There are many reports of ventricular arrhythmias following the injection of epinephrine under general anesthesia with halothane or cyclopropane. Raventos reported that catecholamines given animals during chloroform, cyclopropane or halothane anesthesia have caused ventricular arrhythmias which sometimes developed into ventricular fibrillation. But there are a few reports of atrial arrhythmias in patients under general anesthesia with alone halothane. While it is known that hypercapnia can elicit arrhythmia during halothane anesthesia, Black and coworkers that hypercapnia of 60 to 140mmHg (average 92mmHg) is necessary for the occurrence of arrhythmias during halothane anesthesia. Hellewell and Potts reported 12 cases of arrhythmias under halothane anesthesia which were treated by propranolol, producing a return of sinus rhythm in an average time of 46 seconds. The authors reported one case with atrial arrhythmias induced by halothane anesthesia, which were arrested by the IV injection of 5mg of tolamolo, beta-receptor blocking agent. Thereafter arrhythmias did not reappear.
Anesthesia* ; Anesthesia, General ; Animals ; Arrhythmias, Cardiac* ; Catecholamines ; Chloroform ; Epinephrine ; Halothane* ; Humans ; Hypercapnia ; Propranolol ; Ventricular Fibrillation

Six patients of sick sinus syndrome were described with review of literatures, who demonstrated either persistent unexpected sinus bradycardia (5 patients) with sinus arrest in one patients or bradycardia-tachycardia syndrome (1 patient). These occurred due to disorders of sinoatrial conduction and depression of atrioventricular junctional escape pacemaker system. Singificant atrioventricular block was not present. Coronary heart disease, hypertension, valvular heart disease, and tetanus were demonstrated where etiology could be determined, but in one patient no clear etiologic diagnosis could be established. Syncope and dizziness were common sympotms and in one patients with atrial fibrillation occurred cerebral embolism.
Atrial Fibrillation ; Atrioventricular Block ; Bradycardia ; Coronary Disease ; Depression ; Diagnosis ; Dizziness ; Heart Valve Diseases ; Humans ; Hypertension ; Intracranial Embolism ; Sick Sinus Syndrome* ; Syncope ; Tetanus ; United Nations

Statistical observation was made on 2,639 cases with heart disease which has been seen in the Deparment of Internal Medicine, National Medical Center, in Korea, during the past 15 years ranging from January 1959 to December 1973. The results were as follows; 1. During the last 15 years, 2,639 cases with heart disease were observed, which represents about 12.9% of total 20,434 medical In-patients, and variable incidence for the consecutive years was noted. 2. The disease occurred most frequently in group aged under thirty and its incidence decreased in the fifth and sixth decades. 3. The incidence in male was 49.8% and in female 50.2%, the ratio of which was almost same. 4. The most common etiologic form of heart disease was hypertensive heart disease which occurred in 43.2% of all cardiac patients, corresponding to 5.57% of all In-patients. The incidence was most frequent in the sixth decade and decreased in the fifth and fourth decades with the male preponderance. 5. The second common heart disease was rheumatic heart disease, 31.6% of all cardiac patients, corresponding to 4.08% of all In-patients. It affected the mitral valve in most of the cases, whereas involvement of the aortic valve was rare. 6. Coronary heart disease, the third common heart disease, occurred in 5.1% of all cardiac patients, and most frequently in sixth and seventh decades. it affected male 2.5 times more frequently than female. 7. Postpartum heart failure and beriberi heart disease showed 3.8% and 3.1% respectively. They occurred more frequently in younger female, but the frequency was much decreased recently. 8. Pericarditis occured in 2.6% of all cardiac patients and tuberculosis was still a common cause of pericarditis. 9. Congenital heart disease was seen in 1.7% of the cases and patent ductus arteriosus, tetralogy of Fallot, atrial septal defect and ventricular septal defect occupied 76% of all congenital heart disease. 10. Cor pulmonale was present in 1.6%, arrhythmia 1.3%, cardiomyopathy 1.3%, thyroid heart disease 0.8%, endocarditis 0.7% and syphilitic heart disease 0.2%.
Aortic Valve ; Arrhythmias, Cardiac ; Beriberi ; Cardiomyopathies ; Coronary Disease ; Ductus Arteriosus, Patent ; Endocarditis ; Female ; Heart Defects, Congenital ; Heart Diseases* ; Heart Failure ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Incidence ; Internal Medicine ; Korea* ; Male ; Mitral Valve ; Pericarditis ; Postpartum Period ; Pulmonary Heart Disease ; Rheumatic Heart Disease ; Tetralogy of Fallot ; Thyroid Gland ; Tuberculosis

