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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In 20 patients with acute myocardial infarction hemodynamic controls were performed after digitalisation and following i.v. injection of 0,4 mg of Prindolol. Circulatory changes were most pronounced 5-15 min after Prindolol injection and consisted of decrease in heart rate of 7%, mean arterial blood pressure of 6%, cardiac output of 10,5%, stroke volume index of 5,1% and left ventricular work of 18%. An increase of pulmonary wedge pressure of 17%, pulmonary pressure of 9%, mean right atrial pressure of 16% and peripheral arterial resistance of 6% were calculated. In 5 cases a favourable effect on extrasystoles and in 2 cases on sinus tachycardia were observed. Not infrequently, during the initial phase of acute myocardial infarction, a hyperadrenergic state may be noted. Prindolol may be indicated, when circulatory changes or arrhythmias are suspect to be the result of this hyperadrenergic stimulation. A simultaneous digitalisation may inhibit a more intensive cardiodepression.
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PMID:[Hemodynamics after prindolol and digitalis in acute myocardial infarction (author's transl)]. 5 64

The authors studied 101 patients with a combination of acute disorders of brain circulation and changes in the rhythm of heart activity in the form of sinus tachycardia, extra-systolia, fluttering arythmia. In ischemic strokes fluttering arythmia was encountered quite frequently while as in hemmorhages it was almost never seen. In 20 cases disorders of heart rhythm appeared following several days or more after the stroke. These data permit to assume that disorders of rhythm in the heart activity may be one of the pathogenetical factors of acute disorders of brain circulation. Their appearance after strokes is most frequently associated with signs of acute or exacerbated coronary insufficiency. Flutter arythmia in patients with strokes should be taken into consideration indifferential diagnosis of brain haemmorhages and infarctions.
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PMID:[Heart rhythm disorders in acute cerebral circulatory disorders]. 6 80

Electrocardiograms in young adults with ischaemic stroke were analysed for abnormalities within 24 h after the onset of symptoms. Fifteen patients out of 44 had some ECG abnormality, mainly ST-T changes, sinus tachycardia and minor disturbances of intraventricular conductance. In most cases the ECG abnormality could be attributed to some extracerebral cause. It is concluded that ischaemic brain lesion per se never, or very rarely, affects the electrocardiogram.
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PMID:The electrocardiogram in young adults with ischaemic stroke. 126 67

Serial electrocardiograms as well as echocardiographic studies of 51 pilgrims suffering from acute heat stroke (mean rectal temperature 41.6 degrees C) were performed. All patients were examined immediately after cooling and 24 h later whenever possible. Regional wall motion abnormalities were detected in 9 cases (17.6%) while pericardial effusion was observed in 13 cases (25%) and asymmetrical septal hypertrophy was detected in 8 cases (15.6%). Other cardiac abnormalities included right ventricular dilatation and increased in left ventricular internal dimensions in 4 cases (7.8%), respectively. Thirteen cases (25.5%) had normal echocardiographic findings. Forty (78%) patients had sinus tachycardia while 8 cases (15.7%) showed atrial fibrillation with uncontrolled ventricular rate, and 3 (5.8%) had sinus bradycardia. Heat stroke electrocardiograms showed tracings demonstrating ST segment depression, compatible with ischaemia in 9 cases, while in 6 cases there were nonspecific T wave changes, whereas in another 4 cases the tracings demonstrated different conduction abnormalities. The collected data were analysed and compared to those of 43 control patients. The adverse effects of heat stroke on the heart are multifactorial requiring the utmost attention and understanding, as they reflect the patient's cardiovascular status.
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PMID:Non-invasive evaluation of cardiac abnormalities in heat stroke pilgrims. 145 70

