Mitral balloon valvuloplasty in pregnancy: limiting radiation and procedure time by using transesophageal echocardiography.

A 35-year-old female with mitral stenosis was admitted to hospital in her 23rd week of gestation for management of disabling dyspnea and paroxysmal nocturnal dyspnea. She was in New York Heart Association functional class III and underwent successful percutaneous balloon mitral valvuloplasty with significant improvement of her symptoms. To limit radiation exposure and procedure time, transesophageal echocardiography was used in combination with pulsed fluoroscopy.

Patient-management problems as a learning tool for the continuing medical education of general practitioners.

The value of Patient-Management Problems (PMPs as a learning tool for continuing medical education was studied by using two frequently seen cardiovascular problems (angina and high blood pressure) and a province-wide sample of full-time general practitioners. The results indicate that PMPs can be a motivating and effective means of CME for the general practitioner; that knowledge was gained through the successive resolution of three pmps; that corrective feedback enhanced learning; and, that most of the knowledge gained on the paper cases was transferred to practice as reported by the participants on a questionnaire. Furthermore, while cueing may be a confounding factor when PMPs are used for evaluation purposes, it was shown to facilitate learning in the present learning context.

Predictive value of atrial pacing test for survival of patients with coronary artery disease.

There is evidence that patients with signs of poor left ventricular function or marked ischemia at low work load during an exercise test have a poor prognosis for survival. To determine whether a pacing test can provide similar information, the 6-yr survival rate was computed in 118 medically-treated patients who had undergone a standardized atrial pacing test. Among the 118 patients, 80 had significant coronary artery disease (CAD).

Computer assisted instruction for retraining family doctors in hypertension and hyperlipoproteinemia.

In an attempt to retrain family doctors in hypertension and hyperlipoproteinemia, computer assisted instruction (CAI) was assessed in fourteen doctors (Group 1) and its efficiency was compared to that of traditional lectures given to twenty-one doctors (Group 2). The same objectives, contents and illustrations were used in both teaching approaches. There was no significant difference for age, year of graduation and type of practice in the two groups.

Effects of practolol on exercise tolerance and cardiac haemodynamics and metabolism in patients with coronary artery disease.

Sixteen male patients with typical angina pectoris secondary to coronary atherosclerosis performed two daily standardized exercise tests during two consecutive days. Three hours before each exercise they received placebo or 400 mg practolol administered orally in double-blind fashion in order to complete a cross-over design. Practolol significantly prolonged the exercise duration by 30.

[Values of glucose, potassium and inorganic phosphate as metabolic indicators of myocardial ischemia in humans].

In 34 patients with coronary atherosclerosis a pacing test was performed with measurement of the lactate, glucose, potassium and inorganic phosphate coronary arterio-venous differences. Eighteen of these 34 patients felt no pain during the pacing test. In this group of asymptomatic patients, there was no significant change of the lactate, glucose, potassium and inorganic phosphate myocardial extraction.

Assessment of myocardial free fatty acid metabolism in humans during heparin infusion.

Free fatty acids (FFA) have been shown to be a major myocardial substrates during the postabsorptive state in humans. In order to document the utilization of these substrates by the heart while heparin was infused, the following study was designed. During heparin infusion, total and individual FFA were measured in arterial and coronary sinus plasma during the postabsorptive state in 13 patients with coronary artery disease and in 4 patients with no evidence of cardiac disease.

Comparison of changes in myocardial balances of lactate, glucose potassium, and inorganic phosphate during pacing-induced angina.

During an atrial pacing test, a correlative study in myocardial lactate, glucose, potassium, and inorganic phosphate balances was done in 34 patients with clinical evidence of ischemic heart disease. Electrocardiogram was continuously monitored while left ventricular end-diastolic pressure (LVEDP) was measured before and immediately after pacing. Coronary angiograms performed after the pacing test revealed atherosclerotic narrowings in all patients.