The author measured the value of serum triglyceride, total cholesterol and phospholipid in normal Korean adults and patients with complicated hypertension. Sera obtained from 295 cases of normal Korean male and female, and also 109 cases of patients with hypertension were analysed for triglyceride, cholesterol and phospholipid. The patterns of serum lipoprotein fraction in 171 normal Korean and 109 patients with complicated hypertension including cerebrovascular diseases and ischemic heart disease were studied by agarose gelelectrophoresis. The results are summarized as follows; 1. The mean value of serum triglyceride, cholesterol and phospholipid in normal Korean were 85.4+/-20.5mg%, 187.9+/-16.7mg%, and 193.4+/-34.6mg% respectively. 2. Sex and age difference showed no statistical significance in the mean values of serum triglyceride, cholesterol and phospholipid in hypertensive patients. 3. The mean values of serum triglyceride in the patients with complicated hypertension such as cerebral thrombosis gave higher value than in the patients with other cerebral complications. 4. The mean value of alpha-lipoprotein, pre-beta-lipoprotein and beta-lipoprotein in normal Korean were 29.6+/-5.0% (142.6+/-30.1mg%), 13.0+/-4.3% (62.7+/-24.8mg%), and 57.4+/-30.1% (276.1+/-56.6mg%) respectively. 5. The alpha-lipoprotein fraction in normal Korean demonstrated the tendency of decreasing as age is progressing in both sex, but pre-beta and beta-lipoprotein fraction gave a tendency of increasing by progressing age in both sex, but was not confirmatory in nature. 6. The alpha-lipoprotein fraction in patients with hypertension gave lower value than in the normal subjects, but the value of pre-beta and beta-poprotein were elevated significantly among patients with complicated hypertension than in normal person. 7. The incidence of hyperlipidemia in normal Korean and patients with hypertension were 31.9% and 66.5% respectively. 8. The relative incidences of hyperlipidemic probable phenotypes in normal Korean were as follows: 7% of normal person had Type II (IIa 3.3%, IIb 3.7%), 3.5% had Type III, and 21.4% had Type IV.
Adult* ; Cholesterol ; Female ; Humans ; Hyperlipidemias ; Hypertension* ; Incidence ; Intracranial Thrombosis ; Lipoproteins* ; Male ; Myocardial Ischemia ; Phenotype ; Sepharose ; Triglycerides

Plasma renin activity (PRA) and aldosterone were measured to evaluate various status of clinical conditions in normal controls and patients with essential hypertension. Fourteen controls and 45 essential hypertensive patients for PRA, and 10 controls and 28 patients with essential hypertension for plasma aldosterone were studied. The results obtained are summarizing as follows. 1. Mean value of PRA of normal subjects was 2.9+/-1.4ng/ml/hr at rest, and 5.9+/-2.3ng/ml/hr by double stimulation, respectively, the latter elevated up to twice the former. 2. Mean value of PRA in the patients with essential hypertension was 3.37+/-3.0ng/ml/hr at rest, and 5.99+/-4.9ng/ml/hr by double stimulation. The latter have increased to 1.8 times the former. 3. The patients with low PRA observed in 33.3%, the normal in 42.2%, and the high in 22.5%, at rest. After double stimulation, the low group was observed in 22.2%, the normal in 60.0%, and the high in 17.8%. 4. Mean age of the patietns with low PRA was 57.2+/-2.6 years. Though it was higher than those of normal and high PRA groups(52.0+/-10.1 years), statistical significances were observed (0.05 Aldosterone* ; Blood Pressure ; Cholesterol ; Electrocardiography ; Furosemide ; Humans ; Hypertension* ; Hypertrophy, Left Ventricular ; Motor Activity ; Plasma* ; Potassium ; Proteinuria ; Renin* ; Sodium ; Triglycerides

