Indications for Bishydroxycoumarin (Dicumarol) in Acute Myocardial Infarction

Russek, Henry I.; Zohman, Burton L.; Doerner, Alexander A.; Russek, Allen S.; White, LaVere G.

doi:10.1161/01.cir.5.5.707

Cited by 49 publications

(18 citation statements)

References 2 publications

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“…In those aged 65 or more the mortality from coronary heart disease is high. Russek et al (1951) found it to be 40% in those aged more than 60 and 60% in those who were a poor risk. This increase in mortality in the aged appears to be due to a higher incidence of more severe attacks.…”

Section: Discussionmentioning

confidence: 97%

Coronary heart disease in the aged.

Thould¹

1965

BMJ

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ConclusionThe Heller valve provides a simple, cheap, reliable, and accurate method of giving intravenous fluids to newborn infants. Its use reduces the time spent by the medical and nursing staff in supervising intravenous drips in neonates ; and it can readily be adapted for other purposes.Minor complications occur, as with any form of intravenous infusion in infants, but their incidence is not high, and is probably much lower than that associated with earlier techniques. In a series of 500 valve-infusions only two major complications were found which might be attributed to this method.The valve costs 6s. 9d., which is little more than the cost of a single disposable drip set, and it may be used more than fifty times before leak-back occurs. SummaryA method of administering intravenous fluids to infants is described and assessed in the light of experience of over 1,200 infusions. The advantages over more conventional methods are discussed and the possibilities of the adaptation of the system for other purposes are indicated. J7., 1965, 2, 1089-1093 William Heberden (1802) stated that he had seen nearly 100 people with angina pectoris, and all but four were males near or past the fiftieth year of age. We are now uncomfortably aware of the frequency with which the male members of western populations, especially the relatively young, die of coronary heart disease. The death rate from diseases of the heart is said to have changed very little in the years 1850 to 1920, but from 1924 onwards the death rate rapidly increased until about 1952, when it showed signs of levelling off (Campbell, 1963a). This apparent and alarming increase may well be due to the possibility that those who would have died from the infectious diseases now survive longer to die from coronary heart disease, as so lucidly argued by Campbell (1963b). It is doubtful, judging by post-mortem reports, that there has been any absolute increase in the incidence or severity of atheroma over the years 1908-49 ; the reverse is true if anything (Morris, 1951). There is some evidence that in the elderly the disease is different in its clinical presentation (Dreyfuss, 1959), and it is a comparative rarity to make the diagnosis of a coronary thrombosis in the age group 60-80 years (Howard and Gresham, 1961). Many of the coronary thromboses in the elderly are "silent" (Rodstein, 1956), and the distribution of the atherosclerotic lesions is different (Wright, 1960).We were impressed by the rarity with which we saw the clinical entity of acute coronary heart disease in those admitted to an acute geriatric department serving a sizable area of North Central London. In those in whom the diagnosis was made the clinical severity of the episode was marked and the outlook grave. In this paper we present our findings in a three-year retrospective study.* University College Hospital, London. Now at St. Bartholomew's Hospital, London. MethodsThe case records of all admissions to this 88-bed department over a three-year period were examined, and only those patients who...

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Section: Discussionmentioning

confidence: 97%

Coronary heart disease in the aged.

Thould¹

1965

BMJ

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“…In recent years the use of heparin has been advocated for the prevention of recurrent infarction and for the relief of angina pectoris. The favourable effect on angina when administered intermittently twice weekly, as observed by Graham et al (I95I) and Engelberg (1952), could not be confirmed by several workers (Russek et al, 1952;Miller et al, 1952;Binder et al, 1953;Gruner et al, 1953;Rinzler et al, I953; Chandler and Mann, 1953). However, Engelberg et al (i955) administered 200 mg. of heparin by the subcutaneous route twice weekly to o05 survivors of myocardial infarction for a total period of 2,067 patient-months with only four deaths, whereas of 118 control patients receiving placebo treatment, 2z died during a similar period of observation.…”

Section: Coronary Artery Disease Including Myocardial Infarction Andmentioning

confidence: 88%

An Evaluation of Long-Term Anticoagulant Therapy

Suzman

1956

Postgraduate Medical Journal

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“…The sublingual route has been found to be most useful clinically (Riseman et al, 1958) ; for when the drug is swallowed, even in greatly increased doses, it is much less effective and the onset of activity is considerably delayed (Russek et al, 1953 ;Russek, 1956). The introduction of aerosol administration of glyceryl trinitrate theoretically offers more rapid absorption through the alveolo-capillary membrane, and enables more rapid access to the myocardium and coronary vessels by eliminating the mouth-to-lung circulation time, usually 10 to 12 seconds.…”

Section: Discussionmentioning

confidence: 99%