John B. Johnson

EFFECTS OF SUBLINGUAL NITROGLYCERIN ON PULMONARY ARTERIAL PRESSURE IN PATIENTS WITH LEFT VENTRICULAR FAILURE

Excerpt The retrosternal distress associated with paroxysmal dyspnea may be quite severe, and in many instances it is described by the patient as pain.1This discomfort is sometimes interpreted by t...

Sarcoidosis of the heart

Abstract 1. 1. A case of generalized sarcoidosis in which there was massive infiltration of the myocardium is reported. The patient had had premature ventricular beats from multiple foci, paroxysmal ventricular tachycardia, and severe congestive heart failure. 2. 2. Eight cases of sarcoidosis of the heart were found in a review of the literature. Clinical evidence of heart disease was present in three of these cases, and sudden death occurred in another. The electrocardiogram showed no characteristic changes, but in several of the cases of massive cardiac involvement there were pronounced abnormalities of the cardiac mechanism. 3. 3. There seems to be little or no occasion to doubt that some of the cases reported as atypical tuberculosis, specific myocarditis, granulomatous myocarditis, and myocarditis of unknown cause were, in fact, cases of sarcoidosis of the heart.

Hemodynamic and angiocardiographic observations in an adult with persistent left superior vena cava draining into the coronary sinus and interatrial septal defect

Abstract 1. 1. A case is reported which shows a persistent left superior vena cava draining into the coronary sinus and associated with a large interatrial septal defect in a woman, aged 50 years. 2. 2. The embryologic basis of anomalies of the superior vena cava is reviewed, and a classification of the types of persistent left superior vena cava is presented. 3. 3. The patient was shown to have a large left-to-right shunt and increasing cardiomegaly but normal pulmonary arterial resistance. 4. 4. Although definitive criteria for surgical therapy of interatrial septal defects in adults are not yet crystallized, we believe the patient is approaching the critical stage when heart failure is imminent and, therefore, recommend surgical intervention.

Unsuspected Superior Vena Caval Obstruction Detected by Angiocardiography

Angiocardiography is rapidly becoming a routine method for adequate evaluation of upper mediastinal lesions and has increased significantly the accuracy of diagnosis of mediastinal masses. We report here a case of superior vena caval obstruction which was totally unsuspected clinically. This case takes on added interest since our examinations established the fact that the obstruction to the superior vena cava extended to below the opening of the azygos vein into the superior vena cava, and also that there was obstruction of the left innominate and right subclavian veins. B. S., a 76-year-old Negro female, entered the hospital Nov. 18, 1951, because of a superior mediastinal mass. She had become ill in December 1950, at which time anorexia occurred and she began to lose weight. In July 1951, she began to experience pain, varying in location from the upper right and left parasternal region of the chest to the left side of the neck. This was thought to be precipitated by eating but not by walking. Roentgen e...