• Title/Summary/Keyword: ECG findings

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The Heart Rate and ECG Changes after Endoscopic Thoracic Sympathectomy in Patients with Primary Hyperhidrosis (원발성 다한증 환자에서 흉부 교감 신경 차단술 후의 심박동수 및 심전도 변화)

  • Kim, Jae-Jun;Kim, Young-Du;Park, Chan-Beom;Moon, Seok-Whan;Cho, Deog-Gon;Sa, Young-Jo;Seo, Jong-Hee;Kim, Chi-Kyeong
    • Journal of Chest Surgery
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    • v.42 no.2
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    • pp.214-219
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    • 2009
  • Background: Primary focal hyperhidrosis is characterized by overactivity of the sympathetic nervous function, and this has been effectively treated with endoscopic thoracic sympathetic denervation (ESD). The imbalance of sympathetic and parasympathetic nervous system that's created by ESD may affect the heart, lung and other thoracic organs. We analyzed the heart rate and ECG changes after performing ESD at our hospital, and this is the first such study that has been conducted on this. Material and Method: Of the 263 patients who underwent ESD between October 1996 and October 2006, 130 had ECG before and after ESD, and they were classified into 3 groups according to the level of ESD: Group I (n=40) patients underwent ESD at the 2nd rib (T2ESD), Group II (n=80) at the 3rd rib (T3ESD) and Group III (n=10) at the 4th rib (T4ESD). Result: There was no mortality or major morbidity. Heart rate (HR) was significantly decreased from $71.6{\pm}10.6/min\;to\;66.8{\pm}10.2/min$ after ESD (p<0.01); however, the PR (from $148.6{\pm}21.2$ msec to $152.8{\pm}20.5$ msec) and QTc (from $399.2{\pm}15.4$ msec to $404.0{\pm}15.1$ msec) intervals were significantly increased after ESD in the patients who suffered with primary hyperhidrosis (p<0.01). According to the level of ESD, there were significant changes in the HR and QTc interval in group I (T2ESD), the HR and PR interval in group II and the QTc interval in Group III. Conclusion: There were significant changes in the heart rate and ECG findings after ESD. The thoracic sympathetic denervation of T2, T3 and T4 affected the electrical activity of the heart at the resting state.

Stress Induced Cardiomyopathy after Local Infiltration of Epinephrine for Plastic Surgery in Young Adult (젊은 성인에서 에피네프린 국소침윤 후 발생한 스트레스성 심근병증)

  • So, Kyu Sub;Hong, Yong Taek;Kang, Hyun Jae;Kim, Hoon Nam;Lim, Young Kook;Heo, Jun
    • Archives of Craniofacial Surgery
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    • v.11 no.2
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    • pp.120-123
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    • 2010
  • Purpose: Epinephrine itself exhibits some cardiotoxicity. However, it rarely induces cardiomyopathy when used in standard doses during surgery for local hemostasis. This paper reports a rare case of stress-induced cardiomyopathy in a young woman after the local infiltration of epinephrine. Methods: Corrective rhinoplasty was planned in a 20-year-old woman. Lidocaine mixed with epinephrine 1:100,000 was injected around the skin of the nose and nasal septum after inducing anesthesia, which resulted in sinus tachycardia and hypotension. Postoperative ECG showed a T wave inversion in the lead V2 and echocardiography revealed transient hypokinesia in the cardiac apex. Cardiac enzyme was mildly elevated. Results: Symptoms and laboratory findings improved considerably, and the patient was discharged from hospital without complications on the sixth day after surgery. Conclusion: The prognosis of catecholamine-induced cardiomyopathy is generally favorable. However, it is important to be aware of the possible adverse effects of local epinephrine infiltration. This case highlights the need for caution when using epinephrine.