Postprandial hypotension (PPH) has not been described as a cause of hypotension after the return of spontaneous circulation (ROSC) in the intensive care unit (ICU). A 74 year old man underwent cardiopulmonary resuscitation (CPR) due to monomorphic ventricular tachycardia. After the ROSC, inotropic agents were not reduced but increased. PPH had occurred, according to the flow sheet, so a provocation test was performed. We noted hypotension but no serum hypoglycemia or tachycardia. The hypotension was diagnosed as PPH. We chose acarbose for treatment; thus, the inotropic agents were discontinued. This is the first case in which hypotension occurred in a patient recovering after CPR in the ICU and that the PPH was treated with acarbose. PPH should be considered and treated to manage hypotension in elderly patients in the ICU.
Acarbose ; Aged ; Cardiopulmonary Resuscitation ; Humans ; Hypoglycemia ; Hypotension ; Critical Care ; Intensive Care Units ; Postprandial Period ; Tachycardia ; Tachycardia, Ventricular

Cardiac injury is a common but occasionally serious complication of blunt chest trauma. A ventricular septal rupture (VSR) is a rare complication and is variable in its presentation, temporal course and severity. Here, we report a rare case of 75-year-old man who developed delayed VSR following blunt chest trauma.
Aged ; Humans ; Thoracic Injuries ; Thorax ; Ventricular Septal Rupture

Simultaneous multiple coronary artery thrombosis is a rare finding in ST segment elevation myocardial infarction (STEMI). We report a case of myocardial infarction with multiple ST segment elevation on the electrocardiography and total occlusions of the distal left anterior descending artery (dLAD), as well as of the second and third obtuse marginal artery on emergency coronary angiography. Thrombus aspiration was performed at dLAD and systemic glycoprotein IIb/IIIa inhibitor was used successfully. In patients with STEMI, multiple coronary thromboses are unusual and associated with patient fatality. However, assertive thrombus aspiration and antiplatelet therapy could be effective in STEMI patients with multiple distal coronary artery occlusions.
Arteries ; Coronary Angiography ; Coronary Artery Disease ; Coronary Thrombosis ; Coronary Vessels ; Electrocardiography ; Emergencies ; Glycoproteins ; Humans ; Myocardial Infarction ; Thrombosis

In order to investigate the trend of prevalence of heart disease in Korea, statistical observation was made on 19,239 cases of medical in-patients who were treated in 3 general hospitals, Korea University Hospital, Seoul Red Cross Hospital and Seoul Adeventist Hospital, on 73,484 cases of medical out-patients who were seen at Korea University Hospital and Seoul Adventist Hospital during the period of 5 years, from 1972 through 1976, on 7,746 cases of medical in-patients during the period of 10 years (1967 through 1976), and on 50,083 cases of medical out-patients during the period of 15 years (1962 through 1976) who were treated in Korea University Hospital. The results obtained were as follows. 1. Heart disease was 5.5% (male 5.4%, female 5.7%) of medical out-patients and 16.1% (male 16.7%, female 15.5%) of medical in-patients. 2. The incidence of heart disease was increased with the increase of age in both out-patients and in-patients. The incidences of heart disease in out-patients by age group to the total out-patients of each age group were 1.8% in 15~40 year group, 10.2% in 41~60 year group and 18.4% in over 61 year group, and those in in-patients were 5.0% in 15~40 year group, 24.4% in 41~60 year group and 30.8% in over 61 year group. 3. The incidences of individual heart disease to 4,074 cases with heart disease (male 1,986, female 2,088) of out-patients were as follows. Rheumatic myocarditis was 0.5% (male 0.6%, female 0.5%), mitral valvular disease 8.3% (male 5.8%, female 10.6%), aortic valvular disease 3.1% (male 3.9%, female 2.2%), mitral and aortic valvular disease 0.7% (male 1.3%, female 0.7%), hyper tension 72.0% (male 72.8%, female 71.0%), myocardial infarction 0.7% (male 1.2%, female 0.2%), angina pectoris 2.2% (male 3.1%, female 1.4%), atherosclerotic heart failure 4.5% (male 4.8%, female 4.1%), pericarditis 0.4% (male 0.6%, female 0.3%), idiopathic myocardiopathy 0.5% (male 0.5%, female 0.6%), postpartum myocardiopathy 0.3% in female, cor pulmonale 0.3%(male 0.2%, female 0.4%) and congenital heart disease 1.4% (male 1.8%, female 1.1%). 4. Incidences of individual heart disease to total 3,091 cases with heart disease (male 1,573, female, 1,518) of in-patients were as follows. Rheumatic myocarditis was 0.4% (male 0.5%, female 0.3%), mitral valvular disease 8.1% (male 5.1%, female 11.2%), aortic valvular disease 1.1% (male 1.3%, female 0.8%), mitral and arotic valvular disease 0.3% (male 0.3% female 0.4%), hypertension 69.6% (male 71.3%, female 68.5%), myocardial infarction 2.8% (male 4.3%, female 1.4%), angina pectoris 1.7% (male 2.0%, female 1.3%), atherosclerotic heart failure 7.5%(male 7.7%, female 6.8%), pericarditis 0.8% (male 0.9%, female 0.8%), idiopathic myocardiopathy 1.3% (male 1.3%, female 1.3%), postpartum myocardiopathy 0.7% in female, cor pulmonale 1.5% (male 1.5%, female 1.6%) and congenital heart disease 0.5% (male 0.4%, female 0.5%). 5. There was no significant seasonal variation of the incidences of individual heart diseases. 6. The incidences of rheumatic valvular heart disease, coronary heart disease and congenital heart disease of medical out-putients of Korea University hospital by 5-year-period for 3 consecutive periods (1962 through 1976) were increased and those of hypertension and cor pulmonale were decreased. 7. The incidneces of coronary heart disease and idiopathic myocardiopathy of medical in-patients of Korea University Hospital by 5-year-period for 2 consecutive periods (1967 through 1976) were increased and those of rheumatic myocarditis, hypertension and postpartum myocardiopathy were decreased. There was no change in incidence of rheumatic heart disease including rheumatic myocarditis, and congenital heart disease. 8. The trend of increasing prevalence of coronary heart disease, especially angina pectoris, was noted. Although hypertension was decreased in relative incidence, the total number of patients with hypertension was increased. This seems to suggest that hypertension tends to increase.
Angina Pectoris ; Cardiomyopathies ; Coronary Disease ; Epidemiologic Studies* ; Female ; Heart Defects, Congenital ; Heart Diseases* ; Heart Failure ; Heart Valve Diseases ; Heart* ; Hospitals, General ; Humans ; Hypertension ; Incidence ; Korea* ; Myocardial Infarction ; Myocarditis ; Outpatients ; Pericarditis ; Postpartum Period ; Prevalence ; Pulmonary Heart Disease ; Red Cross ; Rheumatic Heart Disease ; Seasons ; Seoul

