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The precordial K1 to K6 cinetocardiograms in 40 patients with Myocardial Infarction (10 recent and 30 old) were studied. These were compared with the findings of the precordial palpetion, electrocardiograms, and the radiologic studies. In the recent infarcts, all the patients presented abnormal systolic "annoyances", 50% of which were palpable. In the old infarcts, 90% had abnormal cinetocardiograms and 63% had pathological precordial beats. The anterior infarcts tend to present "sounds" more to the right of the precordium than the posterior-inferiors. The diffuse cardiac hypokinesia may give normal cinetocardiograms. The severity of the myocardial disturbance is directly related to the precordial extension occupied by the abnormal systolic "annoyances". An aneurismectomy may cause the disappearance of the pathogenesis of these phenomena.

Two-dimensional echocardiography (2-DE) was used to demonstrate bilateral coronary artery disease in a 2-month-old child presenting with a mucocutaneous lymph node disease. The classic clinical and laboratory signs of this illness, now known as Kawasaki disease, were reviewed. Identification of the high risk patient prone to developing pericarditis and coronary perivasculitis with subsequent congestive heart failure or myocardial damage is essential for lowering morbidity and mortality rate. The 2-DE successfully demonstrated a large right coronary aneurysm and a markedly abnormal left coronary artery. The 2-DE should be used in every patient suspected of having Kawasaki disease not only to determine coronary artery involvement but also to guide medical management.

We report the case of a 50-year-old female suffering from angina pectoris with a positive exercise test and normal coronary arteriography. Nifedipine relieved the angina. Laboratory tests demonstrated hypercalcaemia and led to a diagnosis of parathyroid adenoma. Surgical removal of the adenoma resulted in normalization of calcaemia and, during 4-year follow-up, she has had no angina. Two exercise tests in this period were negative.

Qualitative and subjective analysis of two-dimensional echocardiographic images of the myocardial wall allows one to identify amyloid heart disease; the quantitative analysis of regional image texture might be an accurate method to differentiate normal from amyloid myocardial structures. To test this hypothesis, two-dimensional echocardiograms of nine normal subjects and six patients with histologically documented amyloid heart disease were evaluated. Quantitative texture measurements of the first order (mean gray level, skewness, kurtosis, energy and entropy) overlapped between the two groups. Among the second order statistics variables, entropy was significantly and consistently higher in amyloid versus normal patient data (septum in parasternal long-axis view: 6.3 +/- 0.3 versus 5.9 +/- 0.4; septum in apical four chamber view: 6.2 +/- 0.2 versus 5.8 +/- 0.3). Therefore, amyloid-involved myocardial walls show ultrasound image texture alterations that may be quantified with digital image analysis techniques.

Unlabelled: To test if a low Q wave voltage and its faulty increase after exercise is an additional sign of myocardial ischemia, 64 pts with no previous myocardial infarction, bundle branch block or left ventricular hypertrophy were studied by a treadmill test and coronary angiography. Nineteen had single vessel disease (SVD), 21 double vessel disease (DVD), 4 triple vessel disease (TVD) and 20 normal coronary arteries. Sensitivity (SENS), specificity (SPEC) and predictive value (P) of Q wave changes have resulted as follows: 84%, 55%, 80.4%, respectively, compared to 79.5%, 75%, 87.5% of ST modifications associated or not with angina. The SENS of Q wave changes was 72% in SVD and 92% in multivessel disease (p less than 0.05). In 68% of our pts ST and Q wave changes gave concordant results and their combination increased SENS, SPEC, PV to 90.1%, 80%, 90.3%., In Conclusion: Q wave analysis can provide further evidence of myocardial ischemia and can increase SENS, SPEC of stress test. In our experience Q wave is a more sensitive finding than ST depression in multivessel disease.