[The dipyridamole test in coronary disease diagnosis]. / Próba dipirydamolowa w diagnostyce choroby wiencowej.

One of the coronary disease diagnostic methods of big sensitivity and specificity is perfusive effort scintrigraphy of myocardium by means of thallium-201. For few years the dipyridamole test has been applied instead of the effort test. Perfusive scintigraphy of myocardium after provocative treatment by means of dipyridamole and then selective coronary arteriography of coronary vessels, have been carried out at 25 patients with ischemia. These studies showed almost 100% of conformability with exposing the ischemia zones in scintigraphy and coronary arteriography in cases of coronary vessels contraction over 50%. The dipyridamole test also revealed the ischemzones in myocardium that are in agreement with coronary vascularization deficiency. That test can be utilized in revealing the coronary disease and is helpful in qualifying patients for coronary arteriography. At the same time studies that have been carried out prove that applying dipyridamole is absolutely contraindicated in treating of coronary disease of the organic background.

[Qualifying patients with unstable angina for invasive tests based on electrocardiographic examinations]. / Kwalifikacja chorych z niestabilna choroba wiencowa do badan inwazyjnych na podstawie badan elektrokardiograficznych.

In 40 patients with unstable angina pectoris a variety of electrocardiographic parameters were analysed. In all patients routine ECG, signal averaged high resolution ECG. 24 hour ECG recordings and heart rate variability analysis were performed at admission and repeated at 7 day of hospitalization. During second week patients underwent also exercise treadmill test. On basis of clinical presentation each patient was qualified to invasive investigation, 31 patients had need for urgent cardiac catherization (group I-urgent indications) and in the remaining 9 patients cardiac catherization was performed 3 months after the relief of acute symptoms (group II-non-urgent indications). The most impressive implications were draw from repeated 24 hour Holter ECG monitoring. In patients with urgent indications (gr. I) more frequent and severe ischemic episodes, as well as more frequent ventricular arrhythmias were observed. Patients from group I were unable to achieve higher grades on exercise treadmill test, while ST segment depression was comparable in both groups. Heart rate variability analysis showed greater disturbances of cardiac vagal control in group I. The number of critically stenosed vessels was similar in both groups, however left ventricular systolic dysfunction was observed mainly in patients with urgent indications for cardiac catherization.

Self--administered cough cardiopulmonary resuscitation (c-CPR) in patients threatened by MAS events of cardiovascular origin.

Sudden cardiac death caused by cardiac arrhythmia's or asystolies in patients with coronary heart disease can often be avoided if resuscitation is administered immediately, preferably before the patient loses consciousness. In cases when rapid help is not available usually death occurs. We have studied a method of cardiopulmonary resuscitation (CPR) which can be self--administered by patients trained in recognizing imminent arrival of life-threatening Morgani Adams Stokes (MAS) events. The recent study comprised the three methods of investigation in three separate groups of patients: the first group underwent invasive procedures (20 pts), the second non invasive Doppler studies (31 pts) and the third in-and outhospital clinical observations (115 pts). The results indicate that evoked coughing can effectively prevent fainting and maintaining consciousness until conventional CPR help becomes available.

[Dissecting aneurysm of the ascending aorta as a late complication of the treatment of acquired defects of the aortic and mitral valves]. / Tetniak rzekomy aorty wstepujacej jako pózne powiklanie w przebiegu pooperacyjnego leczenia wady nabytej zastawki aortalnej i mitralnej.

A diffuse aneurysm of the ascending aorta was observed five months after prosthetic valve implantation in to mitral and aortic orifices because of the acquired valvular heart disease. The main factor predisposing to the formation of a false aneurysm was an infection of the endocardium and ascending aortal wall which were observed previously during cardiac surgery. The diagnosis, based on the clinical symptoms and non-invasive investigations, was later confirmed with aortography and intra-operatively.

[Diagnostic difficulties in a case of intracardiac tumor]. / Trudnosci diagnostyczne w przypadku guza wewnatrzsercowego.

64 years old female operated on for right auricular tumor, which manifested as right ventricular heart failure is presented. Although full preoperative diagnostics was performed the tumor appeared to be metastatic one with the primary focus situated in the liver (histologically ca hepatocellular). Necessity of cavography in case of right auricular tumor is stressed in the paper.

[A case of isolated, corrected transposition of great arteries diagnosed with non-invasive techniques]. / Przypadek odosobnionego skorygowanego przelozenia wielkich pni tetniczych rozpoznanego metodami nieinwazyjnymi.

A case of a 34-year female patient with the isolated transposition of the great arterial trunks and mild atrioventricular (tricuspid) valve insufficiency is presented. The disease was diagnosed with non-invasive technique, particularly echocardiography. Cardiac disorders being usually concomitant with this syndrome (interventricular leak, pulmonary arterial wedge stenosis etc.) have been excluded by the aid of the contrast echographic technique and Doppler technique. The results of electrocardiographic records, which are usually helpful in the diagnosis of this abnormality have been completely useless in this case due to atypical ventricular depolarization vector pattern (QS complex in V1-V6 leads).