Heart articles from July 2002

Heart archives from July 2002

Myocardial infarction: redefined or reinvented?(Editorial)
July 1, 2002... Troponins have recently been promoted to playing a pivotal role in the diagnosis of acute myocardial infarction. However, a number of problems arise as a result of this "redefinition" of acute MI The recent joint statement by the European...

Prosthetic valve dysfunction presenting as intermittent acute aortic regurgitation. (Images in Cardiology).(Brief Article)
July 1, 2002... A 69 year old man was admitted to our hospital because of an episode of acute severe dyspnoea associated with transient loss of consciousness. His medical history revealed rheumatic aortic stenosis for which he had undergone aortic valve...

The opium poppy, morphine, and verapamil. (Stamps in Cardiology).(Brief Article)
July 1, 2002... Papaver somniferum, the opium poppy, has been used medicinally for over 5000 years. When the unripe seed capsule is incised a milky fluid runs out and when dried this constitutes opium (Greek opus = juice). This contains three important...

Existence of muscles surrounding the persistent left superior vena cava demonstrated by electroanatomic mapping. (Images in Cardiology).(Brief Article)
July 1, 2002... A 33 year old man was referred to our centre for radiofrequency catheter ablation for clinically documented atrial flutter. A persistent left superior vena cava (PLSVC) draining into a dilated coronary sinus was revealed during angiography....

Worm-shaped thrombus mimicking Chiari's network in a cocaine user. (Images in Cardiology).(Brief Article)
July 1, 2002... A 20 year old man, with a history of cocaine and amphetamine abuse, was admitted to the coronary care unit with mild exertional dyspnoea. His ECG and cardiac enzymes were normal. A transthoracic echocardiogram showed a dilated and hypokinetic...

Patients with acute coronary syndrome should start a statin while still in hospital.(Editorial)
July 1, 2002... Despite well documented clinical benefit of statins in patients with coronary heart disease, there remains a significant "treatment gap" between those patients in whom treatment is indicated and those who actually receive it Two papers...

HLHS: first operative hurdle is the worst. (From BMJ Journals).(hypoplastic left heart syndrome)(British Medical Journal)(Brief Article)
July 1, 2002... Medium term outlook is good for babies surviving stage I reconstructive surgery for antenatally diagnosed hypoplastic left heart syndrome (HLHS). Reconstructive palliative surgery has greatly improved the outlook for this condition and makes...

Bilateral internal mammary artery grafting: are BIMA better? Current evidence supports a policy of increasing use of arterial grafts during CABG, in particular bilateral internal mammary arteries.(bilateral internal mammary artery)(coronary artery bypass grafting)(Editorial)
July 1, 2002... The clinical and prognostic benefits of coronary artery bypass grafting (CABG) are well accepted for certain subgroups of patients with ischaemic heart disease, (1) and as many as one million patients undergo this operation annually on a...

Right atrial lithomyxoma with extramedullary hematopoiesis. (Images in Cardiology).(Brief Article)
July 1, 2002... A 69 year old man was admitted for syncope during physical activity. The history and physical examination was unremarkable. Echocardiographic studies showed normal ventricular dimensions, conserved systolic function, normal left atrium...

Diagnosis of a rare cause of arrhythmogenic syncope by means of an implantable loop recorder.(Brief Article)
July 1, 2002... A 39 year old woman was admitted for evaluation of recurrent syncope. A detailed workup, including invasive electrophysiological testing, was unremarkable. The patient initially refused implantation of a loop recorder, but finally agreed...

Antiplatelet treatment in unstable angina: aspirin, clopidogrel, glycoprotein IIb/IIIa antagonist, or all three? (Viewpoint).
July 1, 2002... Evidence on the role of antiplatelet agents in patients with non-ST elevation acute coronary syndrome is reviewed, and a strategy for their use in unstable angina is presented Plaque rupture, platelet activation, and thrombus formation...

Use of statins in the secondary prevention of coronary heart disease: is treatment equitable? (Cardiovascular Medicine).(Statistical Data Included)
July 1, 2002... Objective: To investigate possible inequities in the use of statins for people with coronary heart disease according to a wide range of social and clinical factors. Design and setting: Cross sectional analysis of data from the Health...

