OST INVESTIGATORS have stressed the benign clinical significance of late systolic murmurs with or... more OST INVESTIGATORS have stressed the benign clinical significance of late systolic murmurs with or without associated systolic clicks. The absence of a relation between these sounds and evident organic heart disease has also been emphasized.r.2 Gallavardin,ssJ the first to describe late systolic clicks, suggested a pleuropericardial origin of these extra sounds. This explanation was widely accepted for many years. Humphries and McKusicks described abnormal T waves in 11 patients with late systolic murmurs, defining this association as an "electrocardiographic-auscultatory syndrome" and attributing the findings to previous pericarditis. Segal and Likoffs demonstrated mitral regurgitation in patients with late systolic murmurs. However, they considered the late systolic murmur associated with a midsystolic click to be innocent. Several investigators'-14 have reported left ventricular angiographic findings consistent with mitral regurgitation in patients with late systolic murmurs at the apex, whether or not a midsystolic click was present. Burch et a1.r5 described mid-late systolic murmurs due to papillary muscle dysfunction with evident coronary artery disease. Their patients were of advanced age and had electrocardiographic changes that suggested an origin other than mitral regurgitation. The purpose of this paper is (1) to report the finding on a group of children and young adults with late systolic murmurs and clicks, and (2) to present evidence that this type of mitral regurgitation is produced by an abnormal structure of the mitral valve ring without morphologic changes of the leaflets, papillary muscles, or chordae tendineae.
After human heart transplantation, separate donor and recipient P waves were seen in 7 of 10 pati... more After human heart transplantation, separate donor and recipient P waves were seen in 7 of 10 patients, and P wave form was changed from the preoperative state. The recipients' P waves responded normally to various degrees of exercise and the Valsalva maneuver, whereas the donor complexes gave a response typical of denervation. The effects of pharmacologic stimulation or blockade were not studied. The possibility of electrical interaction between the recipient atria1 stump and the-donor atrium is discussed.
OST INVESTIGATORS have stressed the benign clinical significance of late systolic murmurs with or... more OST INVESTIGATORS have stressed the benign clinical significance of late systolic murmurs with or without associated systolic clicks. The absence of a relation between these sounds and evident organic heart disease has also been emphasized.r.2 Gallavardin,ssJ the first to describe late systolic clicks, suggested a pleuropericardial origin of these extra sounds. This explanation was widely accepted for many years. Humphries and McKusicks described abnormal T waves in 11 patients with late systolic murmurs, defining this association as an "electrocardiographic-auscultatory syndrome" and attributing the findings to previous pericarditis. Segal and Likoffs demonstrated mitral regurgitation in patients with late systolic murmurs. However, they considered the late systolic murmur associated with a midsystolic click to be innocent. Several investigators'-14 have reported left ventricular angiographic findings consistent with mitral regurgitation in patients with late systolic murmurs at the apex, whether or not a midsystolic click was present. Burch et a1.r5 described mid-late systolic murmurs due to papillary muscle dysfunction with evident coronary artery disease. Their patients were of advanced age and had electrocardiographic changes that suggested an origin other than mitral regurgitation. The purpose of this paper is (1) to report the finding on a group of children and young adults with late systolic murmurs and clicks, and (2) to present evidence that this type of mitral regurgitation is produced by an abnormal structure of the mitral valve ring without morphologic changes of the leaflets, papillary muscles, or chordae tendineae.
Page 1. 1972;61;336-339 Chest Irene Ferrer DV Cokkinos, RD Leachman, Oscar Zamalloa,Reinaldo Cabr... more Page 1. 1972;61;336-339 Chest Irene Ferrer DV Cokkinos, RD Leachman, Oscar Zamalloa,Reinaldo Cabrera and M. ... Duration of the P Wave* DV Cokkinos, MD; RD Leachman, MD, FCCP; Oscar Zamalloa, MD; Reinaldo Cabrera, MD; and M. Irene Ferrer, MD ...
After human heart transplantation, separate donor and recipient P waves were seen in 7 of 10 pati... more After human heart transplantation, separate donor and recipient P waves were seen in 7 of 10 patients, and P wave form was changed from the preoperative state. The recipients' P waves responded normally to various degrees of exercise and the Valsalva maneuver, whereas the donor complexes gave a response typical of denervation. The effects of pharmacologic stimulation or blockade were not studied. The possibility of electrical interaction between the recipient atria1 stump and the-donor atrium is discussed.