Clinical study of myocardial preservation (심근보호에 대한 임상적 고찰)

  • Jo, Jae-Il;Lee, Yeong-Gyun
    • Journal of Chest Surgery
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    • v.17 no.4
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    • pp.557-564
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    • 1984
  • Of the valve replacement patients operated between 1983 and June, 1984, 75 patients need more than 60 minutes of aortic cross-clamping time. 42 patients performed single valve replacement [35 MVR, 7 AVR with or without TAP] and remainder needs double valve replacement with or without TAP. The average aortic clamping time was 95.1 minutes. They need 30 minutes more extra-corporeal circulation time than aortic clamping time. The patients were divided into two groups by usage of cardioplegic solution. Group I [n=31] with Bretschneider solution and group II with potassium cardioplegic solution [M.G.H. modification] were analyzed by extra-corporeal circulation data,/CG and Echocardiography findings, and clinical data. There was no difference between two groups in Bivon addition amounts [cc/kg] and E.F. and S.F. by echocardiography, group I need 1 more electrocardioversion to convert sinus rhythm postoperatively. Also no difference could be found in patients whose preoperative C.I. was above 2.0 between two group. But significant postoperative decrease in E.F. was found in group I whose preoperative C.I. was below 2.0. Relatively longer ECC time was also needed in same group. Ischemic changes in ECG and low cardiac output syndrome was, however more prevalent in groupII. As a whole, the clinical data was satisfactory with both cardioplegic solution in clinical practice.

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A Clinical Evaluation of the Traumatic Sternal Fracture (외상성 흉골 골절에 대한 임상적 고찰)

  • Kim, Jae-Ryeon;Im, Jin-Su;Choe, Hyeong-Ho
    • Journal of Chest Surgery
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    • v.28 no.6
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    • pp.601-605
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    • 1995
  • Clinical evaluations were performed on 54 cases of the traumatic sternal fracture, those were admitted and treated at the department of Thoracic and Cardiovascular Surgery in Chosun University Hospital during the past 5 years period from January 1990 to December 1994. The frequency was about 7.8% of the nonpenetrating chest trauma. The ratio of male to female was 2 : 1 in male predominance. Average age was 45.7 years old and age distribution was from 18 to 80 years old. The most common cause in the sternal fracture were high decelerating injury[ 38 cases . The most common fracture site was sternal body. Associated intrathoracic organ injuries were cardiac contusion[11cases , hemopneumothorax and pulmonary contusion. Added, thoracic cage and extrathoracic organ injuries were rib fracture, head injuries, thoracic spinal fracture and long bone fracture. Abnormal ECG findings were sinus bradycardia[4 cases , sinus tachycardia[3 cases , bundle branch block, atrial fibrillaton, left ventricular hypertrophy and myocardial ischemia. The average days of admission was 19.1 days. All patients were treated with conservative treatment. The complications after treatment were atelectasis[2 cases ,empyema[1 cases , ARDS[1 cases .

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Analeptic Effects of Doxapram on Medetomidine Sedation in Dogs (Medetomidine으로 진정된 개에 있어서 Doxapram에 의한 회복효과)

  • Hong Seung-You;Kim Myung-Cheol
    • Journal of Veterinary Clinics
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    • v.9 no.2
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    • pp.391-399
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    • 1992
  • This study was carried out to evaluate the effects of doxapram after medetomidine treatment. Twenty dogs were sedated with medetomidine(0.04mg/kg IM) Ten dogs were injected doxapram(2mg/kg IV) as a experimental group and ten dogs were injected with saline(5$m\ell$ IV) as a control group in twenty minutes after the injection of medetomidine. Recovery time, heart rate, respiratory rate, body temperature. blood chemistry, electrocardiogram findings (ECG) were recorded. The results obtained were as follows ; 1. Medetomidine revealed fast and excellent sedative effect. 2. Recovery time was shorted by doxapram(p<0.01) 3. Respiratory rates were decreased significantly by medetommidine, but increased remarkably after the injection of doxapram and them decreased gradually and revealed normal levels(p<0.01). 4. Herts rates were decreased significantly by medetomidine but increased remarkably after the injection of doxapram and then decreased gradually and revealed normal levels(p<0.01). 5. Body temperature were increased slightly and then decreased by medetomldine and in experimental group revealed with higher levels than those of control group(p<0.01) 6. Arrhythmias were observed after the injection of medetomidine, but relieved after the injection of doxapram . There was no another change on electrocardiograms.

