Importance of atrial electrophysiology in the work-up of cerebral ischemic attacks.

Recent data suggest that a large proportion of ischemic strokes are due to embolic phenomena from the heart. Atrial fibrillation appears to be one of the principal causes of embolization. If electrophysiologic parameters are considered as determining factors, the existence of atrial hypervulnerability in patients with embolic strokes is significant, when arrhythmia has been excluded as an etiology. This study suggests that an aggressive approach to early diagnosis and management through electrophysiologic studies might aid in preventing future neurologic attacks.

[Pulmonary artery thrombosis during hormonal contraceptive therapy. Treatment with urokinase]. / Thrombose de l'artère pulmonaire sous traitement contraceptif hormonal. Traitement par l'urokinase

PIP: A 32-year-old mother of 3 who had taken .05 mg ethinyl estradiol and .5 mg norgestrel for 3 months had a severe right thoracic pain of 2 weeks' duration, which was diagnosed as pulmonary arterial thrombosis and treated with high doses of urokinase. She was first given 600 mg heparin/24 hours, then 300,000 U of urokinase over 12 hours. There was some improvement, so urokinase was repeated and heparin continued. The patient was then asymptomatic, but she was found to have hyperlipidemia, hyperglycemia, insulinemia, and uricemia. She was well 6 months later on a carbohydrate- and fat-controlled diet. High doses of urokinase are preferred by some who believe that urokinase is thrombolytic in proportion to dose, well tolerated, and not antigenic.^ieng