Edwin L. Rothfeld

Iproniazid in Angina Pectoris A Double-Blind Study

There has been considerable recent interest in the treatment of angina pectoris with iproniazid. In this paper the results of a careful double-blind study of its effect are evaluated.

The Effect of Carotid Sinus Nerve Stimulation On Cardiovascular Dynamics in Man

Electrical stimulation of the carotid sinus nerve (CSNS), sometimes called baropacing, has been proposed as a treatment of uncontrolled essential hypertension.l,2 2 Although the method has been applied clinically, relatively few studies on cardiac performance during CSNS have been reported. The role of the carotid sinus in the regulating of systemic blood pressure was first described by Hering in 1923.3 The carotid sinus &dquo;baroreceptors&dquo; are stretch receptors which are stimulated by an increase in mean arterial pres-

Unusual electrocardiographic evidence of metastatic cardiac tumor resembling atrial infarction

Abstract A case of metastatic carcinoma of the left atrium is described. The correct antemortem diagnosis was made on the basis of electrocardiographic changes resembling atrial infarction. These included deformed P waves, deviation of the P-Ta segments and atrial arrhythmias.

Coexisting paroxysmal ventricular tachycardia and idioventricular rhythm in acute myocardial infarction

Summary Two patients with acute myocardial infarction (AMI) and coexisting paroxysmal ventricular tachycardia (PVT) and idioventricular rhythm (IVR) are described. Accurate diagnosis of these arrhythmias requires elimination of the possibility that a single ventricular mechanism exists with abrupt rate changes due to varying degrees of exit block. Management of coexisting PVT and IVR includes cardio-acceleration by atropine or pacing; cardiosuppressive agents should be used only in the presence of a pacing device, since they may increase the underlying bradycardia.

Prevention of Ventricular Arrhythmias Related to Paired Pacing.

Excerpt Despite the advent of coronary care units and more aggressive management of the patient with acute myocardial infarction, the mortality rate due to the cardiogenic-shock—low-output failure ...

Electrical diagnosis of myocardial infarction in the paced dog heart.

Summary VCGs and ECGs were obtained in 21 dogs during right ventricular pacing, before and after MI produced by coronary artery ligation. The changes produced by MI were more apparent in the VCG than in the ECG. They included: o 1. Altered direction of inscription of QRS loops. 2. Displacement of initial and maximal QRS forces away from the site of infarction. 3. Delayed conduction of initial QRS forces. 4. Development of large ST vectors oriented toward the site of infarction. 5. Appearance of circular T loops with a constant conduction velocity. Experimental MI causes diagnostis electrical changes even during pacemaker rhythm.

THE TREATMENT OF SHOCK ACCOMPANYING MYOCARDIAL INFARCTION.

In patients with myocardial infarction, from 5 to 17 per cent will develop shock which has a mortality rate of from 80 to 90 per cent when untreated.’ In these patients, there is a reduced stroke volume accompanied by tachycardia and peripheral vasoconstriction.2 It has been postulated by some that it is the failure of adequate vasoconstriction to compensate for the degree of fall in cardiac output that is the essential problem in shock accompanying myocardial infaretion.3 , 4 However, it was also once thought that the drop in blood pressure after infarction was beneficial. But, Corday and his associates 5 in 1949 showed that, in dogs, there was a loss of contractility and

Colloidally suspended phytonadione in bishydroxycoumarin-induced hypoprothrombinemia☆

Abstract A study of the effectiveness of a phytonadione (vitamin K 1 ) colloidal suspension in reducing the elevated prothrombin times of bishydroxy-coumarin-treated patients was performed. Prothrombin times were studied two, four, six, eight and twenty-four hours after the administering to groups of ten patients each, of 10 mg. of the phytonadione intravenously, intramuscularly and subcutaneously, as well as after administering 5 mg. intravenously. The 10 mg. dose given intravenously showed a statistically significant acceleration of the return of the elevated prothrombin times toward normal as compared to a control group of eight patients similarly studied. This effect was observed at two hours and was greatest four hours after the vitamin was given. The 10 mg. subcutaneous dose and the 5 mg. intravenous dose failed to accelerate the return of the prothrombin times toward normal. The 10 mg. dose given intramuscularly showed some effect after twenty-four hours, but this could not be proved statistically significant. Using the 50 per cent prothrombin time value as the index of a return to a normal coagulation mechanism, four out of the group of ten patients given 10 mg. intravenously failed to reach this value. Nine bleeding episodes secondary to bishydroxycoumarin therapy were treated. Seven patients receiving 10 mg. intravenously and one who received 10 mg. subcutaneously stopped their bleeding in six to twenty-four hours after treatment. The one patient who received 5 mg. intravenously continued to bleed until a second dose of 10 mg. was given intravenously.

Electrical Diagnosis of Myocardial Infarction in the Paced Dog Heart.

Excerpt There is considerable doubt as to the value of the ECG and vectorcardiogram (VCG) in the diagnosis of myocardial infarction in the paced heart because pacemaker rhythm causes distortion of ...

Idioventricular Rhythm in Acute Myocardial Infarction: A Reappraisal.

Excerpt Controversy exists regarding the incidence, electrogenesis, clinical manifestations, management, and prognosis of idioventricular rhythm in acute myocardial infarction, a mechanism original...