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Tricuspid valve dysplasia(TVD) in an American cocker spaniel dog (American cocker spaniel dog에서 발생한 삼첨판 이형성 증례)

  • Park, Chul;Choi, Chi-Bong;Sur, Jung-Hyang;Chung, Byung-Hyun;Park, Hee-Myung
    • Korean Journal of Veterinary Research
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    • v.44 no.1
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    • pp.125-129
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    • 2004
  • A 2-year-old, female, American cocker spaniel dog presented for a 1-year history of severe ascites, exercise intolerance, tachypnea. At that time, she was in an emergency state. First, the dog was stabilized with oxygen therapy. A diagnosis of cardiac problem was made from history, auscultation, radiograph, ECG, and echocardiography. Jugular pulsation was palpated and a harsh, systolic murmur of tricuspid regurgitation was prominent at the right cardiac apex. Tricuspid valve dysplasia (TVD) was confirmed with echocardiography, accompanying enormous myocardial hypertrophy. The clinical signs had been improved for 8 months with careful therapy and periodic abdominocentesis, and ascites was well controlled. The situation, however, became worse quickly in a week because the client did not follow our management schedule. Finally, she died due to dyspnea and shock. After the spontaneous death, necropsy and histopathological examination were performed and when we opened the thorax, a significantly large heart was observed. On histopathological findings, grossly myocardium appeared pale initially, then progressed to yellow and white. Microscopically, there was an extensive hemorrhage along with loss of myocardial striations. Interstitial fibrosis and various degenerative alterations in myocytes were also present.

The Effect of Cold Air Stimulation on Electroencephalogram and Electrocardiogram during the Driver's Drowsiness (운전자 졸음시 냉풍 자극이 뇌파 및 심전도 반응에 미치는 영향)

  • Kim, Minsoo;Kim, Donggyu;Park, Jongil;Kum, Jongsoo
    • Korean Journal of Air-Conditioning and Refrigeration Engineering
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    • v.29 no.3
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    • pp.134-141
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    • 2017
  • The purpose of this study was to analyze physiological changes via a cold air reaction experiment to generate basic data that are useful for the development of an automobile active air conditioning system to prevent drowsiness. The $CO_2$ concentration causing drowsiness in vehicle operation was kept below a certain level. Air was blown to the driver's face by using an indoor air cooling apparatus. Sleepiness and the arousal state of the driver in cold wind were measured by physiological signals. It was evident in the EEG that alpha waves decreased and beta waves increased, caused by cold air stimulation. The ${\alpha}/{\beta}$ ratio was reduced by about 52.9% and an alert state confirmed. In the electrocardiogram analysis, the efficiency of cold air stimulation was confirmed by the mean heart rate interval change. The R-R interval had a delay time of about one minute compared to the EEG response. The findings confirmed an arousal effect from sleepiness due to cold air stimulation.

Case reports : Proximal aortic dissection with STEMI-equivalent ECG findings (STEMI equivalent 심전도 소견을 동반한 근위부 대동맥박리 1예)

  • Kim, Ji-Won;Kang, Min Seong
    • The Korean Journal of Emergency Medical Services
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    • v.24 no.3
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    • pp.141-145
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    • 2020
  • The most common symptom of aortic dissection is chest pain, which is similar to acute coronary artery syndrome, making it difficult to diagnose with clinical pattern, requiring various diagnostic methods. About 10-15% of the aortic dissection patients are accompanied by changes in the ST segment by the dissecting flap of the coronary opening, which can lead to delayed diagnosis of aortic dissection, or can adversely affect the patient by administration to unnecessary drugs such as nitroglycerin, thrombolytic agent, and anticoagulants. It is difficult to distinguish aortic dissection from an acute myocardial infarction only through a 12-Lead electrocardiogram at the pre-hospital. The application of cardiac ultrasonography through medical direction to chest pain patients who show ST segmental changes in pre-hospital phase will contribute to the diagnosis of aortic dissection and the improvement of survival rate, such as anticoagulant administration, to patients with acute myocardial infarction.

