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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Early ambulation is a recommended component of care for appropriately selected patients with uncomplicated myocardial infarction, which is feasible, safe, and cost-effective. Benefits of this approach include the prevention of cardiovascular "deconditioning" and other complications of prolonged bed rest, the prevention or reduction of anxiety and depression, the enhancement of physical work capacity and of self-image and self-confidence at the time of hospital discharge, and the lessening of total disability as assessed at followup examination. Economic advantages to be derived are those of permitting a shorter hospitalization, a more effective hospital bed utilization, and an earlier and more complete return to work.
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PMID:The physiologic basis for early ambulation after myocardial infarction. 36 Dec 32

Increasing materialism in society is resulting in more wide spread nervous tension in all age groups. While some degree of nervous tension is necessary in everyday living, its adverse effects require that we must learn to bring it under control. Total tension is shown to have two components: a controllable element arising from factors in the environment and the inbuilt uncontrollable residue which is basic in the individual temperament. The effects of excessive or uncontrolled stress can be classified as 1) emotional reactions such as neurotic behaviour (anxiety hypochondria, hysteria, phobia, depression obsessions and compulsions) or psychotic behaviour and 2) psychosomatic reactions (nervous asthma, headache, insomnia, heart attack). Nervous energy can be wastefully expended by such factors as loss of temper, wrong attitudes to work, job frustration and marital strains. Relaxation is the only positive way to control undesirable nervous tension and its techniques require to be learned. A number of techniques (progressive relaxation, differential relaxation, hypnosis, the use of biofeedback, Yoga and Transcendental Meditation) are described and their application to dental practice is discussed.
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PMID:Tension and relaxation in the individual. 37 62

56 patients with Hodgkin's disease treated with large field megavolt irradiation are presented. Complications in the parenchymal organs were few, although patients developed an appreciable grade of pulmonary radiofibrosis, two patients had a myocardial infarction and one patient thrombosis of the portal veins. Depression of the bone marrow frequently interfered with the radiation treatment. In five cases radiotherapy had to be discontinued. In three cases bone marrow depression persisted to the time of death. The total mode treatment was often to be discontinued and the treatment with cytostatics was started. The extended and total node treatment for Hodgkin's disease must be planned to spare as much of the bone marrow as possible.
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PMID:Complications after megavoltage therapy of Hodgkin's disease. 40 31

The haemodynamic profiles of 147 cases of myocardial infarction investigated within 30 hours of the clinical onset were studies in relation to the topography of the necrosis on the ECG: there were 36 inferior (I), 29 postero-inferior (PI), 22 antero-septal (AS), 38 antero-lateral (AL), 15 deep septal (DS), and 7 strictly posterior or lateral (PL). Simultaneous recordings of the diastolic pulmonary arterial pressures and the left ventricular diastolic pressures (pre-and post-a) have shown different degrees of correlation with the topographical site. The correlation found in AS, AL and I necrosis are clearer with respect to the pre-a. The PI necroses show no correlation. Graphs of left ventricular function as well as an analysis of the various other parameters show that the DS, the AL, and to a lesser extent the PI are associated with the grossest depression of left ventricular function. A study of the amplitude of the "a" wave also shows that the effect of infacts of the free wall of the left ventricule on the compliance is greater. A study of right ventricular function as well as the correlations between the pulmonary and right atrial pressures confirms the presence of right ventricular disfunction in DS and PI necroses. Impaired left ventricular function, impaired right ventricular function, and disorders of compliance seem to be the determining factors in changing the haemodynamics in the various ECG sites of infarction.
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PMID:[Hemodynamic profile of acute myocardial infarction as a function of electrocardiographic localization]. 40 72

The authors have studied the exercise test carried out at least three months (3-6 months: 52 cases; greater than 6 months: 48 cases) after myocardial infarction in the anterior position (50 cases), in the "inferior" position (42 cases), and of a diffuse type (8 cases), in patients who were taking no treatment which might interfere with interpretation of the test. For the anterior infarctions there was a good correlation between ST elevation (J max greater than or equal to 1 mm, or better than the sun of the J greater than or equal to 2 mm) and the presence of severe involvement of the left ventricle. A depressed ST segment beyond the area of necrosis corresponds to a stenosis greater than or equal to 75 p. 100 in 36 p. 100 of cases. In inferior infarctions, the correlation between ST elevation and left ventricular involvement is also specific but less sensitive. ST depression outside the area of necrosis corresponds to a stenosis greater than or equal to 75 p. 100 in 66 p. 100 of cases; it is then lateral, but may extend as far as V2. They also indicate a mirror image, especially when the depressed area slopes upwards, and is localised in V2-V3. The other changes which were found have no practical application.
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PMID:[Exercise test after myocardial infarct. Correlations with data of coronary angiography and ventriculography]. 41 12

