[The cumulative risk index in stroke prevention]

The screening and special management of high risk patient, is possible strategy to reduce the high morbidity and mortality of stroke. In the II. district of Budapest we examined high vascular risk patients cooperating with general practitioners. We let the severity of risk with arithmetic of the cumulative risk index. Significant relation was found between of high cumulative risk index and 50% or higher carotis stenosis, as well as the cumulative risk index and low Se HDL level. Increased blood pressure level has been found in among the treated hypertonic patient. Reduction of high blood pressure was documented in the 6 month control examination. Finally there was very low level of smoking in the high vascular risk patient group.

[Constrictive pericarditis following heart surgery]

A case history is presented of a patients with postoperative constrictive pericarditis (PCP) after five months of coronary artery bypass grafting. No previous report was found in Hungary on this subject. The authors summarize the main points of etiology, diagnosis and treatment of PCP according the data found in the literature. They point out that the possibility of PCP should arise in every case when the patient's health deteriorates after open heart surgery especially in the case of serious right heart failure. The diagnosis is very important because the patient can be cured with a subsequent open heart surgery.

[Prinzmetal angina pectoris causing diagnostic and therapeutic problems]

A 53 year old patient was hospitalized because of retrosternal oppression which was unrelated to effort and recurred in the early morning hours. An esophageal diverticulum and a hiatal hernia were found. The patient had complaints in spite of medical therapy and an operation was performed because of his oesophageal disorders. After operation the patient had the same pain. A cardiologist was asked, who suggested Prinzmetal variant angina. During arteriography coronary artery disease was found. Coronary bypass surgery was indicated and performed, after that procedure the patient was and remained free of any complaints. This observation reaffirmed Prinzmetal original statement "The key to the diagnosis ... is the taking of a painstaking history".