Browsing by Author "Weich, H. F. H."

Now showing 1 - 12 of 12
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    Acute coronary thrombus formation after stress testing following percutaneous transluminal coronary angioplasty : a case report
    (Health and Medical Publishing Group -- HMPG, 1985-03) Przybojewski, J. Z.; Weich, H. F. H.
    Successful percutaneous transluminal coronary angioplasty (PTCA) was performed on a 37-year-old white man with an isolated 95% right coronary artery stenosis who initially presented with type II unstable angina. Submaximal treadmill stress testing was not carried out before PTCA, but testing 3 days after PTCA was strongly positive without accompanying symptoms of myocardial ischaemia. Some 30 minutes after this test the patient experienced severe precordial pain with features of a hyperacute transmural inferior myocardial infarction. Immediate coronary arteriography delineated fresh thrombus related to the previous PTCA site. Intracoronary thrombolysis with streptokinase was successful, revealing an underlying severe stenosis at the PTCA site. PTCA was not repeated, nor was emergency coronary artery bypass grafting (CABG) performed. This is the second such case documented in the literature; the first patient failed to respond to intracoronary thrombolysis with streptokinase and was submitted to emergency CABG. The possible underlying pathophysiological mechanisms are discussed. We believe that the late thrombus formation was directly related to submaximal stress testing after successful PTCA, and recommend that testing to assess the efficacy of PTCA be deferred until at least 1 month after the procedure to allow for completion of the healing process.
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    Aneurysm of a peripheral pulmonary artery : case report and brief review of the literature
    (Health and Medical Publishing Group (HMPG), 1975-08) Janson, P. M. C.; Barnard, P. M.; Weich, H. F. H.; MacMahon, A. G.
    A patient is presented in whom a solitary aneurysm of a peripheral pulmonary artery was treated by left lower lobectomy. This is the eighth reported successful resection of such an aneurysm. A brief review of the literature is also presented and the importance of pulmonary arteriography in the diagnosis of this condition is mentioned.
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    Aortokoronêre omleidingschirurgie te Tygerberg-Hospitaal, 1978-1980
    (Health & Medical Publishing Group, 1982-11) Barnard, P. M.; Lubbe, J. J. De W.; Rossouw, J. J.; Weich, H. F. H.
    ENGLISH ABSTRACT: Between January 1978 and December 1980, 118 patients underwent saphenous vein bypass surgery for obstructive coronary artery disease at Tygerberg Hospital. Sixteen patients in addition to bypass surgery underwent mitral and/or aortic valve replacement or resection of a ventricular aneurysm. The operative and hospital mortality was 3.0% (4/134) for all patients and 3.3% (4/118) for patients who had aortocoronary bypass surgery as the sole procedure. Follow-up of the surviving patients for a mean period of 16.4 months revealed a low incidence of late myocardial infarction of 3.6% (4/112) resulting in the death of only 1 patient; 89.1% of patients were free of angina pectoris and the majority of these resumed their normal work or enjoyed their retirement.
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    A DNA polymorphism in the human low-density lipoprotein receptor gene
    (Health and Medical Publishing Group -- HMPG, 1986-07) Kotze, M. J.; Retief, A. E.; Brink, P. A.; Weich, H. F. H.
    A new restriction fragment length polymorphism (RFLP) in the low-density lipoprotein receptor gene is described using the Stu I restriction endonuclease and a cDNA probe. The frequency of the two RFLP alleles was determined in 60 unrelated white subjects and 11,70/6 of them were found to be heterozygous for the polymorphism. Mendelian segregation of the RFLP was found in 3 informative families. The possible use of the RFLP in the diagnosis of familial nypercholesterolaemia in South Africa is discussed.
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    Effects of nifedipine on the peri-operative ECG, as determined by continuous Holter monitoring : a double-blind study
    (Health & Medical Publishing Group, 1986-03) Du Toit, H. J.; Weich, H. F. H.; Weymar, H. W.; Przybojewski, J. Z.
