Insidious endocarditis caused by Chlamydia psittaci

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Comparison of Triosil 370 with Urografin 76 and Hypaque 65 for coronary arteriography

Triosil 370 has been compared with Urografin 76, and Hypaque 65 by injecting identical volumes into the coronary arteries of human subjects in the course of coronary arteriography. The injection times used were the same and neither the patient nor the coronary artery catheter were moved between injections. The order in which the solutions compared were injected was alternated. The deviation in the ST segment and of the T wave which resulted from the injection was measured. The Triosil caused significantly less change than Urografin and Hypaque. A numerical expression of the T wave deflection derived from the data showed Triosil:Hypaque:Urografin equals I:2.6:2.9.

Classification of ventricular pre-excitation. Vectorcardiographic study

In a study of 45 cases of ventricular pre-excitation, 19 were classified as type A and 20 as type B according to Rosenbaum's criteria, which depend on the polarity of the major deflections in the right praecordial leads and not, as is commonly thought, on the direction of the delta vector. Six cases that could not be classified as type A or type B were termed intermediate. Vectorcardiograms were recorded from 29, and these showed a wide but continuous range of values for both the delta and the main QRS vectors in all three planes. Any classification based on these features must, therefore, depend on arbitrary quantitative data. Three patients in this series had associated right bundle-branch block. A review of the published reports on the association of pre-excitation and bundle-branch block failed to provide a rational basis for the classification of pre-excitation. It is emphasized that Rosenbaum's classification is empirical and its validity is questioned.

Extreme pulmonary hypertension caused by mitral valve disease. Natural history and results of surgery

Five hundred and eighty six patients with mitral valve disease were studied with cardiac catheterization between 1961 and 1972; 48 (8.2%) had extreme pulmonary hypertension (resting systolic pulmonary artery pressure of 80 mmHg or above and pulmonary vascular resistance of 10 units or greater) and of these patients, 27 underwent cardiac surgery. The operative mortality for mitral valvotomy was 11 per cent and for mitral valve replacement 56 per cent. The overall mortality was 31 per cent. The risks of operation were increased in those with a long history of cardiac symptoms, those over 50 years of age, and in the presence of associated aortic valve disease. The mean survival for those patients not having operation was only 2.4 plus or minus 0.5 years. The mean follow-up period for those surviving operation has been 5.8 plus or minus 0.6 years, and symptomatic improvement has been good.

Left ventricular hemiblock patterns in ventricular pre-excitation

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Arborescent Burning by Lightning

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Notes of a Case of Pseudo-hermaphroditism

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