Abstract:
:We report four patients who developed severe adverse reactions to protamine sulfate following cardiac surgery. Two types of reactions were seen. First, an immediate anaphylaxis which is a complement-dependent IgG antibody-mediated reaction. In the literature, 80% of patients who had similar reactions have had previous exposure to protamine. All patients adequately tested had positive skin tests and there is 6% mortality. The second reaction to protamine during cardiac surgery is characterized by delayed onset and profound vascular damage presenting as noncardiogenic pulmonary edema or total vascular collapse with prolonged hypotension and anasarca. These patients have negative skin tests and in our studies, no evidence of antibody mediated reaction, suggesting some other mechanisms may play a part. The mortality is high (30% of patients reported) and survivors have significant morbidity.
journal_name
Clin Cardioljournal_title
Clinical cardiologyauthors
Holland CL,Singh AK,McMaster PR,Fang Wdoi
10.1002/clc.4960070305subject
Has Abstractpub_date
1984-03-01 00:00:00pages
157-62issue
3eissn
0160-9289issn
1932-8737journal_volume
7pub_type
杂志文章abstract::Two cases with acute myocardial infarction are presented. Both had thrombotic occlusion of the infarct-related artery. Following successful thrombolysis with streptokinase, coronary angiography was normal. These cases prove that "myocardial infarction with normal coronaries" can be associated with coronary thrombosis ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960061107
更新日期:1983-11-01 00:00:00
abstract::The coronary sinus (CS) is a small tubular structure just above the posterior left atrioventricular junction. The CS can be imaged in several different echocardiographic views. Using zoom M-mode recordings of the CS in apical two-chamber view, CS caliber can be sharply imaged and easily measured during different phase...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960230304
更新日期:2000-03-01 00:00:00
abstract::In order to assess the diagnostic value of dipyridamole (D) testing, we studied the responses of 34 patients with chest pain and 10 normal subjects. Blood pressure and 12-lead ECG were recorded during and after intravenous infusion of 0.6 mg/kg dipyridamole for 10 minutes. Coronary arteriography and maximal or symptom...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960050402
更新日期:1982-04-01 00:00:00
abstract::Lipoprotein(a) [Lp(a)] is independently associated with atherosclerotic cardiovascular disease and calcific aortic valve stenosis. Elevated Lp(a) affects approximately one in five individuals and meaningfully contributes to the residual cardiovascular risk in individuals with otherwise well-controlled risk factors. Wi...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.23456
更新日期:2020-11-01 00:00:00
abstract::Pathophysiology of malignant hypertension, of which underlying disease was essential hypertension (EHT) in 33 cases and chronic glomerulonephritis (CGN) in 26 cases, was studied with reference to the renin-angiotensin system. Plasma renin activity (PRA) was significantly higher in the EHT than in the CGN group, and an...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960100911
更新日期:1987-09-01 00:00:00
abstract:BACKGROUND:Pulse pressure (PP) has recently been found to be predictive of subsequent cardiovascular, particularly coronary, events in some middle-aged and elderly populations. HYPOTHESIS:The aim of this prospective population-based study was to evaluate the roles of systolic (SBP), diastolic blood pressure (DBP), and...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960260209
更新日期:2003-02-01 00:00:00
abstract::Recommendations in the 2007 update of the American College of Cardiology/American Heart Association guidelines for patients with non-ST-elevation myocardial infarction (NSTEMI) provide considerable latitude regarding treatment choices and care pathways. Nevertheless, as accumulating evidence leads to increased recomme...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.20671
更新日期:2009-11-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960100506
更新日期:1987-05-01 00:00:00
abstract::Despite the proven benefits of using antiplatelet therapy in patients undergoing percutaneous coronary intervention (PCI), a number of key questions remain to be answered. In recent years, clopidogrel dosing strategies among such patients have evolved considerably, with newer approaches involving loading doses prior t...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.20359
更新日期:2008-03-01 00:00:00
abstract:INTRODUCTION:Some previous studies have suggested a high prevalence of pulmonary embolism (PE) during exacerbations of chronic obstructive pulmonary disease (ECOPD). The SLICE trial aims to assess the efficacy and safety of an active strategy for the diagnosis and treatment of PE (vs usual care) in patients hospitalize...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.23161
更新日期:2019-03-01 00:00:00
abstract::The histories, rest, and exercise ECG results of 60 patients without myocardial infarction complaining of chest pain were submitted to 6 physicians (3 cardiologists and 3 noncardiologists) who were unaware of the angiographic findings. The physicians were requested to estimate the probability of coronary artery diseas...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960071207
更新日期:1984-12-01 00:00:00
abstract::In this report, a rare case of tricuspid stenosis uncomplicated by other valve lesions is presented, with clinical, hemodynamic, echocardiographic, and angiographic studies. The patient was markedly incapacitated, mostly as a result of a restricted cardiac output. Tricuspid commissurotomy was performed, with a stenoti...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960060406
更新日期:1983-04-01 00:00:00
abstract::To determine the accuracy of two-dimensional echocardiography (2-D echo) for assessment of exercise-induced wall motion abnormalities in patients with coronary artery disease, the results of stress echocardiography were compared with exercise cineventriculography. In 56 consecutive patients, biplane cineventriculograp...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960110808
更新日期:1988-08-01 00:00:00
abstract::The realization that cardiovascular morbidity and mortality increases in patients with mild elevation of either systolic or diastolic blood pressure has led to a consideration to treat millions of patients with mild diastolic or isolated systolic hypertension. The cost of administering a successful antihypertensive tr...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章
