis. An unusual combination.

We describe a case of atrial septal defect associated with constrictive pericarditis. This combination is extremely rare and clinically misleading, since it may simulate other more common conditions. A variety of techniques, such as computerized tomography, echocardiography and cardiac catheterization were necessary for establishing the right diagnosis.

Q and non-Q wave myocardial infarction: current views.

The new terminology "Q and non-Q wave myocardial infarction" (MI) tends to replace the traditional terms "transmural" and "subendocardial" MI since the anatomy cannot be accurately predicted by electrocardiography. Although some subtypes of non-QMI display a favorable early or in-hospital prognosis, the long-term outlook seems less benign, particularly when early or late recurrence of MI occurs. Coronary arteriograms show an equal number of diseased vessels in both types of MI, but complete coronary artery occlusion is less frequent in non-QMI.

Increased mortality of diabetics after acute myocardial infarction attributed to diffusely impaired left ventricular performance as assessed by echocardiography.

Five hundred and forty-eight patients who sustained their first acute myocardial infarction (AMI) were admitted to the coronary care unit (CCU). Ninety-eight of them were known diabetics. The diabetic patients were younger, 50 +/- 12 vs.

Arrhythmogenic right ventricular dysplasia: case report presentation and review of the literature.

A man complaining of palpitations was found to have ventricular tachycardia (VT) with LBBB configuration. From the investigations which followed, he was diagnosed as having arrhythmogenic right ventricular dysplasia (ARVD). The patient has been treated with amiodarone and propafenon for 7 months without VT recurrence.

Unstable angina pectoris as a warning symptom before acute myocardial infarction.

Four hundred patients who were admitted over the last three years with myocardial infarction were questioned about the presence and pattern of angina before its onset. Two hundred and twenty-four (56 per cent) patients had angina before their infarction; 184 (46 per cent) had the unstable pattern of angina. That such a high proportion of patients experience unstable angina as a prodromal symptom makes it possible that myocardial infarction could be prevented in some of these patients.

Calcification of the tricuspid annulus. Case report and review of the relevant literature.

We present a case of tricuspid annulus calcification, documented by fluoroscopy, chest X-ray and cross sectional echocardiography. This case is interesting for two reasons: 1) Tricuspid annulus calcification is extremely rare and very few cases have been reported. 2) It is the third case described where two-dimensional echocardiography established the diagnosis of this very rare condition.

The influence of R-wave amplitude on the degree of ST-segment depression in exercise electrocardiography in the individual patient.

Many factors have been found to influence the magnitude of ST-segment depression in the exercise electrocardiogram. We investigated whether R-wave amplitude is a significant factor. We studied the exercise electrocardiogram of 20 patients with angiographically documented coronary artery disease, including greater than or equal to 70% stenosis of the left anterior descending artery, who had an ischemic response to exercise but no previous anterior myocardial infarction.

Effects of alcohol on the heart: current views.

Chronic and heavy alcohol consumption has deleterious effects upon the cardiovascular system and may cause congestive cardiomyopathy. Evidence of cardiac malfunction has been found in chronic alcoholics without overt heart failure by invasive and noninvasive methods. Ethanol is the incriminated factor having a direct cardiotoxic effect.

The significance of a persistent precordial ST segment greater than or equal to 0.1 mV depression in acute inferior myocardial infarction (coronary angiographic and ventriculographic findings).

40 patients with acute inferior myocardial infarction (MI) associated with persistent precordial ST segment depression greater than or equal to 0.1 mV underwent coronary arteriography and left ventriculography within 5-6 days of their admission. The inferior MI was the result of complete occlusion of the right coronary artery (RCA) in 38 patients and the result of complete occlusion of the posterior descending artery (PDA) coming off the circumflex artery (Cx) in two patients.

Strokes and mitral valve prolapse. Coincidence or relation?

Four cases with cerebral ischaemic events and mitral valve prolapse are described. Full investigations failed to reveal any other potential cause for these cerebral events.