    A double-blind study was performed on 50 elderly patients undergoing hip-replacement surgery under general anaesthesia; 26 were given nifedipine and the remaining 24 placebo to determine effects on the continuously monitored (Holter) ECG during the 4 peri-operative days. Drugs were only administered during the latter 3 days of the observation period. Surgery was performed on the morning of the 3rd day. A striking feature was a high incidence of arrhythmias in both groups of patients, a finding previously documented in both 'normal' and elderly people. A decrease in ST-segment changes was expected in the nifedipine-treated patients. An unexpected finding, therefore, was the lack of protection against cardiac ischaemic changes in the nifedipine-treated patients compared with the placebo patients. Interpretation of the ST segment as seen in the Holter-monitored ECG remains controversial. We have no clear explanation for the lack of protection against ischaemic changes. The effects of profound vasodilatation produced by nifedipine in elderly patients subjected to major surgery, general anaesthesia including administration of enflurane, and a variable amount of blood loss in the postoperative period may be important factors. In conclusion, one should perhaps be cautious of nifedipine administration under these circumstances.
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    Die effek van heparien-geinduseerde styging in vrye plasmatiroksien op die hartritme na miokardiale infarksie
    (Health and Medical Publishing Group (HMPG), 1985-12) Van Heerden, B. B.; Klopper, J. F.; Weich, H. F. H.; Van Heerden, P. D. R.
    It is well known that an acute myocardial infarction is accompanied by a rise in levels of plasma free fatty acids (FFA), which may lead to a subsequent increase in cardiac arrhythmias. Administration of heparin to patients after an acute myocardial infarction gives rise to an increase both in plasma FFA levels and plasma free thyroxine levels. If administered without a fatty meal the rise in FFA is not accompanied by an increase in arrhythmias. The effect of the heparin-induced rise in plasma free thyroxine on cardiac rhythm has never been investigated. The aim of the present study was to investigate a possible arrhythmic effect of a heparin induced increase in plasma free thyroxine in a group of patients with acute myocardial infarction. We were able to confirm a significant heparin-induced rise in plasma free thyroxine levels, as measured by the effective thyroxine ratio. Although a slightly significant increase in ventricular premature beats could be demonstrated after heparin administration when using the Wilcoxon rank sum test for statistical analysis (but not when the paired t-test was utilized), no significant correlation with free thyroxine levels could be found. Heparin administration to patients suffering from myocardial infarction seems to be safe in terms of a possible arrhythmic effect.
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    Late symptomatic exercise-induced coronary vasospasm after percutaneous transluminal coronary angioplasty
    (Health and Medical Publishing Group (HMPG), 1986-03) Przybojewski, J. Z.; Weich, H. F. H.
    A patient who underwent a successful double-vessel percutaneuos transluminal coronary angioplasty (PTCA) had suffered from exercise-induced ST-segment elevation associated with angina pectoris (AP). This ECG pattern was present both before and 12 months after PTCA while nifedipine (Adalat; Bayer-Miles) therapy was electively discontinued. Reintroduction of calcium blockade with this drug eliminated the chest pain and resulted in normalization of stress ECG. Cardiac catheterization at 6 and 12 months after PTCA demonstrated continuing angiographic improvement of the coronary stenoses of the left anterior descending and left circumflex (LCx) coronary arteries previously subjected to PTCA. It is believed that coronary artery spasm at the PTCA site on the LCx coronary artery was responsible for the AP and exercise-induced ST-segment elevation. Likely pathogenetic mechanisms of coronary vasospasm during and after the performance of PTCA, as well as the interrelationship with re-stenosis and the clinical implications of drug therapy, are discussed.
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    Percutaneous transluminal coronary angioplasty : a review of the literature
    (Health & Medical Publishing Group, 1984) Przybojewski, J. Z.; Weich, H. F. H.
