[Pulmonary embolism. A case report of right atrial thromboembolism treated by thrombolysis]. / Embolia polmonare. Descrizione di un caso di tromboembolia atriale destra trattata con trombolisi.

This case report describes a 40-years-old man affected by fracture of leg and pulmonary embolism. Two-dimensional echocardiography showed a large right atrial migrant thromboembolus prolapsing into tricuspid valve during diastole. The patient was treated with rt-PA through right atrial venous catheter and underwent to serial echocardiographic examinations. The rt-PA determined the dissolution of the thrombo-embolus at the 2nd hour of infusion. It is concluded that early two-dimensional echocardiography might be a very helpful technique to diagnose and follow-up therapy of pulmonary embolism.

[Incidence of exertion hypertension in normotensive individuals]. / Incidenza della ipertensione da sforzo nei normotesi.

Exercise hypertension is the blood pressure response to dynamic exercise stress which is considered excessive as compared to what is normally observed in a healthy population. It is a useful indicator to assist in detecting those persons who may develop sustained hypertension. Research has been conducted on a large number of patients, carefully selected using as criteria: arterial pressure, presence of other diseases and age. The examination has been conducted by observing the stressor test on the cycloergometer and annotating the Pa with the traditional method. The data was then analyzed using statistical methods. We conclude that at the moment of maximum effort the patients can be divided into two groups based upon PaD values superior or inferior to 20% of base values or to 95 mmHg. Those who exceed these values (43% of all patients studied) are considered as effort hypertensive subjects. The work's originality derives from the statistically proven consideration that the evaluation of PaD at the 8th minute of the test with cardiac rate between 70 and 90% of the maximum theoretical cardiac rate is predictive of effort hypertension. Hence continuation of the test can be avoided with advantages in terms of time and reduction of the generic risks inherent in carrying out a maximal test. Follow up on the patients is in progress.

Detection of normotension, borderline and hypertension cutoffs in a population evaluated by non invasive blood pressure monitoring.

The 24-hour blood pressure (BP) average value in normotensive and hypertensive subjects is not defined. In 329 subjects three occasional blood pressure data were measured. The same day a non invasive 24-hour blood pressure monitoring was performed. The average of the occasional blood pressure and the average of the 24-hour blood pressure data were compared. In many cases the occasional blood pressure average was not strictly linked with the 24-hour blood pressure average. A statistical procedure (K-Means Cluster Analysis) was performed separately on occasional blood pressure values and on the hourly blood pressure average of the whole day. By this method three clusters of subjects were selected to evaluate the occasional and the 24-hour blood pressure cluster's cutoffs. The cluster's blood pressure cutoffs evaluated on occasional blood pressure values were not dissimilar from the blood pressure values suggested by literature for normotensive, borderline and hypertensive groups. The K-Means Clusters Analysis seems an interesting statistical method to research the subsets in a population evaluated by 24-hour blood pressure monitoring. We suggest that the 24-hour BP cutoffs evaluated in the three cluster groups may be considered as indicative for a clinical diagnosis of normotensive, borderline and hypertensive state.