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This investigation was designed to determine the role of echocardiography in the assessment of left ventricular function in patients with significant coronary arterial disease. Satisfactory echocardiograms were obtained in 43 patients with coronary arterial disease. The ventriculographic ejection fraction was determined by the area length method. The echocardiographic left ventricular end-diastolic dimension was increased to more than 5-4 cm in 17 patients. Fifteen of these patients had an ejection fraction of 0-45 or less. Three patients had a normal left ventricular end-diastolic dimension but an ejection fraction of less than 0-45. Twenty-three patients had an ejection fraction of more than 0-45 and a normal left ventricular end-diastolic dimension. The left ventricular end-diastolic dimension index was increased (greater than 3 cm/m2) in 15 patients, all of whom had ejection fraction of less than 0-45. Three patients had a normal left ventricular end-diastolic dimension index and an ejection fraction of less than 0-45. Twenty-five patients had a left ventricular end-diastolic dimension index of less than 3 cm/m2 or less and an ejection fraction of more than 0-45. The percentage fractional shortening of the echocardiographic left ventricular dimension was reduced in 25 patients. In 18 of these the ejection fraction was 0-45 or less. The percentage fractional shortening of the left ventricle was normal in 18 patients. In 2 of them the ejection fraction was less than 0-45. In summary, increase of the left ventricular end-diastolic dimension or left ventricular end-diastolic dimension index is usually associated with a critical reduction of the ejection fraction as determined by ventriculography. Since the ejection fraction is an important determinant of mortality related to bypass graft surgery, echocardiography should be useful in the detection of patients with a poor prognosis. [ABSTRACT FROM PUBLISHER]

Angina may be accompanied by hypertension, congestive heart failure, arrhythmias, or other disorders. Here's how to treat one effectively without exacerbating the other. [ABSTRACT FROM AUTHOR]

One hundred three patients with persistent sinus bradycardia were evaluated electrophysiologically and followed prospectively for a mean of 4.6 years. The 5-year survival rate was 74.8%, not significantly different from the 72% rate in the general population with similar age and sex distribution. Forty-one patients had abnormal corrected sinus-node recovery time. Overall accuracy of abnormal corrected sinus-node recovery time in predicting serious sinus node disease in symptomatic and asymptomatic patients was 90% (37 of 41 patients) and 100% in patients with syncope (18 of 18 patients). The sensitivity of the test was 66%. Abnormal corrected sinus-node recovery time in patients with sinus bradycardia appears to be a valuable specific, predictive index of serious sinus node disease and therefore a useful test in selecting patients for pacemaker therapy, especially if symptoms such as dizziness or syncope are present. [ABSTRACT FROM AUTHOR]

Reports on a patient with coarctation of the aorta with mental retardation and characteristic facies. Physical examination and treatment of the patient; Review of related literature.

A 68-year-old white male underwent permanent pacemaker implantation with an atrial synchronous ventricular inhibited pulse generator (Medtronic model 2409) because of syncope and abnormal H-V interval of 70 ms. Paroxysmal bouts of pacemaker associated tachycardia were subsequently recorded on several occasions, initiated and terminated by spontaneous ventricular premature beats. The mechanism for the occurrence of the tachyarrhythmia is discussed in detail and the functional characteristics of the pulse generator are described. Replacement of the unit with a different pacer device prevented further occurrence of the arrhythmia. [ABSTRACT FROM AUTHOR]