[Cardiologic-psychosomatic primary prevention of coronary heart disease]. / Kardiologisch-psychosomatische Primärprävention der koronaren Herzkrankheit.

Although there exist many relevant data about the significant influence of psychosocial risk factors for coronary artery disease, there is no reliable concept for an integrated psycho-somato-social primary prevention for CAD. So this article is to be a first attempt on such a psycho-somatic primary prevention, based on the well known psycho-social risk factors. Referring to the pathological and psycho-physiological effects of these risk factors the need of equal assessment of all risk factors will be discussed. There will also be introduced a comprehensive risk evaluation and the possibility of a psychcardiological consultation.

[Psychosomatic determinants of restenosis after percutaneous transluminal coronary angioplasty]. / Psychosomatische Einflussgrössen auf die Restenosierung nach Percutaner Transluminaler Koronarangioplastie (PTCA).

Coronary Angioplasty (PTCA) has become one of the standard procedures in the therapy of coronary heart disease. One of the main issues is the 20-40% incidence of restenosis of the dilated vessel. Up to now, the subject of predictors of restenosis has not yet been sufficiently clarified. Our study is concerned with two questions; first, is it possible to prove any connections between the amount of restenosis and psychosocial factors? Second, is it possible to distinguish groups of patients with and without subsequent restenosis on the basis of psychosocial variables, even before the diagnostic coronary angiography? 138 (91m, 47f) patients were assessed before the diagnostic coronarangiography, the 25 PTCA-patients (20m, 5f) were furthermore reassessed three months after the PTCA (the time of the angiographic control). Somatic and social data were collected and a semistandardised interview was conducted. In addition, coping, stress-coping control over disease and health and life-contentment were determined. Highly significant correlations was found between the amount of restenosis and resignative stress-coping, self-pity, depressive coping and flight-tendency. With the help of stress-coping-subtests (which were given at the first examination) it was possible to separate the group of patients with restenosis from the group without it.

[Implantation of a cardiac pacemaker in the 25th week of pregnancy in acquired 3d degree AV-block]. / Implantation eines Herzschrittmachers in der 25. SSW bei erworbenem AV-Block III. Grades.

It is well documented, that bradycardiac electrical heart activity disturbances occur very rarely in women of reproductive age. Therapy is in fact redundant in congenital AV-block. However, acquired AV-block in pregnancy constitutes a risk for both mother and child. In the following case, we report on an acquired third-degree AV-block, which worsened during the pregnancy from N.Y.H.A stage I to stage III, and hence required the implantation of a pacemaker during pregnancy.