Clinical observation was done on 302 cases of cerebrovascular accidents admitted at Sung-Sim hospital, Chung-Ang University from January, 1968 to August, 1976. 1) Of 302 cases of cerebrovascular accidents, the incidence of cerebral hemorrhage was 28.8, cerebral thrombosis 47,7 Subarachnoid hemorrhage 20.2% and cerebral embolism 3.3%. 2) The peak age incidence was in the fifth decade in cerebral hemorrhage, subarachnoid hemorrhage, whereas in cerebral thrombosis, it was in the sixth decade. 3) The most frequent predisposing factor in cerebral hemorrhage and subarachnoid hemorrhage were physical activity and emotional stress, whereas in thrombosis and embolism, it was rest. 4) Among disease preceding the onset of cerebrovascular accidents, hypertension were presented 65.4% in cerebral hemorrhage, 63.6% in cerebral thrombosis, 56.6% in subarachnoid hemorrhage and valvular heart disease was presented 40.0% in cerebral embolism. 5) Serum cholesterol level over 200mg% was seen in 33.0% of cerebrovascular accidents. 6) Leukocytosis was seen 58.6% of cerebrovascular accidents which was predominantly found in the hemorrhagic group. 7) The pressure of cerebrospinal fluid was elevated in 61.7% of cerebrovascular accidents, predominantliny the hemorrhagic group. 8) The peak duration of admission was present in 51.7% of cerebrovascular accidents within 7 days and mortality rate during hospitalization was 38.0% in cerebral hemorrhage, 10.4% in cerebral thrombosis and 27.8% in subarachnoid hemorrhage. 9)The mortality rate during hospitalization was 35.3% in all cerebrlavascular accidents within 24 hours.
Causality ; Cerebral Hemorrhage ; Cerebrospinal Fluid ; Cholesterol ; Embolism and Thrombosis ; Heart Valve Diseases ; Hospitalization ; Hypertension ; Incidence ; Intracranial Embolism ; Intracranial Thrombosis ; Leukocytosis ; Mortality ; Motor Activity ; Stress, Psychological ; Stroke ; Subarachnoid Hemorrhage