Impact of availability and use of coronary interventions on the prescription of aspirin and lipid lowering treatment after acute coronary syndromes. (Cardiovascular Medicine).(Statistical Data Included)
July 1, 2002... Background: It has been suggested that patients undergoing acute intervention for coronary syndromes may not receive adequate secondary prevention. Objective: To analyse the impact of availability and use of coronary interventions on the...

Multiple ischaemic events set the pattern in patent foramen ovale. (From BMJ Journals).(Brief Article)
July 1, 2002... In cryptogenic stroke and patent foramen ovale (PFO) multiple ischaemic strokes or transient ischaemic attacks (TIA) before diagnosis predispose to recurrent strokes later, Nedeltchev et al have found. Whether PFO causes cryptogenic...

Low prevalence of lipid lowering drug use in older men with established coronary heart disease. (Cardiovascular Medicine).(Statistical Data Included)
July 1, 2002... Heart 2002;88:25-29 Objective: To determine the prevalence and correlates of lipid lowering drug use among older British men with established coronary heart disease (CHD). Design: Cross sectional survey within a cohort study (British...

Intercoronary communication between the circumflex and right coronary arteries: distinct from coronary collaterals. (Images in Cardiology).(Brief Article)
July 1, 2002... A 49 year old man presented with atypical chest pain for five months. He had no risk factors for atherosclerosis. Exercise electrocardiography was stopped prematurely because of leg cramp. Coronary angiography was performed and revealed...

Seasonality of coronary artery deaths in New South Wales, Australia. (Cardiovascular Medicine).(Statistical Data Included)
July 1, 2002... Background: Complex temporal variations in coronary deaths, including diurnal, weekly, and seasonal trends, hove been reported worldwide. Objective: To describe the magnitude of seasonal changes in coronary artery deaths in New South...

Regional left ventricular function during transient coronary occlusion: relation with coronary collateral flow. (Cardiovascular Medicine).(Statistical Data Included)
July 1, 2002... Heart 2002;88:35-42 Objective: To test the hypothesis that regional left ventricular (LV) function during balloon angioplasty is related to the amount of collateral flow to the ischaemic region. Design: Prospective study. ...

Unruptured aneurysm of the sinus of Valsalva obstructing the right ventricular outflow tract: magnetic resonance imaging findings. (Images in Cardiology).(Brief Article)
July 1, 2002... A 49 year old man was admitted to our hospital because of exertional dyspnoea and chest discomfort. On admission, physical examination revealed a grade 2/6 systolic ejection murmur that was most prominent at the second intercostal space along...

Prospective analysis of the association of infection with CagA bearing strains of Helicobacter pylori and coronary heart disease. (Cardiovascular Medicine).(cytotoxin associated gene A)(Statistical Data Included)
July 1, 2002... Heart 2002;88:43-46 Objective: To see whether it was possible to replicate in a prospective study the association recently reported between infection with the more virulent (type 1) cytotoxin associated gene A (CagA) antigen carrying...

Incremental changes in QRS duration in serial ECGs over time identify high risk elderly patients with heart failure. (Cardiovascular Medicine).(Statistical Data Included)
July 1, 2002... Heart 2002;88:47-52 Aims: To investigate the hypothesis that changes in the ECG over time may be an important and readily available marker of prognostic value in patients with heart failure. Methods: 112 elderly patients (81 men)...

Arrhythmogenic giant submitral left ventricular diverticulum. (Images in Cardiology).(Brief Article)
July 1, 2002... A 55 year old man presenting with upper abdominal discomfort and orthopnoea, and sustained wide QRS tachycardia in which the QRS configuration showed right axis deviation and right bundle branch block pattern on ECG, was referred to our...

Thrombus after transcatheter closure of ASD with an Amplatzer septal occluder assessed by three dimensional echocardiographic reconstruction.(atrial septal defect)(Brief Article)
July 1, 2002... A 50 year old woman who had a secundum atrial septal defect underwent transcatheter closure. The procedure was performed under general anaesthesia with mechanical ventilation. Multi-plane transoesophageal images were acquired with a...

