Bayesian probability analysis: a prospective demonstration of its clinical utility in diagnosing coronary disease.

One hundred fifty-four patients referred for coronary arteriography were prospectively studied with stress electrocardiography, stress thallium scintigraphy, cine fluoroscopy (for coronary calcifications), and coronary angiography. Pretest probabilities of coronary disease were determined based on age, sex, and type of chest pain. These and pooled literature values for the conditional probabilities of test results based on disease state were used in Bayes' theorem to calculate posttest probabilities of disease.

Amaurosis fugax in a patient with a left ventricular endocardial pacemaker.

A transvenous left ventricular endocardial pacemaker catheter is a potential source of systemic arterial embolization. The case of a woman who presented with left-eye amaurosis fugax is reported. The patient had a history of contralateral carotid atherosclerosis; however, the digital subtraction angiography of the carotid arteries was not sufficiently abnormal to account for her present symptoms.

Echocardiographic findings in 25 patients with left atrial myxoma.

The echocardiographic findings were studied in 25 patients with pathologically proved left atrial myxoma. All patients had M-mode echocardiograms and 14 had two-dimensional studies. Seventeen patients had pre- and postoperative echocardiograms.

Cardiac function in adolescents and young adults with anorexia nervosa.

Twelve patients with anorexia nervosa (mean age 17.6 years) underwent noninvasive cardiac evaluation. All patients had normal sinus rhythm at rest, during exercise, and following 24-hr electrocardiographic monitoring.

Long-term control of congestive heart failure with captopril.

The long-term effects of captopril therapy were assessed by sequential hemodynamic studies over a 6 month period in 19 patients with resistant congestive heart failure. Initial improvement during the first week of therapy was noted only in 11 and was marked by significant (p less than 0.005) increases in cardiac output and stroke volume, slowing of heart rate, and reduction of total peripheral resistance.

Acute effects of hemodialysis on echographic-determined cardiac performance: improved contractility resulting from serum increased calcium with reduced potassium despite hypovolemic-reduced cardiac output.

The hemodialysis session leads to reduction in circulating blood volume (TBV) and arterial pressure (BP) plus correction of electrolyte imbalance. The effect of these alterations on cardiac performance was evaluated in 18 patients with end-stage renal disease. Hemodialysis for 5 hours led to significant reduction (p less than 0.

Reversal of left ventricular hypertrophy in hypertensive patients treated with methyldopa. Lack of association with blood pressure control.

Ten patients with essential hypertension and left ventricular hypertrophy were treated with relatively small doses of methyldopa (500 to 750 mg/day) added to long-term diuretic therapy. Sequential M mode echocardiography showed significant reduction in left ventricular mass 36 weeks after addition of methyldopa in four patients (359 +/- 77 [standard error of the mean] to 235 +/- 63 g) although blood pressure was not significantly altered by the added treatment. In three of these patients, reduction of left ventricular mass was observed as early as 12 weeks of treatment (384 to 262 g).

Echographic-quantified severity of mitral anulus calcification: prognostic correlation to related hemodynamic, valvular, rhythm, and conduction abnormalities.

Clinical and echocardiographic findings in 123 patients with mitral anulus calcification (MAC) were analyzed. In all patients M-mode echocardiography demonstrated a dense band of echoes posterior to the mitral valve, moving parallel and anterior to the left ventricular endocardium. Thirty-three per cent of patients were classified as having minimal to mild MAC (< 5 mm) and 67% had moderate to severe MAC (greater than or equal to 5 mm).

M-mode echocardiography in anteroseptal myocardial infarction. Lack of sensitivity.

Eighteen patients with documented anteroseptal myocardial infarction (ASMI) were investigated with both cardiac catheterization and M-mode echocardiography. All had greater than 75% occlusion of the left anterior descending artery (LAD), proximal to the first septal perforator in 12, and distal to it in 6; 17 of 18 had abnormal septal motion by angiography. In contrast, echocardiography revealed abnormal septal motion in only 5 of 18; two others had diminished septal wall thickness in relation to posterior ventricular wall.

Prolapsed mitral valve associated with the Holt-Oram syndrome.

The association of hypoplastic thumb and atrial septal defect, (Holt-Oram syndrome) with a prolapsed mitrial valve is described. Recognition of this association adds further support to the concept that the prolapsed mitrial valve syndrome is not necessarily an isolated cardiac disorder but may be part of a more generalized heritable disorder of connective tissue.