We compared electrocardiographic abnormalities and plasma norepinephrine concentrations in 40 patients with subarachnoid hemorrhage within the first 24 hours, at 72 hours, and after 1 week. In 20 patients with high plasma norepinephrine concentrations within the first 24 hours, sinus tachycardia (p less than 0.02) and negative T waves (p less than 0.01) were more frequent than in the 20 patients with normal plasma norepinephrine concentrations. After 72 hours, only sinus tachycardia (p less than 0.03) was found with increased frequency in the 26 patients with high plasma norepinephrine concentrations. Although 24 patients had high plasma norepinephrine concentrations after 1 week, we found no differences in the frequency of electrocardiographic abnormalities compared to patients with normal plasma norepinephrine. However, QTc prolongation, U waves, ST depression, and arrhythmias were found with similar frequency in patients with both high and normal plasma norepinephrine concentrations. We conclude that, with the exception of sinus tachycardia and negative T waves, electrocardiographic changes in patients with subarachnoid hemorrhage do not depend on elevated plasma norepinephrine concentrations.
Stroke 1991 Jun
PMID:Effect of elevated plasma norepinephrine on electrocardiographic changes in subarachnoid hemorrhage. 175 60

From 1979 to 1989, 18 patients were seen in the Electrophysiology Service, Duke University Medical Center, with automatic atrial tachycardia. There were 8 male and 10 female patients with a mean age of 28.1 +/- 2.9 years. Electrophysiological mapping localized automatic foci to right atrial sites (14 patients) and left atrial sites (4 patients). Depending on origin of the focus, patients were further diagnosed as having either chronic ectopic atrial tachycardia or inappropriate sinus tachycardia. Of the 15 patients with chronic ectopic atrial tachycardia, 6 responded to medical treatment; in 9, the tachycardia was not adequately controlled. Six of them were referred for surgical intervention. All 3 patients with inappropriate sinus tachycardia underwent operative therapy. In the surgical group of patients with chronic ectopic atrial tachycardia, all 6 had a tachycardia-induced cardiomyopathy with ejection fractions ranging from 14% to 27% (mean ejection fraction, 21% +/- 2.7%). Surgical techniques used (alone or in combination) included an isolation procedure in 1 patient, cryoablation in 4 patients, and excision of atrial appendages or portions of atrial free walls in 7. Normal sinus rhythm developed in all surgical patients except 1 patient who had intractable congestive heart failure preoperatively and died of this condition and stroke. The overall success rates for medical and surgical therapy were 33.3% and 88.9%, respectively (p less than 0.01). Long-term follow-up was possible for 7 (87.5%) of 8 patients 3 to 7 years after operation. All patients with chronic ectopic atrial tachycardia were cured, but only 1 of 3 patients with inappropriate sinus tachycardia was in sinus rhythm.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Surgical treatment of automatic atrial tachycardias. 230 47

In order to analyze peripheral circulation in coronary disease (CD) patients with tachysystolic atrial fibrillation (TAF), as many as 108 patients were examined. Based on the magnitudes of the cardiac index and the pressure of left ventricle filling the patients were distributed into 5 groups depending on the variant (hypovolemic, hypokinetic, hypervolemic, normokinetic, and hyperkinetic) of the TAF dynamics. Twenty-two CD patients with sinus tachycardia and 28 persons without any cardiovascular pathology were also examined. All the examinees were exposed to longitudinal bipolar rheovasography (RVG) of the legs. The most pronounced changes in the blood flow in the lower limbs manifested by the lowest magnitudes of the pulse blood content, circulation intensity, velocity of the systolic inflow, and the highest tone of the peripheral arteries were recorded in patients with the hypovolemic and hypokinetic patterns of the TAF hemodynamics. The peripheral circulatory disorders correlated well with the degree of circulatory failure and with the incidence of the clinical manifestations of microcirculatory abnormalities. At the same time the RVG readings in patients with the hyperkinetic, normokinetic, and hypervolemic variants of the hemodynamics and in those with sinus tachycardia appeared to be similar. The relationship was also established between the time of pulse wave spreading and the degree of circulatory failure, atherosclerosis of the peripheral arteries and the degree of the reduction in stroke volumes because of variations in the duration of cardiac cycles. Antiarrhythmic treatment favoured the improvement of the RVG readings both in cases where the rhythm became rarer and where the sinus rhythm got recovered.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Status of the peripheral circulation in patients with ischemic heart disease with the tachysystolic form of atrial fibrillation according to data of bipolar rheovasography]. 276 97

