The electrocardiogram is notoriously unreliable for the diagnosis of ischaemic heart disease in patients with Wolff-Parkinson-White syndrome. Abnormalities in the resting tracing may lead to false positive diagnoses of inferior or anterior myocardial infarction. Although ST segment depression with exercise has been reported in patients with Wolff-Parkinson-White syndrome, the depth of depressio...

Three cases of rapidly reversible severe myocardial depression are described in patients with status asthmaticus. Initial echocardiograms obtained within 1 day of hospital admission revealed global left ventricular hypokinesis with ejection fractions of 11 to 34%. Follow-up echocardiograms obtained only 3 to 8 days later revealed marked improvement of left ventricular function. Possible mechani...

Incorporation of tritiated leucine into myocardial proteins was inhibited at low concentration by quinidine, procaine amide, and diphenylhydantoin, but not by lidocaine or propranolol. This inhibition could be demonstrated in vitro and when the animals were treated with these agents. The relationship between this finding and myocardial depression produced by these antiarrhythmic agents is not k...

To the Editor:—In a recent commentary, Fleisher stated that even if ST segment trend monitoring has identified accurately a significant ST segment change, ST segment depression may not represent myocardial ischemia in younger individuals or in those with a low probability of coronary artery disease (CAD). In support of this contention, the argument is made that structural CAD usually is absent ...

Berkman LF, Blumenthal J, Burg M, et al. Effects of treating depression and low perceived social support on clinical events after myocardial infarction. The Enhancing Recovery in Coronary Heart Disease patients (ENRICHD) randomized trial. JAMA 2003;289:3106–16. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....

OBJECTIVE To assess the five year prognostic significance of transient myocardial ischaemia on ambulatory monitoring after a first acute myocardial infarction, and to compare the diagnostic and long term prognostic value of ambulatory ST segment monitoring, maximal exercise testing, and echocardiography in patients with documented ischaemic heart disease. DESIGN Prospective study. SETTING C...

A previously healthy woman developed streptococcal cellulitis of the leg after falling and lacerating her knee. On admission her blood pressure was unrecordable and her respiratory rate greater than 60 beats/minute. Mechanical ventilation was necessary, and plasma volume expansion was started, with little effect. Infusion of dopamine restored the blood pressure to 150/90 mm Hg, but interrupting...

TNF-α has been shown to be a major factor responsible for myocardial depression in sepsis. The aim of this study was to investigate the effect of an anesthetic, propofol, on TNF-α expression in cardiomyocytes treated with LPS both in vivo and in vitro. In cultured cardiomyocytes, compared with control group, propofol significantly reduced protein expression of gp91phox and phosphorylation of ex...

Background: Anxiety and depression are both predisposing and consequent factor in patients with myocardial infarction (MI). Thus relief of anxiety and depression has an important role in reducing possibility of further MI and also quality of life promotion. Aim: The aim of the current study was to determine the effect of cognitive behavioral therapy (CBT) on the anxiety and depression in patien...