Mortality from infective endocarditis: clinical predictors of outcome. (Cardiovascular Medicine).(Statistical Data Included)
July 1, 2002... Heart 2002;88:53-60 Objective: To identify clinical markers available within the first 48 hours of admission that are associated with poor outcome in infective endocarditis. Designs: Retrospective cohort study. Setting: Teaching...

Myocardial infarction and coronary thrombosis. (Images in Cardiology).(Brief Article)
July 1, 2002... A 37 year old woman was admitted because of acute non-ST segment elevation myocardial infarction. Treatment with nitrates, [beta] blocker, aspirin, and heparin was initiated. The next day her EGG revealed new Q waves with a negative T wave in...

Infective endocarditis: determinants of long term outcome. (Cardiovascular Medicine).
July 1, 2002... Objective: To evaluate predictors of long term prognosis in infective endocarditis. Design: Retrospective cohort study. Setting: Tertiary care centre. Patients: 212 consecutive patients with infective endocarditis between 1980...

Prospective comparison of costs and short term health outcomes of surgical versus device closure of atrial septal defect in children. (Congenital Heart Disease).
July 1, 2002... Objective: To compare surgical and device closure of isolated secundum atrial septal defect (ASD) in terms of hospital costs, clinical outcome, and impact on the patient and family. Design: Prospective, observational study. Setting:...

Bilateral origin of a split left anterior descending coronary artery combined with atypical branching of the left circumflex coronary artery. (Images in Cardiology).
July 1, 2002... A 51 year old diabetic presented with a five hour history of severe chest pain at a community hospital, The EGG showed an acute anterolateral wall myocardial infarction and the patient was treated with intravenous tissue plasminogen activator...

Quality of life in adults with congenital heart disease. (Congenital Heart Disease).
July 1, 2002... Objective: To examine the quality of life of adults with congenital heart disease. Design and setting: Observational, cross sectional study conducted at one general hospital in Birmingham, UK. Patients: All 471 patients registered at...

Congenital bilateral coronary fistulae. (Images in Cardiology).(Brief Article)
July 1, 2002... An asymptomatic 7 week old infant presented with a soft continuous murmur at the left sternal border and decreased volume femoral pulses. Both the chest radiograph and ECG were unremarkable. Echocardiography revealed an aortic coarctation and...

A new, simple, and accurate method for non-invasive estimation of pulmonary arterial pressure. (Basic Research).
July 1, 2002... Heart 2002;88:76-80 Objective: To develop and validate a new non-invasive method for the estimation of pulmonary arterial pressure (PAP) based on advanced signal processing of the second heart sound. Design: Prospective comparative...

Evaluation of long term cardiotoxicity after epirubicin containing adjuvant chemotherapy and locoregional radiotherapy for breast cancer using various detection techniques. (Scientific Letter).
July 1, 2002... Heart 2002;88:81-82 Breast cancer patients who present with only locoregional lymphatic metastases have good life expectancy after treatment with surgery and adjuvant anthracycline-containing chemotherapy. Anthracyclines, however, can...

Correction.(Correction Notice)
July 1, 2002... Constantinides S, Lo TSN, Been M, Shiu MF. Early experience with a helical coronary thrombectomy device in patients with acute coronary thrombosis. Heart 2002;87:455-60 The figures accompanying the captions to figs 4 and 5 were...

Is early, low level, short term exercise cardiac rehabilitation following coronary bypass surgery beneficial? A randomised controlled trial. (Scientific Letter).
July 1, 2002... Heart 2002;88:83-84 Through the relief of myocardial ischaemia, the goal of coronary artery bypass grafting (CABG) is to preserve and if possible to restore cardiac function towards normality. Evaluation of cardiovascular haemodynamics...

Web top 10.(heart disease web sites)(Brief Article)
July 1, 2002... www.heartjnl.com These articles scored the most hits on Heart's web site during April 2002 1 The medical management of valvar heart disease NA Boon, P Bloomfield April 2002;87:395-400. (Education in Heart) 2 Joint...

