[The drug treatment of cardiogenic shock--our experience].

For the period 1970-1989 in the intensive care unit of the National Center for Cardiovascular Diseases, 178 patients with cardiogenic shock were treated and died. These patients were studied retrospectively. In all patients an acute myocardial infarction was proved clinically and post mortem.

[Changes in the hemoglobin A2 level of patients with ischemic heart disease].

40 patients with ischemic heart disease were studied. In 60% of them a higher content of HbA2 was found. These data for higher frequency of HbA2 among the patients with ischemic heart disease do not correspond with the average incidence of the genetically determined anomaly A2-beta-thalassemia among the Bulgarian population.

[Choice of the effective electrical power in cardioversion].

On the base of his own studies, the author established that the effective quantity of electric energy for cardioversion is from 150 to 350 W/s. A greater quantity of energy (285.6 +/- 53.

[Clinico-hemodynamic changes in paroxysmal cardiac arrhythmias].

The stroke and minute volumes, according to the method of Fick and formula of Staar, were studied with a view to the necessity of objectivization of some hemodynamic indices for the needs of clinical practice. Based on the good results, obtained by the formula of Staar, the stroke volume was calculated according to the same mode in patients with rhythm disorders. The stroke volume was established to reveal a dependence on heart rate, type of rhythm disorder and character of the basic disease.

[Electroshock (cardioversion) treatment problems in rhythm disorders].

Some problems associated with the results from the electroshock treatment of 1027 patients with rhythm disorders are discussed, as well as the choice of the necessary quantity of electric energy and the way of preparation of the patients. It was established, that sinus rhythm restoration was attained in 90.1% under planned conditions, and in emergency cases--in 86.

[The question of fibrinolytic therapy of myocardial infarction in practice].

Systemic application of streptokinase in fibrinolytic therapy of acute myocardial infarction was reported and the advantages over intracoronary application were discussed.

[Cardiological problems in pheochromocytoma patients].

The course of the disease of six cases with pheochromocytoma was analyzed in patients, aged from 19 to 65, with manifestations mainly of the cardiovascular system. The diagnosis was verified in five of them at necropsy and in one of them--intraoperatively. The arterial hypertension accompanied by distinct vegetative symptomatics were the basic clinical signs and in some of the cases--disturbances in the carbohydrate metabolism.

[Determination of the effect of furanthril on myocardial infarct lesion size according to precordial electrocardiogram (mapping) and enzyme activity findings].

The ECG Mapping from 30 precordial points in 56 patients with recent anterior transmural infarctions was followed up as well as the level of the enzymes, acid phosphokinase, SGOT and LDH-iso during the first 6 days after the origination of the cardiac infarction. Thirty six patients were treated according to the generally adopted treatment schedule of cardiac infarction (group without furanthril) and 20 patients were administered, in addition to the generally adopted schedule, one tablet furanthril daily during the first six days (group with furanthril. Though no manifested discrepancies were observed in the indices studied in both groups (without and with furanthril)--in patients administered furanthril systematically--a better manifested drop was found in ECG Mapping indices and the enzyme activity in the course of the cardiac infarction, as compared with the group without furanthril.

[Diagnostic value of the spatial velocity electrocardiogram in myocardial infarct].

The object of the study were 220 patients with a myocardial infarction, confirmed clinically, enzymatically and electrocardiographically. Seventeen indices were studied, processed via variation analysis with 8 sites of the infarction alterations. The results were compared with those in subjects with intact hearts, examined and described by the authors in another study with the aid of the same devices.

[Effect of korvatone on hemodynamics in the acute stage of myocardial infarct].

The pressure in pulmonary and brachial arteries, cardiac output and the period of isovolumetric contraction of left ventricle were measured prior to and by 15, 30 and 60 min post 4 mg corvaton sublingual administration in 20 patients with acute cardiac infarction by the third day after the disease onset (12--with normal diastolic pressure in pulmonary artery--under 1.87 kPa (14 mm Hg)--group I and 8--with elevated pressure--group II). The mean pressure in brachial artery was established to decrease more pronouncedly in group I (from 12.

[Clinical characteristics, immediate therapeutic results and the outcome in rhythm and conductivity disturbances in myocardial infarct].

