RESUMEN
In a study of 60 newly diagnosed hypertensive patients, left ventricular mass was assessed echocardiographically by 2-D-derived M-mode, using the Penn cube function. Electrocardiographic variables of R1, RaVF, RaVL, RV5, RV6, SV1, SV2, SV1 + RV6, SV2 + RV6 and Estes' point score were determined for each of the patients. These variables were then compared in-turn with the left ventricular mass to determine the degree of correlation. ECG variables correlate very poorly with Echo left ventricular mass with Estes point score showing the highest correlation(0.39) and RaVL the least(-0.01). Since these ECG variables constitute the criteria used in the diagnosis of left ventricular hypertrophy caution should therefore be applied in the reliance on electrocardiography for the diagnosis of this clinical entity.
Asunto(s)
Ecocardiografía , Electrocardiografía , Hipertensión/complicaciones , Hipertrofia Ventricular Izquierda/diagnóstico por imagen , Hipertrofia Ventricular Izquierda/etiología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Hipertensión/diagnóstico por imagen , Hipertensión/fisiopatología , Hipertrofia Ventricular Izquierda/fisiopatología , Masculino , Persona de Mediana EdadRESUMEN
Non-invasive cardiac studies using systolic time intervals were performed on 89 diabetic Nigerians and 45 non-diabetic controls, to investigate possible preclinical abnormality of left ventricular function. There was no significant difference in the pre-ejection period to left ventricular ejection time ratio (PEP/LVET) between the patients and controls: 0.373 +/- 0.011 vs 0.365 +/- 0.013 (P = 0.688). Patients at higher risk for developing significant vascular disease i.e. those with peripheral vascular insufficiency, those in higher socio-economic class and those with disease duration of 10 or more years had the highest mean values of PEP/LVET (0.403, 0.403 and 0.412 respectively). However, these values did not reach a level of significance. There was no correlation between PEP/LVET and age, body mass index, duration of diabetes, total or HDL cholesterol and the HDL to total cholesterol ratio. Because recent reports have related diabetic cardiomyopathy to angiopathic disease in diabetes, these results suggest that Nigerian patients, who like most other black African diabetics show little susceptibility to severe vascular complications of diabetes may enjoy some protection from a preclinical abnormality of left ventricular function as well.
Asunto(s)
Diabetes Mellitus/fisiopatología , Contracción Miocárdica , Sístole , Adolescente , Adulto , Anciano , Cardiomiopatías/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , NigeriaRESUMEN
Over a period of 6 years, only twelve cases of dilated cardiomyopathy were clinically diagnosed in Nigerians between the ages of 11-30 years at the University College Hospital, Ibadan, Nigeria. Eleven presented with heart failure, while the twelfth patient presented with a cerebrovascular accident. Two other patients also had a cerebrovascular accident. A history of febrile illness was obtained in seven, but in only three was fever unresponsive to antimalarials, documented on admission. Antistreptolysin-O titre was normal and erythrocyte sedimentation rates elevated in each of the patients. Leucocytosis was present in six, three had a four-fold rise or fall in antibody titres against Coxsackie-B viruses and one, a four-fold rise or fall against Toxoplasma gondii. Histological evidences of myopericarditis were found in three of the six patients who died. It is concluded that dilated cardiomyopathy is rare in young adult Nigerians, and that constitutional upset is common, as in children, but prognosis is poorer. Infections by Coxsackie-B viruses, T. gondii and possibly other viruses appear to be of major aetiological factors
Asunto(s)
Cardiomiopatías/epidemiología , Adolescente , Adulto , Factores de Edad , Cardiomegalia/diagnóstico , Cardiomegalia/epidemiología , Cardiomiopatías/diagnóstico , Niño , Infecciones por Coxsackievirus/diagnóstico , Electrocardiografía , Enterovirus Humano B , Femenino , Humanos , Masculino , Nigeria , Toxoplasmosis/diagnósticoRESUMEN
Of 60 cases with pericardial metastatic disease, 26 had significant effects on the cardiovascular system. Pericardial metastases were suspected in 18 of these cases before death. The most common features reported were dyspnea on exertion and pleural effusion. While these were nonspecific for circulatory disturbance, ECG features of ST-T changes and low voltage QRS complexes were helpful in suspecting pericardial metastases. Thoracic roentgenograms were not helpful unless there was a large pericardial effusion. Echocardiography reported in one case promises a higher incidence of suspicion in the future.
Asunto(s)
Neoplasias Cardíacas/diagnóstico , Derrame Pericárdico/diagnóstico , Adulto , Anciano , Preescolar , Ecocardiografía , Electrocardiografía , Femenino , Neoplasias Cardíacas/secundario , Humanos , Masculino , Persona de Mediana Edad , PericardioRESUMEN
3 cases of aplastic anaemia occurring in association with anti-tuberculosis chemotherapy are reported. The patients had been on anti-tuberculosis chemotherapy for 13, 11 and 14 months, respectively, prior to the diagnosis of aplastic anaemia. Agents used included streptomycin, thiacetazone, isoniazid, p-aminosalicylic acid and dimethylcarbazine. Recovery from aplasia did not occur 6. 1.5 and 0.8 months, respectively, after the discontinuation of the suspect myelotoxic agents and despite the use of myelostimulatory agents. All 3 patients died of haemorrhage secondary to thrombocytopenia. The observations are consistent with a protracted and probably irreversible damage of the bone marrow by anti-tuberculosis agent(s) in susceptible individuals.