Atypical Aortic Coarctation at the Level of Aortic Hiatus: Report of a case treated by bypass graft (대동맥 열공부에 발생한 비전형적 대동맥 협착증: 외과적 수술을 가한 1례)

  • 남민우;유회성;지정희
    • Journal of Chest Surgery
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    • v.5 no.1
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    • pp.13-18
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    • 1972
  • In 1835,Schlesinger first described a case of subisthmlc lower thoracic aortic coarctation. Since Olim`s unsuccessful reconstructive surgery in 1949 and Beattie`s first successful resection with homograft replacement on such a lesion in 1951 were reported,about 20 cases of atypical aortic coarctation had been treated by definitive surgery until 1964. In Korea, only 2 cases of atypical aortic coarctation treated by bypass graft were reported until now. This is the third case-report treated by reconstructive surgery. The patient,11 year old girl who had 2 year history of headache, visual weakness, intermittent claudlcation, and general weakness, was first diagnosed of having the hypertension due to atypical coarctation by the findings of high blood pressure[170/110mmHg] at the upper extremity and weak pulsation on both femoral artery,murmur on the epigastrium, absence of aortic knob, and aorto graphy. Aortography demonstrated the isolated segmental narrowing[length 5cm, diameter 0.4cm] at the level of aortic hiatus 2cm above celiac arterial origin, the dilated right 9th, 10th, 11th intercostal arteries with multiple dimunitive collaterals and no associated abnormalities in the other arteries. Preoperatlve positive findings were strong positive mantoux test, high AST[720 units]. transient mild cardiomegaly with right lung infiltration on chest X-ray and suggestive left ventricular hypertrophy on ECG. On December 1970, through separate left thoracotomy and abdominal approach, bypass graft between descending thoracic aorta and abdominal aorta below renal artery was performed. The operation was first successful with satisfactory reduction of hypertension on the upper trunk[postoperatlve 130/80mmHg] and strong pulsation on the lower extremities[postop. O, postop. 140/100mmHg]. However,6 weeks after surgery, she expired of sudden hemoptysis and shock due to anastomotic leak within the thorax. Operative finding disclosed that the affected aorta was firm, with rich periaortic fibrosis and the outer diameter of stenotic site was not attenuated. Histopathology of the resected specimen was also compatible with primary arteritis.

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The Effects of the Walking Exercise on ST/HR Slope and QRS Vector in the Middle-Aged Men (운동부하 심전도를 이용한 중년 남성들의 걷기 운동이 ST/HR 경사 및 QRS 벡터에 미치는 영향)

  • Kim, Duk-Jung
    • Journal of Life Science
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    • v.20 no.1
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    • pp.71-76
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    • 2010
  • The purpose of this study was to investigate the changes of long term ECG response in a company with middle-aged male employees. Subjects were 60 men who were 40~55 years old. We enrolled 30 exercise group subjects into a 3-year exercise program. In measurement index, body composition was measured by % body fat and BMI. Exercise stress test analyses were measured using ST/HR slope and QRS vector. Statistical analysis was performed using analysis of repeated ANOVA. Results of this study were as follows: In ST/HR slope, the control group showed symptoms of ischemia after nine minutes of exercise. In the rest frontal axis of the QRS vector, the control group had a tendency towards right axis deviation. In the rest horizontal amplitude of the QRS vector, the control group had a tendency to show a significant decrease, but it was increased significantly in the exercise group. These findings suggest that inactive company workers was showed a decrease of exercise capacity, early diagnosis exercise-induced ST depression, and prolonged deviation of QRS vector, but that cardiac function could be elevated in active middle aged men through regular exercise program participation.