[Congenital quadricuspid aortic valve]. / Valvola aortica quadricuspide congenita.

A case of a 17-year-old asymptomatic man is reported. The patient had no other cardiac congenital abnormalities. Transthoracic echocardiography revealed a rare quadricuspid aortic valve malformation without aortic regurgitation.

[Level of knowledge on cardiovascular health in schools]. / Il livello di conoscenze sulla salute cardiovascolare nella scuola.

In order to determine the status of cardiovascular health knowledge, a standardized questionnaire was administered to 325 students (currently) in their last year, in 18 high schools of Trieste. The schools were divided into 3 groups according to their teaching programmes: technical schools (Group A), teacher-training colleges (Group B) and junior high schools (Group C). The adopted questionnaire was that developed by the cardiovascular centre of the University of Iowa, slightly modified by the authors, but keeping the "multiple choice" pattern. The questions were focused on the three major areas of anatomy, physiology and pathology. All the students answered the questionnaire although none with 100% accuracy. The highest performance (95% of correct answers) was given in the field of the physiology of the heart of effort, the lowest one concerned the position of the heart in the chest (20%). Fifty-seven per cent of the students refrained from answering the question on myocardial ischaemia. The total score (based on the number of correct answers, incorrect ones and the number of blanks) revealed a significantly different level of cardiovascular health knowledge between the various school groups: group C (64.13 +/- 7.55) performed better than group A (67.15 +/- 9.45, P less than 0.001), which in turn was more successful than group B (71.6 +/- 10.0, P less than 0.001). In comparison to the group of 325 students, the score obtained by a sample group of hospital nursing students, showed a significantly higher level of health knowledge (46.1 +/- 1.56, P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

[Clinical and hemodynamic implications of anterior ST segment depression in inferior myocardial infarct]. / Implicazioni cliniche ed emodinamiche del sottoslivellamento anteriore del tratto ST nell'infarto inferiore.

The finding of ST segment depression (reduced ST) in the anterior leads during acute inferior myocardial infarction is a common clinical sign. Nevertheless, its significance is not yet well established. To evaluate the significance of this finding, 58 patients with acute inferior myocardial infarction, who has an electrocardiogram within 8 hours from the onset of the disease, were divided into 2 groups: group A (14 patients with anterior reduced ST less than 1 mV) and group B (44 patients with reduced ST greater than or equal to 1 mV in one or more anterior leads). All patients subsequently underwent coronary angiography and left ventriculography, mean 50 days after acute myocardial infarction. reduced ST was not predictive of left anterior descending coronary artery disease. On the contrary, a significantly higher rate of 2-3 vessel disease (p less than 0.05) and of critical stenosis or occlusion of the right or circumflex coronary artery (p less than 0.05) was found in group B. Peak CK level was significantly higher (p less than 0.01) in this group as well. No significant difference was found in ejection fraction and anterior wall motion abnormalities, whereas a higher number of patients in group B showed a depressed function of the postero-basal segment (p less than 0.05). During 6 months follow-up, 2 patients in group A and 24 in group B experienced cardiac events (angina, reinfarction, heart failure, coronary artery by-pass grafting, cardiac death) (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of a new transdermal therapeutic system containing nitroglycerin on exercise capacity in patients with angina pectoris.

In a double-blind, within-patient, randomized, placebo-controlled, acute study, the effects at rest and on exercise capacity of two doses of a new transdermal therapeutic system (TTS), releasing respectively 10 and 20 mg of nitroglycerin (NTG) over 24 hours, were assessed in 15 outpatients with stable exercise-induced angina pectoris. A symptom-limited exercise test was performed 4 and 24 hours after the application of each system. In comparison with placebo, both TTS-NTG doses induced a statistically significant (p less than 0.01) increase in total duration of exercise, in exercise duration to 1 mm ST segment depression, in maximal workload and in total work performed, at both 4 and 24 hours after dosing. Furthermore, both TTS-NTG doses induced a significant rise in the pressure-rate product, both 4 and 24 hours after dosing (p less than 0.01 and p less than 0.05, respectively). No statistical difference was found between the two doses of active drug in any of the above-mentioned evaluation parameters. The only unpleasant side effect was the typical nitrate headache, which occurred in 11 of 15 patients. In conclusion, a single application of TTS-NTG, 20 cm2 or 40 cm2, may improve exercise capacity over a 24-hour period in patients with stable exercise angina due to atherosclerotic heart disease.

[Comparison of dynamic electrography and stress test in the diagnosis of ventricular arrhythmias in the early phase of myocardial infarction]. / Confronto tra elettrocardiografia dinamica e prova da sforzo precoce nella diagnosi delle aritmie ventricolari nell'infarto miocardico.

UNLABELLED: Ventricular premature beats are probably important in the prognostic evaluation after acute myocardial infarction and may allow a better management of these patients. The purpose of this study was to compare the sensitivity of two methods exercise testing - ET - and ambulatory electrocardiographic monitoring - AM - detecting potentially dangerous ventricular arrhythmias and to evaluate their prognostic value. Sixty-four patients have been studied (53 males and 11 females); their mean age was 61 years. They underwent ET and AM before discharge (mean 13.9 days) and were followed for a period of 12 months. CONCLUSIONS: -- ET and AM are useful to detect ventricular arrhythmias; -- AM is the most sensitive method; -- there are no significant differences between the two methods in the diagnosis of major arrhythmias; -- the combined use of the two methods has a greater sensitivity; -- late mortality is not higher in the patients who have suffered from major arrhythmias in the acute phase of the disease.

[Malignant ventricular hyperkinetic arrhythmias. Classificational criteria: review of Lown's classification. Polycentric study]. / Aritmie ipercinetiche ventricolari maligne. Criteri classificativi: revisione della classificazione di Lown. Studio policentrico.

Although Lown grading system of ventricular premature complexes (VPCs) has important conceptual shortcomings and has shown severe limitations in either cross-sectional or longitudinal studies, this classification is still the most well-known and used method to characterize the arrhythmologic ventricular pattern of the individual patient. We have looked at a modification of VPCs Lown grading scheme to correct the defects and to make the use of the classification more accurate. Our proposal is based on maintenance of 5 classes--similar to those of Lown original classification--to which we have assigned a score from 0 to 60. We have also introduced many sub-classes, each with a definite score, to better characterize the type of arrhythmic event. The sum of the score of the highest class and the score of every subclass furnishes the final score. This score is a direct index of the importance of the ventricular arrhythmias and seems to be useful for statistical evaluation of the anti-arrhythmic therapy and for follow-up studies, as confirmed by preliminary clinical results obtained through the use of this new VPCs classification.