doi:10.1002/clc.4960060101
更新日期:1983-01-01 00:00:00
abstract:BACKGROUND:Identifying patients with advanced left atrial (LA) remodeling before catheter ablation (CA) of atrial fibrillation (AF) is crucial. HYPOTHESIS:This study aimed to identify echocardiographic parameters associated with changes in anatomy and conduction properties of the left atrium (LA). METHODS:We examined...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.23515
更新日期:2021-01-01 00:00:00
abstract::Coronary collateral perfusion to the completely obstructed coronary artery was evaluated by coronary cineangiography in 32 patients. In 13 patients, there was neither history of severe chest pain of longer than 30-min duration nor electrocardiographic evidence of a transmural myocardial infarction (Group I). Among pat...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960100705
更新日期:1987-07-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.23325
更新日期:2020-04-01 00:00:00
abstract::To assess right ventricular (RV) diastolic filling in coronary artery disease (CAD), with special reference to the involved lesions of the coronary arteries and left ventricular (LV) systolic function, gated radionuclide ventriculography was performed at rest in 106 patients with single-vessel CAD. Based on the site o...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960161112
更新日期:1993-11-01 00:00:00
abstract:BACKGROUND AND HYPOTHESIS:Although it is well established that diabetes mellitus (DM) induces more severe coronary artery disease (CAD), it is not known whether it contributes to the development of coronary collateral circulation. The present study examines coronary collateral circulation in diabetic and nondiabetic pa...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960220706
更新日期:1999-07-01 00:00:00
abstract::In this editorial, I would like to share some thoughts about clinical studies, including value and limitations using as an example a recently published randomized clinical trial. Randomized and non-randomized clinical trials, epidemiologic studies, and registries guide our clinical practice. They are good but not perf...
journal_title:Clinical cardiology
pub_type: 社论
doi:10.1002/clc.20598
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Metabolic syndrome (MS) and diabetes mellitus (DM) are risk factors for cardiovascular diseases in general population. However, there was a paucity of studies investigating their impact in primary glomerular diseases (PGD). HYPOTHESIS:MS and concomitant DM are associated with higher risk of cardiovascular c...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.23388
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Most information concerning hypertrophic cardiomyopathy has been derived from western countries and Japan. HYPOTHESIS:Patients with hypertrophic cardiomyopathy in Taiwan may have a distinct morphology and clinical picture. METHODS:Information from 163 consecutive patients with hypertrophic cardiomyopathy a...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20057
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:Following successful cavotricuspid isthmus (CTI) ablation during typical atrial flutter (AFL), anticoagulation therapy is usually withdrawn. However, potential subsequent atrial fibrillation (AF) in these patients may increase embolic risk in the long term. Embolic rates in this setting have not been clearly...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22538
更新日期:2016-06-01 00:00:00
abstract::High dose-dobutamine (DOB) has been previously used as a pharmacological stress test to evaluate wall motion abnormalities. As a result, recent stress echocardiography with low-dose DOB has been reported to be valuable for investigating stunned myocardium after thrombolysis. However, echocardiography requires an opera...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960160604
更新日期:1993-06-01 00:00:00
abstract::Nicardipine a second-generation dihidropyridine calcium antagonist, has been approved in oral formulation for use in the United States, and is under review for parenteral use. Nicardipine is the most vascular-selective agent of this class currently approved and should, on theoretical grounds, be ideal for combination ...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960150403
更新日期:1992-04-01 00:00:00
abstract:BACKGROUND:One-third of patients who receive cardiac resynchronization therapy (CRT) are classified as nonresponders. Characteristics of responders to CRT have been studied in multiple clinical trials. HYPOTHESIS:Independent predictors of CRT response may be identified by studying a series of patients in routine clini...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22043
更新日期:2012-12-01 00:00:00
abstract::We attempted to evaluate left ventricular performance from the shortest distance between the mitral leaflets coaptation and the interventricular septum at end-systole (MVC-IVS distance). The subjects were 37 patients with coronary artery disease (CAD) with prior myocardial infarction (MI), 8 with CAD without prior MI,...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960150908
更新日期:1992-09-01 00:00:00
abstract::Diffuse pulmonary hemorrhage has rarely been reported as a complication of thrombolytic therapy. Recently, two patients who developed this complication were observed at our institution. This diagnosis should be considered in any post-thrombolytic patient with respiratory distress, diffuse pulmonary infiltrates, and an...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960200321
更新日期:1997-03-01 00:00:00
abstract:BACKGROUND:Recently, electrocardiogram (ECG) criteria have been proposed for the diagnosis of acute myocardial infarction (AMI) in the presence of left bundle-branch block (LBBB). However, clinical experience indicates that such ECG changes indicative of AMI are occasionally noted in clinically stable patients with LBB...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960241004
更新日期:2001-10-01 00:00:00
abstract::The 2011 Update of the American Heart Association's Cardiovascular Disease Prevention Guideline for Women is designed to help women and their physicians understand cardiovascular Disease (CVD) risks and undertake practical steps that are most effective in preventing heart disease and stroke. Defining a woman's risk st...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.20940
更新日期:2011-09-01 00:00:00