This work is based on the results of a systematic scheme of investigation consisting of an exercise test on the bicycle ergometer with analysis of the ECG and of the pulmonary arterial pressure measured by cardiac micro-catheterisation, and of ventricular and coronary arteriography; 60 patients were investigated in this way after the third month following a myocardial infarction. After an anterior infarction, there is no significant correlation between the ECG changes and the coronary arteriogram. An elevation of the tracing is often (but not always) indicative of akinesia or dykinesia of the ventricle. After a posterior infarction, depression of the trace in leads which were initially normal indicates extension of the coronary lesions in 9 cases out of 10. It, is, however, possible for a tight stenosis on the anterior descending artery to exist with no changes on the ECG. A highly significant (p less than 0.001) and strong (r=0.83) correlation between an index of haemodynamic severity as defined by variations in the pulmonary arterial pressure on exercise and by the score on coronary arteriography, allows us to define certain indications for coronary arteriography and ventriculography after infarction.
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PMID:[Exercise electrocardiogram coupled with right cardiac microcatheterization after myocardial infarct. Correlations with ventriculo-coronarography]. 41 13

The QRS complex and ST segment in the ECGs of 80 patients who died of an acute myocardial infarction (MI) were studied in relation to the extent of the MI (subendocardial vs. transmural). Changes in the QRS complex developed in nine out of the 15 cases with an acute subendocardial MI. Five of these cases fulfilled the conventional QRS criteria for a myocardial infarction. A definite ST segment depression (a J point depression of 2 mm. or more in at least one lead, and a horizontal or downward sloping ST segment with a minimum duration of 0.08 sec.) occurred most frequently in connection with a circumferential subendocardial MI (88 per cent), but it was also found in a regional subendocardial (43 per cent) and transmural MI (43 per cent). In 17 per cent of the cases with a transmural MI, this was the only ECG abnormality. It is concluded that cases with a subendocardial MI cannot always be distinguished from transmural MI on the basis of the presence or absence of the QRS changes, and that an ST segment depression, as defined in this study, can give additional information in the evaluation of an acute phase of an MI.
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PMID:Changes in the QRS complex and ST segment in transmural and subendocardial myocardial infarctions. A clinicopathologic study. 45 20

Serial treadmill exercise testing (mean 5.5 tests/patient) was used to evaluate the prognosis of 200 males (mean age 53 years) without clinical heart failure or unstable angina pectoris 3 weeks after acute myocardial infarction (MI). Exercise-induced ischemic ST-segment depression greater than or equal to 0.2 mV 3 weeks after MI was significantly more prevalent in patients with subsequent cardiac arrest (100%) or coronary artery bypass graft surgery (64%) than in patients without subsequent events within 2 years of infarction (35%) (p less than 0.05). Exercise-induced ventricular arrhythmia on multiple tests 5-52 weeks after MI was more prevalent in patients with recurrent myocardial infarction (90%) than in patients without subsequent events (47%) (p less than 0.001). By contrast, exercise-induced ventricular arrhythmia on a single test at 3 weeks was a less powerful predictor of subsequent cardiac events. Exercise-induced ischemia 3 weeks after MI predicted early fatal events, while ventricular arrhythmia on serial testing predicted later nonfatal events.
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PMID:The prognostic significance of serial exercise testing after myocardial infarction. 49 48

To determine the response to repeated treadmill exercise testing soon after uncomplicated myocardial infarction, 24 males (mean age 54 +/- 6 years) performed two symptom-limited tests several days apart 3, 7 and 11 weeks after the acute event. Significant within-week differences were noted for peak exercise tolerance (mets) and peak heart rate at 7 weeks (p less than 0.05). Significant within-week differences in these variables were not noted for other weeks or for systolic blood pressure or heart rate-systolic blood pressure product for any of the three test periods. No significant within-week differences were noted for any variable recorded at a submaximal work load of 4 mets. The frequency of exercise-induced ischemic ST-segment depression, angina pectoris and premature ventricular complexes did not change from visit to visit and was highly reproducible (p less than 0.01). All test variables measured at peak exercise increased significantly between 3 and 11 weeks after infarction. We conclude that cardiovascular responses to symptom-limited exercise testing are highly reproducible in the 3 months after uncomplicated myocardial infarction. Changes in the response to treadmill exercise tests performed several weeks apart reflect alterations in cardiovascular performance.
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PMID:Cardiovascular responses to repeated treadmill exercise testing soon after myocardial infarction. 49 49

The clinical and prognostic significance of the direction of the S-T segment shift on the 12-lead electrocardiogram was evaluated in medically treated patients with unstable angina pectoris. Long-term mortality and morbidity of 11 patients with transient S-T segment elevation (group I) were compared to that of 21 patients with transient S-T segment depression (group II). The average follow-up duration was 62 months. There was no significant difference between groups I and II with respect to survival or nonfatal myocardial infarction over a five-year period. Mortality was related to the extent of coronary artery disease and left venticular ejection fraction rather than to the direction of the S-T segment shift.
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PMID:Transient S-T segment elevation in unstable angina: prognostic significance. 50 91


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