eLetters

174 e-Letters

published between 2001 and 2004

  • Is Higher Blood Pressure always better for Patients With Post-MI Cardiogenic Shock ?
    Mohamad Abdelsalam Abdelkader

    Dear Editor

    Cardiogenic shock is an ominous complication of myocardial infarction (MI), occurring in 4 to 7%of cases. The majority of patients have an ST elevation (Q wave) MI, but cardiogenic shock can occur, although less frequently after a non-ST elevation (non-Q wave) MI.[1,4]

    The clinical definition of cardiogenic shock is decreased cardiac output and evidence of tissue hypoxia in the presence of adequ...

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  • The French paradox: lessons for other countries
    Charles F George

    Dear Editor

    The article by Professor Ferrières on the French Paradox,[1] suggests that “under certification of CHD deaths in France is a possible bias, but after correction, it remains a low bias”. However, MONICA data from Glasgow and Belfast show an underestimate of only 9.9% and -0.4% respectively, whereas those from Lille , Strasbourg and Toulouse underestimate CHD deaths by 93.3, 76.3 and 71.7% respectively. In ad...

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  • Re Pregnancy in heart disease, author's response
    Sara A Thorne

    Dear Editor

    Steve Yentis raises relevant discussion points.[1] A detailed discussion of anaesthetic methods was beyond the scope of the article and Steve's comments regarding the safety of low-dose epidural are welcome.

    I agree that assisted vaginal delivery is the safest mode of delivery for most women with heart disease. His comments about instrumental vaginal delivery for women with Marfan syndrome underl...

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  • True difference or bias comparison ?
    Jean-Jacques Goy

    Dear Editor

    Schwerzmann et al.[1] report a comparison of 2 PFO closure devices, the Amplatzer and the PFO Star, and concluded that the Amplatzer device was superior. Even if the data are of some interest, I see some major limitations of this trial, making the conclusions of little value in the daily practice.

    First, it is a non-randomized trial. In addition the PFO star device used in this comp...

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  • Status of rheumatic heart disease in Pakistan - An Underestimate ?
    Fahim H. Jafary

    Dear Editor

    We read Rizvi et al's article on the status of rheumatic heart disease (RHD) in rural Pakistan with considerable interest.[1]

    Rizvi and colleagues highlight an extremely important problem facing cardiologists in Pakistan. However, it is possible that the true prevalence of RHD in this population may have been underestimated as echocardiography was only performed in those with an audible...

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  • Aortic mechanical properties and left ventricular diastolic functions
    Erdem Kasikcioglu

    Dear editor

    I read with great interest the recently published study by Eren et al. [1]

    They reported that increased aortic stiffness in patients with hypertension, diabetes mellitus, and both caused to impaired left ventricular (LV) diastolic functions. Furthermore, they also found that there was a relation between the diastolic function and aortic stiffness in the patients. It is known that the ao...

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  • Screening for subclavian A stenosis
    Aham Amadi

    Dear Editor

    As a response to the case report by Bilkhu et al,[1]we wish to report our experience with a 66 year old lady with hypertension and hypercholesteremia.

    Our patient had had bypass graft surgery for triple vessel disease - Left Internal mammary artery (LIMA) to Left anterior descending (LAD), Radial A via LIMA to Obtuse Marginals (OM1 and OM2). She presented with angina 6 months post CABG, and...

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  • Re: Pregnancy in heart disease
    Steve M Yentis

    Dear Editor

    Sara Thorne give a comprehensive account of heart disease in pregnancy [1] which, as she says, represents an increasing challenge to high-risk obstetric teams. I wish to raise three points.

    First, in most cases the "good analgesia" in labour mentioned by Dr Thorne should be provided (anticoagulation allowing) by epidural analgesia using modern low-dose solutions of local anaesthetic/opioid,...

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  • Great vascular adaptation and cardiac remodelling in athletes
    Erdem Kasikcioglu

    Dear Editor

    We read with great interest the published study by Fagard.[1]

    Cardiovascular adaptations in athletes are dependent multi- factorial parameters (genetic, age, type of exercise, exercise duration). However, it is accepted that type of exercise is key role for cardiac remodelling to regularly and intensive exercise training. The review on this topic confirmed how endurance- and strength-training may...

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  • Age is the key factor
    Ganesh Nallur Shivu

    Dear Editor

    One of the main concerns is that the incidence of atrial fibrillation increase with age; almost doubling every decade in adult life.[1] Although, there are various options available for the management of this very common condition, the main hurdle that we have to overcome in clinical practice is the age factor. Many of them develop side effects to the antiarrhytmic drugs which has been well documented in...

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