Percutaneous coronary intervention in octogenarians with refractory angina. (Scientific Letter).
July 1, 2002... Heart 2002;88:85-86 Very elderly patients are excluded from most trials of percutaneous coronary intervention (PCI). (1 2) There is little contemporary data to guide clinical decision making, particularly in elderly patients presenting...

Saphenous vein graft aneurysm presenting as an anterior mediastinal mass. (Images in Cardiology).(Brief Article)
July 1, 2002... A 63 year old man underwent coronary artery bypass grafting in 1995 from which he made an excellent recovery. In early 2000 he was admitted to hospital with a lower respiratory tract infection. A chest x ray taken at the time suggested a...

Acquired von Willebrand syndrome in children with patent ductus arteriosus. (Scientific Letter).
July 1, 2002... Heart 2002;88:87-88 Since acquired von Willebrand syndrome (AVWS) was first described in 1968, approximately 270 cases have been reported in the literature. In 12% of these cases AVWS was secondary to cardiovascular disorders. (1) Only...

Crossed pulmonary arteries, ventricular septal defect, and chromosome 22q11 deletion. (Images in Cardiology).(Brief Article)
July 1, 2002... A 2 month old was referred for ventricular septal defect closure. Echocardiography demonstrated malposed (crossed) pulmonary arteries and a large subarterial ventricular septal defect. Magnetic resonance imaging confirmed the anatomy....

Fatal cardiac tamponade in a child due to rupture of a mycotic aneurysm. (Images in Cardiology).(Brief Article)
July 1, 2002... A 3 year old child presented with a three week history of febrile illness associated with pharyngitis and erythema. A throat swab was positive for type A [beta] haemolytic streptococcus. Two dimensional echocardiography revealed pericardial...

Intracellular cardiac amyloidosis in familiar amyloid polyneuropathy of the Portuguese type. (Images in Cardiology).(Brief Article)
July 1, 2002... We report on a 38 year old woman of Portuguese origin with peripheral ascending polyneuropathy for several years. Her family history was positive for hereditary systemic amyloidosis. A familial amyloidotic polyneuropathy with a Portuguese...

Understanding coronary artery disease: tomographic imaging with intravascular ultrasound. (Imaging Techniques).
July 1, 2002... Heart 2002;88:91-96 In 1856 the pathologist Virchow published his now classic observations on atherothrombosis based on the examination of postmortem tomographic artery sections. The Virchow triad describes three components contributing...

Management of Marfan syndrome. (General Cardiology).
July 1, 2002... Heart 2002;88:97-103 Marfan syndrome is a variable, autosomal dominant connective tissue disorder, affecting mainly the cardiovascular system, eyes, and skeleton. The incidence is approximately 1 in 9800, and around 26% of cases have no...

Development and structure of the atrial septum. (Anatomy).
July 1, 2002... Heart 2002; 88: 104-110 Most cardiologists would probably consider that, during their training, they had received appropriate instruction concerning the mode of development and structure of the atrial septum. This is likely to be founded...

Lipomatous hypertrophy of the interatrial septum. (Images in Cardiology).(Brief Article)
July 1, 2002... A 69 year old woman with a history of obesity, hypertension, nicotine abuse, and periods of atrial flutter, was admitted with a New York Heart Association (NYHA) grade III dyspnoea. She did not complain of angina. Chest x ray revealed no...

Imaging of massive pulmonary embolism.(Brief Article)
July 1, 2002... A 26 year old woman was admitted with fever and illness caused by an infiltration of the lingula. The day after admittance, symptoms of acute dyspnoea and tachypnoea developed. Pulmonary embolism was suspected. A perfusion scan showed...

Ischaemic heart disease. (Journal Scan).
July 1, 2002... Statin treatment: the longer the better * At what concentration of cholesterol should treatment be initiated? The answer from the heart protection study (HPS) seems to be anything above a total cholesterol of 3.5 mmol/l. The cost...

Heart failure. (Journal Scan).(Brief Article)
July 1, 2002... Clinical assessments of heart failure are flawed * The rule of halves states that 50% of patients treated for heart failure do not have systolic dysfunction. This study of 225 patients presenting with clinical heart failure revealed that no...