Richard W. Booth

Supravalvular aortic stenosis: Clinical experiences with four patients including familial occurrence☆

Abstract The clinical findings in four patients with supravalvular aortic stenosis are described, and previously reported cases reviewed. The association of this defect with the clinical findings of aortic stenosis, a marked difference in the blood pressures and pulses in the upper extremities, and the frequent absence of poststenotic dilatation of the aorta is stressed. The frequency with which one or a combination of the following defects occur, namely, aortic valve deformity, aortic regurgitation and abnormalities of coronary artery filling, is noted. The present study provides documentation of the familial occurrence of this defect, or combination of defects. Angiocardiographic studies are necessary to confirm the diagnosis. Complete surgical correction may not be possible, and there is no objective evidence available at present that partial correction will be accompanied by increased longevity.

Friedreich's ataxia: a neurocardiac disease.

Abstract Seven cases of Friedreichs ataxia are reported, and in six of these, electrocardiograms were recorded, all of which were abnormal. A review of the literature discloses increasing awareness of the cardiac aspects of the disease. We find that in every autopsied case reported upon in the American and English literature there were abnormal findings in the heart; usually, these were findings of chronic interstitial myocarditis. We believe that Friedreichs ataxia is a neurocardiac disease which involves both the central nervous system and the heart.

Transcarotid coronary arteriography in man with emphasis on intercoronary arterial anastomosis.

At the annual meeting of the Radiological Society of North America in 1957 we demonstrated the technic and the results of transcarotid aortic valvulography based on a series of 51 injections in 49 patients (1). On that occasion, and in subsequent publications, attention was called to the incidental satisfactory, although inconstant, visualization of the normal coronary arteries in these cases (2, 3). It became evident that, after certain modifications, the method (4) could be utilized for the direct visualization of the coronary arteries in those patients in whom clinical findings and electrocardiography failed to establish a diagnosis. Experimental studies, including approximately 300 injections in 50 mongrel dogs, helped us to introduce the changes in the method necessary for constant detailed visualization of both coronary arteries without increasing the risk associated with thoracic aortography. The results of these experimental studies in animals and the associated electrocardiographic and physiologi...

Bidirectional tachycardia. Three cases and a review of its mechanism.

Abstract Three cases of bidirectional tachycardia are presented and the theories proposed to explain its mechanism are reviewed. Whether the ectopic foci are ventricular, supraventricular or both is still unsettled. The underlying heart disease limits the response to treatment and the grave prognosis associated with the arrhythmia is stressed.

Lymph node compression of the pulmonary artery causing a continuous murmur.

Abstract A patient with lymph node compression of the left pulmonary artery is presented in whom a continuous murmur suggested the diagnosis of patent ductus arteriosus. The numerous causes of continuous murmurs are tabulated and the mechanism of the production of continuous murmurs by vascular narrowing is reviewed.

A Saline Conductivity Method for Detection of Cardiac Shunts by Indicator-Dilution Technic

A new method for cardiovascular shunt detection is described using the indicator-dilution principle applied to blood conductivity changes produced by 5 per cent saline. It possesses these distinct advantages over the Evans blue technic: (1) an unlimited number of determinations can be made without an increasing blood dye background or bluish discoloration of the patient, (2) oximetric determination of blood oxygen saturation is not interferred with, and (3) a simple modification of the carrier amplifiers of commonly used recording systems supplies most of the necessary instrumentation.