    The purpose of this article is to review PTCA, which can be considered to be a truly revolutionary and fairly simple non-invasive form of intervention. Furthermore, the 'epidemic' of IHD in the RSA calls for the employment of this technique, which has already been carried out in a few teaching hospitals in this country. Very recently, modified balloon dilatation catheters have been used percutaneously in the non-operative transluminal correction of congenital coarctation of the aorta in infants and children, congenital pulmonary valve stenosis ('valvuloplasty'), and hypoplasia and stenosis of the pulmonary arteries. It has also been employed for PTCA and for the simultaneous occlusion of coronary-bronchial artery anastomosis using a detachable balloon.
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    Plasma vitamin A, E, C and B6 levels in myocardial infarction
    (Health & Medical Publishing Group, 1987-5) Labadarios, D.; Brink, P. A.; Weich, H. F. H.; Visser, L.; Louw, M. E. J.; Shephard, G. S.; Van Stuijvenberg, M. E.
    ENGLISH ABSTRACT: Vitamin A, E, C and B6 status was studied in 30 patients with myocardial infarction and in 19 age- and sex-matched patients after elective surgery or trauma. Plasma levels of the four vitamins studied were low, remained low or decreased transiently in both groups of patients during the acute catabolic response phase, and began to return to normal after the third day from the start of the catabolic response. These changes in plasma levels are therefore neither of any special pathophysiological importance in nor specific to myocardial infarction.
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    Pre-operative assessment of cardiac patients for non-cardiac surgery
    (Health & Medical Publishing Group, 1984) Ford, B. M.; Weich, H. F. H.; Coetzee, A. R.
    Non-cardiac surgery presents significant risks to patients with cardiac diseases. With the improvement in anaesthetic techniques and intensive care facilities, many cardiac patients who in the past would have been considered as being at too great a risk are now being considered for non-cardiac surgery. Smaller centres must still practice strict selection of patients if they do not possess an intensive care unit with facilities for full haemodynamic monitoring. We present a review of the recent literature and current practice at our hospital to assist clinicians in assessing these patients for anaesthesia. However, the final decision whether the patients is fit for anaesthesia still rests with the anaesthetist.
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    Progressive familial heart block type I : clinical and pathological observations
    (Health & Medical Publishing Group, 1991) Van der Merwe, P.-L.; Rose, A. G.; Van der Walt, J. J.; Weymar, H. W.; Hunter, J. C.; Weich, H. F. H.
    Progressive familial heart block type I (PFHB-I) is an autosomal inherited disease. It was previously postulated that the disease is limited to the cardiac conduction tissue. The presentation of a patient with dilated cardiomyopathy focused on the possibility that this might be part of PFHB-I. This observation led to routine echocardiographic examination of patients with complete heart block, who belonged to PFHB-I families, and another 5 cases with signs of dilated cardiomyopathy were identified. This is the first time, to our knowledge, that the histological picture of PFHB-I has been described. From these case reports it is clear that in the presence of a dilated cardiomyopathy the prognosis in PFHB-I tends to be poor.
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    Two simple inexpensive photographic methods for viewing ECG-gated radionuclide blood pool images
    (HMPG, 1979-04) Van Heerden, P. D. R.; Baard, W. P.; Klopper, J. F.; Reyneke, N. J.; Weich, H. F. H.; Blake, R. S.; Przybojewski, J. Z.
    Although the ECG-gated radionuclide blood pool scan (GBPS) has become an established method for studying regional myocardial wall motion, it is usually performed with the aid of an expensive computer system. A simple, inexpensive method was developed to view gated radionuclide blood images by a film loop and a photographic motion detection (PHOMOT) technique. These techniques were compared with left ventricular cine angiography in 15 patients. Segmental wall movement (78 segments) showed identical results in 92% of cases. In all patients the same diagnosis was arrived at by GBPS and cine angiography. The photographic techniques developed offer a simple screening procedure to reduce cardiac catheterization in patients with suspected abnormalities of left ventricular wall contraction.