The effects of alinidine on systemic and pulmonary haemodynamics and the ECG were studied in 8 patients early after open heart surgery as a double-blind cross-over comparison between alinidine and placebo. Placebo had no effect on any of the measured variables. Alinidine given as an i.v. bolus (10 mg) followed by an infusion (10 mg h-1) was associated with alinidine plasma levels of 172 +/- 17 and 114 +/- 13, respectively, (+/- SE, ng ml-1) and decreased heart rate (-12%) and rate-pressure product (-14%) in all patients. While stroke volume index tended to increase, there were no changes in arterial, pulmonary and atrial pressures, cardiac index, and systemic and pulmonary vascular resistances. PR and QRS intervals of the ECG remained unaffected, and the QTc interval transiently decreased. Alinidine appears to be a suitable drug for control of inappropriate sinus tachycardia in patients with heart disease undergoing surgery.
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PMID:Value of a specific bradycardic agent in cardiac surgery compared to placebo. 345 78

The antiarrhythmic, electrophysiologic and hemodynamic effects of a new antiarrhythmic agent, ACC-9358, were evaluated. In anesthetized dogs, ACC-9358 converted ouabain-induced ventricular tachycardia to normal sinus rhythm at a cumulative dose equal to encainide or flecainide and less than disopyramide. In 24-hr coronary artery ligated dogs, ACC-9358 suppressed spontaneous ventricular arrhythmias for up to 6 hr after oral or i.v. administration. The antiarrhythmic effect and plasma concentrations of ACC-9358 correlated well for both oral (r = 0.88) and i.v. (r = 0.87) administration. ACC-9358, flecainide and disopyramide were equieffective in converting crush-stimulation-induced atrial flutter in anesthetized dogs to normal sinus rhythm. In alpha-chloralose-anesthetized, closed-chest dogs, ACC-9358 slowed impulse conduction through the atria, atrioventricular node, His-Purkinje system and ventricles and prolonged atrial functional refractory period. In conscious dogs, ACC-9358 increased heart rate, reduced stroke volume and had no effect on mean arterial pressure, systemic vascular resistance or cardiac output. In alpha-chloralose-anesthetized dogs, ACC-9358-induced sinus tachycardia was unaffected by propranolol but was blocked by hexamethonium or vagotomy. In isolated cat ventricular muscle, the IC50 for the negative inotropic effect of ACC-9358 was significantly greater than flecainide or disopyramide. These results indicate that ACC-9358 is a potent, broad-spectrum, long-acting, orally and intravenously active class Ic antiarrhythmic agent that 1) may be devoid of active metabolites, 2) exerts little or no vascular effects and 3) has less direct cardiodepressant activity than flecainide or disopyramide.
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PMID:Antiarrhythmic, electrophysiologic and hemodynamic effects of ACC-9358. 369 32

The long-term efficacy of surgical correction of Wolff-Parkinson-White syndrome was evaluated in 45 consecutive patients. Before surgery, 42 patients had reciprocating tachycardia and 12 had atrial fibrillation. The principal operative procedure was endocardial incision in 42 patients, endocardial cryoablation in 2 patients and epicardial cryoablation without dissection of the atrioventricular (AV) fat pad in 1 patient. Two patients had perioperative complications. One patient had bleeding that necessitated reoperation, and one had a right cerebral stroke with subsequent clearing of neurologic deficit. At postoperative electrophysiologic study, only the patient who underwent epicardial cryoablation had conduction over an accessory connection. Two others had intermittent delta waves in the early postoperative period but no accessory connection conduction at electrophysiologic study. During a mean follow-up of 3.1 years, the patient with ineffective cryoablation had recurrent orthodromic tachycardia, and one other patient had late recurrence of delta waves without arrhythmias. Four other patients had frequent palpitation, which was caused by premature ventricular complexes in three and sinus tachycardia in one. Seventeen patients had occasional "skipped beats" without recurrence of tachyarrhythmias. Twelve of 13 patients whose arrhythmias limited employment before surgery returned to work after surgery. By actuarial analysis at 1, 2 and 3 years, all patients were alive and 98% were free from tachyarrhythmias. Surgical correction of Wolff-Parkinson-White syndrome provides excellent long-term results with low morbidity. Patients who are disabled by arrhythmias return to work after successful surgery. Delta waves may persist or recur without return of arrhythmias. Minor postoperative episodes of palpitation are common and do not correlate with tachyarrhythmias.
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PMID:Long-term follow-up after surgical correction of Wolff-Parkinson-White syndrome. 380 16


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