Exercise tests performed 3 and 9 weeks after acute myocardial infarction in 205 patients were found to give prognostic information on the survival during a follow-up period of 2 to 5 years. The appearance of tachycardia, major ventricular arrhythmias, or anginal complaints during these early exercise tests was thus accompanied by a significantly increased mortality during the observation period. Ventricular arrhythmias disclosed by exercise proved to be of higher prognostic significance than those recorded at rest on the same occasions. The usefulness of early exercise tests in the evaluation of the response to antiarrhythmic treatment after acute myocardial infarction as well as of the prognostic importance of the effects was documented in a smaller series of patients.
SubjectsThe study comprises I00 consecutive exercise tests on a treadmill performed by patients with acute myocardial infarction in the period April 1970 to October I97I. There were 97 patients altogether (go men and 7 women), 3 being examined a second time because of reinfarction. All were treated in the hospital's coronary care unit which serves a population of i8o,ooo. The tests were performed immediately before the planned discharge from hospital, i.e. a mean of 2I days after the acute episode began. A total of 228 patients with infarction (I74 men and 54 women) attended the unit during the period in question. Of these, 44 died during their stay in the hospital and 95 of the remaining I84 were older than 65 years. Nobody above this age was tested on the treadmill during the first half of the study, owing to a lack of resources, and only i6 during the second half.Of the remaining patients under 65, 8 were not tested.
Three patients, aged 16-44 years, with complete heart block in acute myocarditis are reported. The diagnosis of mywarditis was based on the development of transitory repolarization disturbances on the ECG in association with clinical signs of acute infectious disease. All patients were brought to hospital due to repeated StokeAdam attacks and demonstrated ventricular asystoles for up to 25 sec.The patients were all successfully treated with temporary intracardiac pacing but one of them later turned out to require a permanent pacemaker. The possibility of differences in localization and in prognostic importance of conduction disturbances between infectious and ischemic myocardial disease is discussed.
A retrospective analysis has been performed on patients investigated with pulmonary scintigraphy on suspicion of pulmonary embolism. Seventy‐four patients have been investigated during a 2‐year period and a comparison has been made between clinical diagnosis, scintigraphy, chest X‐ray and ECG. The method of scintigraphy is described and evaluated. Scintigraphy is of considerable value in the diagnosis of pulmonary embolism as it is a simple procedure for the patient, well correlated to clinical findings, as well as giving good quantitative data. It also allows for an evaluation of therapeutic results. Chest X‐rays provide poor information, and characteristic ECG changes are only seen in the most advanced cases.
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