[Intracerebral haematoma during a stress test]. / Hématome intracérébral au cours d'une épreuve d'effort intérêt médico-légal.

We report the case of a 64 year-old moderately hypertensive patient investigated for dyspnoea on exertion with no chest pain. After informing the patient, an ergometric test following a gentle protocol was performed, according to the French Society of Cardiology guidelines. At the peak of effort the patient developed a sudden left hemiplegia with a right capsulo-thalamic haematoma on cranial CT. No other case has been described and a literature search showed no relationship between physical effort and cerebral haematoma. Following an administrative tribunal enquiry, no medical fault was attributed regarding the indication and performing the test; no failure to inform could be established for a risk that was unknown at the time of the test.

Evaluation of haemodynamic effects of intravenous propranolol at low dosage (1 and 2 mg) in acute myocardial infarction.

The haemodynamic effects of intravenous propranolol at low dosage (1 and 2 mg) have been evaluated on 14 patients in the acute stage of myocardial infarction. The first 1 mg propranolol was not followed by any significant variation in the variables measured. After the second 1 mg propranolol, the heart rate, cardiac index, and stroke index decreased significantly but moderately. Changes in pulmonary wedge pressure were not significant. It is concluded that intravenous propranolol in the small dosage of 1 or 2 mg, at which antiarrhythmic effect is still produced, has only a negligible depressant myocardial effect.

[Massive myocardial infarct with healthy coronary arteries caused by ostial thrombosis]. / Infarctus myocardique massif sur coronaires saines par thrombus ostial

Report of an exceptional case of massive anterior-wall myocardial infarction ending in death in a man aged 42, with no previous coronary history nor risk factors of atherosclerosis. Autopsy has demonstrated a thrombus obliterating the coronary artery ostium, penetrating into the first centimetre of the common trunk, while the coronary network was otherwise normal. The nature of this thrombus remains unexplained and did not seem to be of embolic origin.