Cardiology Commons^™

Respiratory Arrest In A Child After Flushing Of Pancuronium From The Dead Space Of Intravenous Cannula, Robyna Irshad Khan, Fazal Hameed Khan, Hamid Iqil Naqvi

Department of Anaesthesia

It is common practice for patients admitted to Intensive Care Units to have indwelling intravenous cannulae. Sometimes these cannulae are used only for the administration of drugs and are closed otherwise. Residual drugs in the deadspace of these intravenous cannulae as well as connected stoppers or 3-way stopcocks can later be flushed unknowingly. We would like to report a case in which inadvertent flushing of residual pancuronium caused complete muscle paralysis and respiratory arrest in a young child.

Drug Eluting Stent: A Major Advance In Fighting Coronary Artery Restenosis, Yuk-Kong Lau

Journal of the Hong Kong College of Cardiology

Since the first use of coronary angioplasty in 1977, there have been major growth and development in percutaneous coronary intervention (PCI). Due to the advances in techniques, experiences, devices, and newer potent antiplatelet and antithrombotic medications, PCI is increasingly performed in highly complex and high risk patients with a reasonably low complication rate. Coupled with reduced discomfort, shorter hospital stay and recovery time, it has far outnumbered the volume of coronary artery bypass surgery. Currently, 1.7 million PCI procedures are performed annually worldwide with increases by 15-20% per year the last decade.

Is Dynamic Atrial Overdrive Pacing Anti-Arrhythmic Or Proarrhythmic: A Case Report, Ngai-Yin Chan, Miu-Fong Kwok, Chi-Chung Choy

Journal of the Hong Kong College of Cardiology

No abstract provided.

The Post-Madit Ii Era: Icd For All Post-Infarct Patients With Moderate To Severe Left Ventricular Dysfunction?, Kathy Lai-Fun Lee, Chu-Pak Lau

Journal of the Hong Kong College of Cardiology

Device therapy has become the preferred treatment for patients who have survived sudden cardiac death. Throughout the last decade, large-scale randomized clinical trials have provided consistent evidence on the clinical efficacy of device therapy. ICD is proven to be superior to anti-arrhythmic drugs in patients with structural heart diseases who suffer from haemodynamically significant ventricular arrhythmias. The role of ICD in primary prevention of sudden death in selected patients with coronary artery disease and left ventricular dysfunction is also widely established after the Multicenter Automatic Defibrillator Implant Trial (MADIT) and the Multicenter Unsustained Tachycardia Trial (MUSTT).

Role Of Signal-Averaged Ecg In Predicting Results Of Flecainide Provocation Test Used In Family Screening For Brugada Syndrome, Ngai-Shing Mok, Chi-Chung Choy, Ngai-Yin Chan, Amy Ho

Journal of the Hong Kong College of Cardiology

Brugada syndrome (BS) is an inherited arrhythmogenic disease with an autosomal dominant mode of inheritance. Flecainide provocation test (FPT) has been shown to be highly sensitive and specific in unmasking the Brugada ECG pattern in affected subjects. We sought to test if late potential (LP) in signal averaged electrocardiogram (SAECG) is helpful in predicting the results of FPT used in family screening for BS. The study included 17 asymptomatic Chinese subjects from 8 families (M:F 10:7, mean age 24.8±11.4 years) who have undergone family screening for BS. All screened subjects had a normal 12-lead ECG at baseline. None had structural …

Percutaneous Revascularisation In Diabetic Patients With Coronary Artery Disease, Wai-Hong Chen, Chu-Pak Lau

Journal of the Hong Kong College of Cardiology

Diabetic patients with coronary artery disease are associated with an unfavourable long-term outcome. Surgical revascularisation on top of medical therapy has been shown to confer survival benefit in patients with mutivessel and left main disease. With the emergence of the percutaneous approach of revascularisation, several clinical trials have been conducted to compare these two modalities of treatment. Consistent results were demonstrated in the diabetic subgroup that coronary artery bypass grafting is superior to balloon angioplasty in preventing late adverse cardiac event. With the advancement of percutaneous technique using coronary stenting as the predominant mode of catheter based revascularisation, the latest …

Update - May 2002, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- The Compleat Physician
-- Informed Consent Documentation for Total Artificial Hearth Technology
-- Ralph J. and Carolyn Thompson Endowment established in 2001

Typical Symptoms Are Predictive Of Acute Coronary Syndromes In Women, Kerry A. Milner, Marjorie Funk, Amy L. Arnold, Viola Vaccarino

Nursing Faculty Publications

Background: Previous research suggests that the presentation of acute coronary syndromes (ACS) may differ in women and men. No study has prospectively evaluated the role of a comprehensive set of typical and atypical symptoms and whether different symptoms on presentation predict ACS diagnosis in women and men. Methods and Results: We directly observed 246 women and 276 men seen in the emergency department with symptoms suggestive of ACS and documented their symptoms verbatim. ACS was eventually diagnosed in 89 (36%) women and 124 (45%) men on the basis of standard electrocardiogram and cardiac enzyme criteria. Presence of typical symptoms (chest …

The Long-Term Clinical Prognosis In Patients With Anterior Wall And Non-Anterior Wall Acute Myocardial Infarction Referred To Primary Percutaneous Transluminal Coronary Angioplasty, Mingzhong Zhao, Dayi Hu, Tianchang Li, Sanqing Jia

Journal of the Hong Kong College of Cardiology

Objective: To investigate the long-term clinical prognosis in patients with anterior wall acute myocardial infarction (AW-AMI) and non AW-AMI (NAW-AMI) referred to primary percutaneous transluminal coronary angioplasty (P-PTCA). Methods: 287 patients with AMI who underwent P-PTCA were divided into AW-AMI group (142 cases) and NAW AMI group (145 cases) according to different sites of AMI. The baseline characteristics and coronary artery lesions of patients were analysed. The primary end points were in-hospital mortality and the major cardiovascular events (MACE) during a mean 17.3±9.8 months follow-up including the occurrences of non-fatal myocardial infarction, non-fatal congestive heart failure, revascularization of target vessels …

Appropriate Use Of Clopidogrel, Cyrus R Kumana, Bernard Man-Yung Cheung, Ij Lauder

Journal of the Hong Kong College of Cardiology

Clopidogrel (Plavix®) is an orally administered pro-drug, whose pharmacology and therapeutic role has been extensively reviewed in recent publications.1-5 In essence, it results in selective and irreversible antagonism of ADP-induced platelet aggregation. Such aggregation normally results in the surface expression of platelet glycoprotein (GP) IIb/IIIa receptors, which facilitate fibrinogen binding as well as consequential further platelet aggregation – the final common pathway of vascular occlusion. Specific cytochrome P450 enzymes are thought to generate the responsible active metabolite (believed to persist transiently). However, dosage adjustment is not recommended in hepatic impairment (unless severe) and drug-drug interactions and co-administration with meals are …

Spatio-Temporal Variation In Activation Intervals During Ventricular Fibrillation, Sachin Anil Moghe

University of Kentucky Doctoral Dissertations

Spatio-temporal variation in activation rates during ventricular fibrillation (VF)provides insight into mechanisms of sustained re-entry during VF. This study had three objectives related to spatio-temporal dynamics in activation rates during VF.

The first objective was to quantify spatio-temporal variability in activation rates,that is, in dominant frequencies, computed from epicardial electrograms recorded during VF in swine. Results showed that temporally and spatially, dominant frequencies variedas much as 20% of the mean dominant frequency, and the mean dominant frequencies increased during first 30 sec of VF. These results suggest that activation rates are nonstationary during VF.

The second objective of the study …