OST INVESTIGATORS have stressed the benign clinical significance of late systolic murmurs with or... more OST INVESTIGATORS have stressed the benign clinical significance of late systolic murmurs with or without associated systolic clicks. The absence of a relation between these sounds and evident organic heart disease has also been emphasized.r.2 Gallavardin,ssJ the first to describe late systolic clicks, suggested a pleuropericardial origin of these extra sounds. This explanation was widely accepted for many years. Humphries and McKusicks described abnormal T waves in 11 patients with late systolic murmurs, defining this association as an "electrocardiographic-auscultatory syndrome" and attributing the findings to previous pericarditis. Segal and Likoffs demonstrated mitral regurgitation in patients with late systolic murmurs. However, they considered the late systolic murmur associated with a midsystolic click to be innocent. Several investigators'-14 have reported left ventricular angiographic findings consistent with mitral regurgitation in patients with late systolic murmurs at the apex, whether or not a midsystolic click was present. Burch et a1.r5 described mid-late systolic murmurs due to papillary muscle dysfunction with evident coronary artery disease. Their patients were of advanced age and had electrocardiographic changes that suggested an origin other than mitral regurgitation. The purpose of this paper is (1) to report the finding on a group of children and young adults with late systolic murmurs and clicks, and (2) to present evidence that this type of mitral regurgitation is produced by an abnormal structure of the mitral valve ring without morphologic changes of the leaflets, papillary muscles, or chordae tendineae.
After human heart transplantation, separate donor and recipient P waves were seen in 7 of 10 pati... more After human heart transplantation, separate donor and recipient P waves were seen in 7 of 10 patients, and P wave form was changed from the preoperative state. The recipients' P waves responded normally to various degrees of exercise and the Valsalva maneuver, whereas the donor complexes gave a response typical of denervation. The effects of pharmacologic stimulation or blockade were not studied. The possibility of electrical interaction between the recipient atria1 stump and the-donor atrium is discussed.
OST INVESTIGATORS have stressed the benign clinical significance of late systolic murmurs with or... more OST INVESTIGATORS have stressed the benign clinical significance of late systolic murmurs with or without associated systolic clicks. The absence of a relation between these sounds and evident organic heart disease has also been emphasized.r.2 Gallavardin,ssJ the first to describe late systolic clicks, suggested a pleuropericardial origin of these extra sounds. This explanation was widely accepted for many years. Humphries and McKusicks described abnormal T waves in 11 patients with late systolic murmurs, defining this association as an "electrocardiographic-auscultatory syndrome" and attributing the findings to previous pericarditis. Segal and Likoffs demonstrated mitral regurgitation in patients with late systolic murmurs. However, they considered the late systolic murmur associated with a midsystolic click to be innocent. Several investigators'-14 have reported left ventricular angiographic findings consistent with mitral regurgitation in patients with late systolic murmurs at the apex, whether or not a midsystolic click was present. Burch et a1.r5 described mid-late systolic murmurs due to papillary muscle dysfunction with evident coronary artery disease. Their patients were of advanced age and had electrocardiographic changes that suggested an origin other than mitral regurgitation. The purpose of this paper is (1) to report the finding on a group of children and young adults with late systolic murmurs and clicks, and (2) to present evidence that this type of mitral regurgitation is produced by an abnormal structure of the mitral valve ring without morphologic changes of the leaflets, papillary muscles, or chordae tendineae.
Page 1. 1972;61;336-339 Chest Irene Ferrer DV Cokkinos, RD Leachman, Oscar Zamalloa,Reinaldo Cabr... more Page 1. 1972;61;336-339 Chest Irene Ferrer DV Cokkinos, RD Leachman, Oscar Zamalloa,Reinaldo Cabrera and M. ... Duration of the P Wave* DV Cokkinos, MD; RD Leachman, MD, FCCP; Oscar Zamalloa, MD; Reinaldo Cabrera, MD; and M. Irene Ferrer, MD ...
After human heart transplantation, separate donor and recipient P waves were seen in 7 of 10 pati... more After human heart transplantation, separate donor and recipient P waves were seen in 7 of 10 patients, and P wave form was changed from the preoperative state. The recipients' P waves responded normally to various degrees of exercise and the Valsalva maneuver, whereas the donor complexes gave a response typical of denervation. The effects of pharmacologic stimulation or blockade were not studied. The possibility of electrical interaction between the recipient atria1 stump and the-donor atrium is discussed.
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Papers by Oscar Zamalloa