Certain rhythm and conduction disorders in 252 patients with myocardial infarction were studied. Twenty one of them had auricular fibrillation, influenced by medicaments, with the exception of one, six had relapses and 4 of the patients died. Ventricular extrasystoles (frequent, polytopic, more than three one after the other, R of T) were found in 48 patients.

[Treatment of cardiac insufficiency in the acute stage of cardiac infarct].

The studies on Strophantin effect upon the hemodynamics in the acute stage of cardiac infarction has revealed that it elevates the pressure in pulmonary artery and reduces the cardiac output, in certain cases deteriorating the patient's state. Furanthril and Droperidol reduce the cardiac output but at the same time diminish the pressure in the pulmonary artery and reduce the pulmonary resistance, thus having a favourable effect on the patient's state. Proceeding from the results obtained, a treatment scheme, including Furanthril, Droperidol and Strophantin, is recommended for the cardiac insufficiency treatment in the acute stage of cardiac infarction depending on the disease onset and the degree of cardiac insufficiency manifested.

[Precordial electrocartography (mapping) in cardiac infarct].

After a detailed literature survey the authors share the results from the precordial electromapping with the registration of 30 points upon the chest in 34 patients with ischemic heart disease (30 with transmural infarction and 4 with intermediary syndrome). The following indices were followed up: sigmaST (the sum of the elevation of ST segment measured at 60 msec of the S deflection recording) and the index nST (the sum of the points with an elevation greater than 0.1 mV/1 mm).

[Comparison of precordial electrocartography with pathologicoanatomic data on 20 patients with recent myocardial infarct].

In 20 patients with recent myocardial infarction, that died till the 40th day after the onset of the disease, a comparison is made of the data from the pathologoanatomical findings with the indices from the precordial electromapping. The changes in the ST segment of the precordial electromapping correlate, to a significant extent, to the weight of the infarction zone in patients with interior site of the myocardial infarction (sigmaST r = 0.89, p less than or equal to 0.

[Effect of furanthril on several hemodynamic indices during the acute stage of myocardial infarction].

Pulmonary arterial pressure, heart rate and peripheral arterial pressure were followed up by the 15th, 45th and 105th minute post intravenous introduction of 40 mg furanthril in patients with myocardial infarction in acute stage (in 42 cases of 12 patients with left cardiac insufficiency and in 14 cases--of 8 patients without cardiac insufficiency). Furanthril induced clearly manifested pressure decrease in the pulmonary artery in patients with left cardiac insufficiency, developing between the 15th and 45th minute and continuing till the end of the second hour and a negligible elevation of peripheral arterial pressure by the 15th minute, followed by a slight decrease of the latter under the initial value by the 45th and 105th minute. Similar tendency, but less manifested, exists and in patients without cardiac insufficiency.

[Several "risk factors" in patients with ischemic heart disease and hypertension].

The observation covers 123 patients (30 males and 43 females). Serum cholesterin and triglycerides of the patients were investigates. All the patients have been put stereotype questions about the preferred kind of main food, body weight changes and nutritional rhythm especially at an early age.

[Experience with the electrophoretic separation of lipoproteins on Celogel].

Hydroxycellulose gel foils (cellogel) were used for the serum lipoproteid separation in conditions of routine practice, Ninety four serum tests of patients with hypertension were investigated as well as with coronary disease, essential hyperlipoproteidemia, diabetes and infarction-acute stage. Total cholesterol and triglycerides in serum were determined to the same patients. The ratio between the numerical values of the latter is confronted to the ratio between the percentage part of beta-lipoproteids and the sum of the same parts of chylomicrons and pre-beta-lipoproteids.

[Our experience in using temporary and permanent electric stimulation in conduction disorders].

The results from the observation of 49 patients with complete and incomplete AV block are reported, 33 of them with attacks of MAC syndrome; asystolia 25, ventricular tachycardia and ventricular fibrillation--8. Temporary electric stimulation is carried out in 31 patients (21 with chronic complete AV block and 10 with incomplete and complete with recent cardiac infarction). In all patients with chronic AV block but one, implantation of a permanent artificial rhythm nuide was necessary.

[Rhythmic and conductive disorders in the acute stage of cardiac infarct].

Rhythm and conductive disturbances were established in 170 (63,8%) out of 266 patients with fresh cardiac infarction, in the greatest part with prophylactically applied lidocain i.m. With age advancing a growth in their incidence is established but no statistical difference between the age groups 20-59 and 60-90 was found.