R. Bruce Logue
Emory University
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Featured researches published by R. Bruce Logue.
American Journal of Cardiology | 1982
Michael A. Kutcher; Spencer B. King; Benjamin N. Alimurung; Joseph M. Graver; R. Bruce Logue
Among 5,207 adult patients who underwent cardiac surgery, postoperative constrictive pericarditis was recognized in 11 patients (0.2% incidence rate). Seven patients had coronary arterial bypass grafting and 4 had valve replacement; the pericardium was left open in all cases. The average interval between surgery and presentation of pericardial constriction was 82 days (range 14 to 186). M mode echocardiography revealed epicardial and pericardial thickening in 7 cases and variable degrees of posterior pericardial effusion in 5 cases. Cardiac catheterization demonstrated uniformity of diastolic pressures with a characteristic early diastolic dip and late plateau pattern. Two patients responded to medical therapy for chronic pericarditis. One patient had a limited parietal pericardiectomy followed by recurrent constrictive pericarditis that eventually stabilized with medical therapy. The other 8 patients required radical pericardiectomy. The pathophysiology of constriction after surgery is unclear. Its clinical expression involves a wide spectrum of presentation and therapeutic response. Constrictive pericarditis may be a complication of cardiac surgery in spite of an open pericardium and should be considered in postoperative patients who present with deteriorating cardiac function.
American Heart Journal | 1963
R. Bruce Logue; James V. Rogers
Abstract One hundred fourteen unselected cases in which the radiographic diagnosis was that of pulmonary edema have been reviewed. In 27 cases (24 per cent) the diagnosis of pulmonary edema was suggested radiographically at a time when this diagnosis was unsuspected clinically. The radiographic changes in early left heart failure have been described in detail. These include dilated pulmonary veins, increased interstitial density (clouding) of the lungs, septal lines, thickened interlobar fissures, and dilatation of the pulmonary artery and its major branches. More advanced changes include pleural effusion and alveolar edema.
American Journal of Cardiology | 1976
Douglas C. Morris; J. Willis Hurst; R. Bruce Logue
This study of 24 women under age 40 years with myocardial infarction demonstrates that even in young women myocardial infarction is most commonly due to coronary atherosclerotic heart disease. Other causes of coronary occlusion were documented in 17% of these patients, indicating that these lesser causes of myocardial infarction are more common in young women than in older persons or in young men. In those patients with coronary atherosclerosis one or more significant risk factors could usually, but not always, be documented. The clinical manifestation of the coronary occlusion in the study group was not unlike its manifestation in groups of different ages or sex, or both.
Annals of Internal Medicine | 1959
Lamar E. Crevasse; R. Bruce Logue
Excerpt Despite the fact that myxedema is a time-worn subject, it is so insidious and protean in its manifestations that even today the average duration of symptoms prior to recognition is 4.8 year...
Circulation | 1972
Marshall C. Dunaway; Spencer B. King; Charles R. Hatcher; R. Bruce Logue
A patient with W-P-W syndrome (type A) and disabling supraventricular tachycardia was studied with epicardial mapping prior to surgical interruption of the circus pathway. Analysis of the delta vector and results of the epicardial mapping strongly suggested aberrant pathway located very posteriorly and crossing the atrioventricular sulcus in or adjacent to the interventricular septum. A circus movement responsible for the supraventricular tachycardia was felt to be a mechanism of antegrade A-V conduction and retrograde accessory bundle conduction. Attempts to interrupt the aberrant pathway primarily were unsuccessful, and surgical A-V block was performed. An epicardial demand pacemaker was inserted as a safety feature. Since the operation the patient has been free of supraventricular tachycardia. The postoperative electrocardiograms demonstrated antegrade accessory pathway conduction, but neither antegrade nor retrograde A-V conduction. Failure to interrupt the accessory pathway after incision of the entire right posterior A-V sulcus supported a location with, or to the left of, the atrioventricular septum for the pathway. This case, with the recent results of others, adds to the further understanding of accessory pathway location in W-P-W syndrome (type A).
Circulation | 1959
Lamar E. Crevasse; R. Bruce Logue
Approximately 95 per cent of patients with patent ductus have characteristic machinery murmurs. Five per cent have only systolic murmurs. In such patients, the intravenous or intramuscular administration of a pressor substance, mephentermine, may bring out a continuous murmur. This simple test is a useful adjunct in diagnosis.
