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The authors examined using selected non-invasive cardiological examination methods 33 patients with neurosis. Four were eliminated on account of organic heart disease. From the group of 29 patients 12 had ECG changes (41%)--of those 5 (17%) had an incomplete right bundle branch block and 1 (3%) had a left anterior fascicular block; 2 (7%) had the syndrome of early repolarization and 4 (14%) had changes of the T wave. The polycardiogram did not reveal a statistically significant difference in the investigated indicators (PEPc, LVETc, WI, PVR) between the group of sick and healthy patients at rest. Ambulatory 24-hour monitoring of the ECG was done in 21 patients--in 2 (10%) it revealed a sinoatrial block, in 10 (50%) episodic sinus tachycardia, in 6 (30%) occasional supraventricular extrasystoles, in 5 (25%) rare ventricular extrasystoles. The echocardiographic examination confirmed the statistically significantly increased systolic function of the left ventricle (P less than 0.05) in all investigated parameters (%D, Vcf, MNSER, EF), as compared with healthy subjects. After a loading ECG test of 28 patients 2 (7%) had ST-T changes. Statistical comparison with the group of healthy subjects revealed in the patients with neurosis a significantly reduced value of systolic (P less than 0.005) and median blood pressure (P less than 0.01), as well as of the inner cardiac work at the peak of the submaximum load (P less than 0.05) and an increase of the diastolic blood pressure (P less than 0.05) during the 10th minute of recovery. The orthostatic test in 20 patients with neurosis revealed a significantly higher heart rate at rest and during the 30th and 60th second after rising (P less than 0.05) and a significantly lower orthostatic index (P less than 0.001) on statistical comparison with healthy subjects.

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Echocardiographically established tumors occurring in the left side of the heart in three female patients are described. Two patients had myxoma in the left atrium and one patient presented with a rarely occurring pseudomyxoma in the left ventricle. Two patients were operated on and the echocardiographic finding was verified topically and histologically. One of the patients with myxoma in the left atrium has so far refused cardiosurgical treatment.

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The authors examined the prolactin (PRL) and thyrotropin (TSH) response to stimulation with chloropromazine and thyreoliberin in 10 patients with pituitary tumours. They observed a hypothalamic response instead of the expected pituitary response. These findings may be of importance for the understanding of the aetiopathogenesis of pituitary tumours. As we are able to influence nowadays some expansive pituitary processes by conservative treatment, these findings may in the near future be important in clinical practice.

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The authors examined in a group of 165 diabetics and 50 healthy subjects the basal fibrinolytic activity after venostasis and in a selected group of diabetics also after stimulation with adiuretin. They revealed not only a retarded fibrinolytic activity in diabetics with angiopathy, as compared with healthy subjects, but also a significant deterioration of the response in this group to stimuli such as venostasis and adiuretin. The authors draw attention to the fact that changes of the fibrinolytic activity which were more marked in diabetics with angiopathy may be conditioned not only by age, the duration of the disease and the elevated inhibitors of plasma fibrinolysis but also by a poorer release of the tissue activator plasminogen.

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The authors examined the plasma renin activity (PRA), serum uric acid and creatinine in 53 patients with essential hypertension (EH). They recorded low renin EH in 28%, normorenin EH in 53% and high-renin EH in 19% of the hypertensive patients. Assessment of basal PRA levels does not suffice for the classification of EH because the PRA response after stimulation is not related to its basal values. The authors found significantly higher levels of serum creatinine in low-renin EH. They did not confirm a relationship between PRA and the uric acid serum level in any form of EH.

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The authors examined 28 patients with mitral stenosis aged 60 years or older, incl. 20 (71%) with atrial fibrillation and 14 (50%) who had moreover signs of heart failure. None of them suffered from severe mitral stenosis with an area of the mitral orifice smaller than 1 sq. cm. Statistical comparison of groups of patients with sinus rhythm and atrial fibrillation and groups with symptoms of heart failure or without it revealed a significant difference only between the areas of the mitral orifice (P less than 0.005). In the other echocardiographic indicators (dimensions of the left atrium and volume ratio of its evacuation, left ventricular ejection fraction) there was no significant difference. According to criteria published by Okamura et al. in 1986 for patients above 60 years with mitral stenosis and incipient cardiac failure cardiosurgery should be an opportunity to prolong life.

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The authors demonstrate the justification of the suprasternal approach from the hollow of the neck in routine two-dimensional echocardiographic examination in adult patients. Echocardiographic and angiographic imaging is documented in two patients after surgery for coarctation of the aorta, with the narrowed section of the arch of the aorta well visualized, and in the third patient with partial anomalous opening of the pulmonary veins, the dilated left innominate vein draining blood from the left vertical vein into the dilated upper vena cava was clearly visible.

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