eLetters

197 e-Letters

published between 2002 and 2005

  • Patients who complain of headaches afler sublingual nitroglycerin usually have no coronary disease
    Tsung O. Cheng

    Dear Editor,

    It is indeed very gratifying to read the report by Hsi et al.[1] that sublingual nitroglycerin (NTG) administration causes significantly more frequent headaches in patients with normal or minimally diseased coronary arteries than in patients with significant coronary artery disease (CAD). Over the years I have always felt that patients with chest pain who complained of significant headaches following s...

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  • Author's reply
    Martyn Thomas

    Dear Editor,

    I have read the letter from Professor Walley and colleagues with interest. I have no desire to restate my editorial but would have the following comments.

    Comments such as “data is virtually complete”, “only two patients underwent a second revascularisation in another north-west NHS hospital” and the low diabetes rates “are probably due to ethnicity differences” reflect all the problems of a...

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  • The rate of non-response to CRT is substantially underestimated
    David H Birnie

    Dear Editor,

    Fox et al. raise the important issue of non-response to CRT and suggest the rate of non-response to CRT is 25%, a figure which is widely quoted. However a careful examination of the published data suggests that this is a substantial underestimate of the problem.

    The non-responder rates in the studies using subjective or (relatively) objective functional capacity as the main definition of respon...

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  • True pseudo-myocardial infarction?
    Robert J Huggett

    Dear Editor,

    In the recent issue of Heart, Egred et al.[1] reported an important example of pseudo-myocardial infarction in a patient with diabetic ketoacidosis. This was presumably related to hyperkalaemic effects on the ECG.

    However, in the current case report it is not mentioned why the patient developed ketoacidosis and in the context of a sepsis syndrome other factors may be at play to orchestrate the...

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  • Long term follow up of rheumatic fever
    oscar jolobe

    Dear Editor,

    Notable by its absence from the list of predictors of severe rheumatic valvar disease[1] was the mention of the role of gender, especially when one considers the fact that rheumatic mitral stenosis is reportedly twice as common in females as in males.[2-4] This was also a missed opportunity to test the hypothesis that there is a role for oestrogen in the expression of rheumatic mitral stenosis. If tha...

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  • Fishy figures
    Uffe Ravnskov

    Dear Editor,

    To estimate children’s intake of fish from total household dietary intake is a daring enterprise. Most children hate fish because of the bones. Here is a likely scenario:

    Father or mother: “There is no dessert before you have eaten up that fish!”

    Therefore, if the figures aren’t a result of chance, they may rather reflect the effect of childhood stress rather than the result of a hi...

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  • Are drug eluting stents worth the money?
    Tom Walley

    Dear Editor,

    We wish to respond to criticisms of our paper on the cost effectiveness of drug eluting stents (DES) by Martyn Thomas in his recent editorial.

    The criticisms are that:

    • Our study is based on data of uncertain quality from one centre, which may be biased, and report unusually low rates of diabetes and revascularisation.

    Processes of validation of our data are available on req...

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  • Systolic impairment in hypertophic cardiomyopathy
    Rajesh Thaman

    Dear Editor,

    In the letter by Olivetto et al. [1] the authors have highlighted two potential limitations of our study firstly that fractional shortening may not be a reliable measure of systolic function in hypertrophic cardiomyopathy and that ejection fraction is better; and secondly, that the cut off value for systolic impairment (...

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  • Bilateral thoracoscopic cervical sympathectomy for the treatment of recurrent polymorphic ventricula
    Andrew J Turley

    Dear Editor

    In January’s edition of Heart we presented the fascinating case of a patient with long QT syndrome who was refractory to conventional pharmacological and pacing techniques.[1] Despite potassium and magnesium supplements, beta-blockade, implantation of a single, then dual chamber implantable cardioverter-defibrillator (ICD), amiodarone, nicorandil and mexiletine; the patient continued to experience life-...

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  • Platypnea-orthodeoxia syndrome associated with aortic root dilatation is not a new syndrome
    Tsung O. Cheng

    Dear Editor,

    I read with interest the article on hypoxemia associated with aortic root dilatation.[1] But this is not a new syndrome as Eicher et al.[1] suggested. It is the platypnea-orthodeoxia syndrome first described in 1949 by Burchell et al.[2] Platypnea-orthodeoxia is a relatively uncommon but often underdiagnosed syndrome [3] with striking clinical manifestations, characterized by dyspnea relieved by assu...

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