American Heart Journal | 1958
Lamar E. Crevasse; R. Bruce Logue
Abstract 1. 1. Mild pulmonic stenosis has an early systolic ejection sound and a characteristic mid-systolic ejection murmur followed by pathologic splitting of the second sound. The aorticopulmonic interval by phonocardiography is 0.03 to 0.06 second, and right ventricular systolic pressure is usually less than 60 mm. Hg. 2. 2. Moderate pulmonic stenosis has an aorticopulmonic interval of 0.06 to 0.10 second, and right ventricular pressure ranges from 60 to 100 mm. Hg. 3. 3. Severe pulmonic stenosis has a late systolic ejection murmur which may override the aortic second sound. The pulmonic second sound is markedly delayed in closure, and an ejection sound may or may not be present. The aorticopulmonic interval is usually 0.10 to 0.14 second, and right ventricular systolic pressure is more than 100 mm. Hg. There is the usual overlap of the groups. 4. 4. We have been able to further corroborate Leathams observations that there is a close linear relationship between the degree of stenosis as reflected by right ventricular systolic pressure and the delay in closure of the pulmonic valve. This is a valuable aid in assessing the status of pulmonic stenosis, and is more reliable than using the height of the R wave in Lead V1. 5. 5. We believe that the pulmonic ejection sound which disappears with inspiration and reappears with expiration is related to mechanical alterations in the initial tension of the poststenotic pulmonary artery, owing to the respiratory cycle. The aortic ejection sound varies little with the respiratory cycle. 6. 6. When a ventricular filling sound (S3) is present with moderate to severe pulmonic stenosis, an atrial septal defect and/or anomalous pulmonary venous drainage is usually associated with it. 7. 7. Aortic stenosis and ventricular septal defect both may present as stenotictype murmurs, maximal in the second left intercostal space, simulating pulmonic stenosis. The graphic character of the systolic murmur, second sound, and ejection sounds are the best means of differentiation, because location, electrocardiography, and x-ray may be of little value in the mild defects.
Circulation | 1972
R. Bruce Logue; Paul H. Robinson
The successful medical management of a patient with angina pectoris requires careful attention to many factors including omission of smoking, control of hypertension, and weight reduction for the obese person. Newer knowledge of the importance of the product of the systolic blood pressure and the pulse rate in determining the threshold of angina affords a more meaningful approach to therapy. Each individual must be educated regarding the factors that aggravate and precipitate his distress so that these can be minimized, or prophylactic nitrite therapy can be appropriately applied. Emotional stress is of equal importance to effort in the production of angina. The mainstay stay of treatment is nitroglycerin and sublingual nitrites combined with beta-blocking drugs. Each drug or combination must be properly readjusted for the individual to assure optimum benefit. Digitalis, diuretics, antiarrhythmic drugs, antihypertensive agents, and radioiodine may be useful in selected cases.
American Heart Journal | 1952
Clyde E. Tomlin; R. Bruce Logue; J. Willis Hurst
Abstract There have been presented two cases of fibrocystic disease of the pancreas with associated chronic cor pulmonale and right ventricular failure, studied at autopsy. The difficulties in the diagnosis and the importance of the recognition of chronic cor pulmonale in the infant have been emphasized. Although the benefit from cardiac therapy in this condition may be limited, it should not be withheld or inadequately administered.
Circulation | 1954
R. Bruce Logue; J. Willis Hurst
The diagnosis of angina pectoris is established by the presence of a characteristic history and does not depend upon the presence of electrocardiographic abnormalities. The pain is usually substernal and occurs characteristically during effort, emotional stress, exposure to cold or after a large meal. It is not well appreciated that it may occur on assuming the recumbent position. The duration is one to five minutes as a rule and relief may be prompt with rest or the administration of nitroglycerin. In inquiring regarding angina, it is not sufficient to ask about pain alone. Since pain may be denied, one should therefore ask about indigestion, tightness, squeezing, burning, heaviness or choking. Discomfort may occur in the arms, epigastrium, back or jaw without being present in the anterior chest. While precordial pain is rare in angina pectoris, it may occur. The sudden onset of angina for the first time or the change in its frequency or severity usually signifies coronary occlusion and rarely myocardial infarction. Judicious periods of rest when such changes occur may allow collateral circulation