Late Ventricular Dysrhythmias after Myocardial Infarction

Spracklen, F. H. N.; Besterman, E. M. M.; Everest, M. S.; Litchfield, J. W.; Petrie, Mark C

doi:10.1136/bmj.4.5627.364

Cited by 26 publications

(4 citation statements)

References 21 publications

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“…As most deaths and complications from myocardial infarction occur within 48 hours of the onset of symptoms (Spracklen et al, 1968;Fulton et al, 1969) it seems reasonable that the period of hospital stay should be quite short. Several studies have compared the effect of varying periods of bed rest and hospital stay in patients with uncomplicated myocardial infarction (Harpur et al, 1971;Hutter et ai., 1973;Medical Division, Royal Infirmary, Glasgow, 1973), and despite a progressive reduction in the time spent in bed and in hospital no difference between patients mobilized "early" or "late" has been observed in terms of morbidity or mortality.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Mobilization after Two and Nine Days in Uncomplicated Myocardial Infarction

Hayes¹,

Morris²,

Hampton³

1974

BMJ

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Where possible the former is to be preferred as the less severe procedure. There is, however, no doubt that these hamartomas should be removed in view of the high mortality rate from haemorrhage in the reported cases. One patient in this series (case 2) was left with a hepatic lesion and only biopsy was performed. At the time of of writing she was being carefully followed up while the situation was reviewed. Her hamartoma was.,the least vascular in our three cases. She stopped taking oral* contraceptives.All three patients were referred to this hospital from other parts of the country for specialized liver surgery. It is not possible, therefore, to make any inferences about the incidence of hepatic hamartoma whether occurring in patients on oral contraceptives or not.More cases will have to be described before an association between liver hamartomas and oral contraceptive therapy can be proved. It is surprising that no cases were described until recently and that none have been reported from the United Kingdom until now. In the meantime, however, it seems prudent for practitioners to exclude the presence of an epigastric mass in their patients before prescribing oral contraceptives and also to bear in mind the possibility of hepatic hamartoma or adenoma as a cause of haemoperitoneum in women on the pill. Journal, 1974, 3, 10-13 Summary A total of 189 patients with uncomplicated myocardial infarction were selected at random for early or late mobilization and discharge from hospital. Patients were admitted to the study after 48 hours in a coronary care unit if they were free of pain and showed no evidence of heart failure or significant dysrhythmia. Randomization was achieved by monthly cross-over of the three medical wards to which the patients were discharged. One group of patients was mobilized immediately and discharged home after a total of nine days in hospital, and the second group was mobilized on the ninth day and discharged on the 16th day. Outpatient assessment was carried out six weeks after admission. No significant differences were observed between the groups in terms of mortality or morbidity, as reflected by the incidence of recurrent chest pain or myocardial infarction, heart failure, dysrhythmia, or venous thromboembolism detected either clinically or by 115I-labelled fibrinogen scanning.

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Section: Introductionmentioning

confidence: 99%

Comparison of Mobilization after Two and Nine Days in Uncomplicated Myocardial Infarction

Hayes¹,

Morris²,

Hampton³

1974

BMJ

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“…The failure of St Mary's rates to decline can be related to the observations that no great change in management occurred during this time and that the earlier admission of cases in 1975 might be expected to have had a small but adverse effect on outcome. Although many patients spent longer in the unit than necessary because of a shortage of medical beds for transferring them, some 21 % of deaths occurred from late arrhythmias in the general ward, an observation previously made from this unit by Spracklen et al (1968) who argued the case for an intermediate care area. A similar study to this one, using similar severity indices is that of Hunt et al (1977) in Melbourne where a decline of fatality rates within groups stratified for severity was observed over the period 1969-1975, from an overall rate which was higher than this one to one that was lower despite a larger proportion of cases classified as severe.…”

Section: Discussionmentioning

confidence: 74%

Audit of an inner city coronary unit

Pedoe

Besterman

Kidner

1981

Postgraduate Medical Journal

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“…With most of these patients the usual warnings of a possible late cardiac arrest were given during the first few days viz. recurrent chest pain, arrhythmias, hypotension or heart failure (Spracklen et al, 1968). However, in one late death and in three late successful resuscitations, the previous clinical course had been entirely uneventful.…”

Section: Time Factor In Deaths and Resuscitationmentioning

confidence: 92%

Experiences of intensive coronary care in a regional hospital

McAllen

1971

Postgraduate Medical Journal

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Late Ventricular Dysrhythmias after Myocardial Infarction

Cited by 26 publications

References 21 publications

Comparison of Mobilization after Two and Nine Days in Uncomplicated Myocardial Infarction

Comparison of Mobilization after Two and Nine Days in Uncomplicated Myocardial Infarction

Audit of an inner city coronary unit

Experiences of intensive coronary care in a regional hospital

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