UNLABELLED Precondition to prevention and control of morbidity and mortality of myocardial ischemia--coronary disease, is its good diagnostic. Goal of this study is to asses diagnostic significance of positive trademill stress test in diagnosis of coronary disease. MATERIAL AND METHODS we analyzed 120 patients with markedly positive classic trademill stress test using Bruce protocol in the year 2003. In all cases, positive stress test was followed by selective angiography, using standard technique with multiple sections. Blood vessel narrowing of more than 50% was chosen as the criteria for positive angiographie finding. With the help of coronary angiography, it was found that 62 (51.7%) of patients has stenosis of less than 50% or normal angiographic finding. 58 (48.3%) of patients had stenosis of more than 50%. Of that number, 24 (41.4%) had one-vessel coronary disease, 12 (20.7%) two-vessel coronary disease, and 10 (34.5%) three-vessel coronary disease. 2 patients (3.4%) had stenosis of the trunk of left coronary artery. Results of this study show that the sensitivity of trademill stress-test is less than optimal, and should be supplemented by other non-invasive techniques (such as myocardial perfusion scintigraphy, radionuclide ventriculography and stress echocardiography) in diagnostics of coronary disease.
Atrial fibrillation characterized by uncoordinated atrial activation. On the electrocardiogram is described by the replacement of consistent P waves by rapid oscillations or fibrillatory waves that vary in size and shape. The incidence of atrial fibrillation in patients under 22 years old is 2%, whereas for patients under 60 years old, the incidence is 8.8%. The most common cause of death in patient with atrial fibrillation is stroke, and occurs in 1% to 5% patients in the age group 50 to 59 years, whereas 30% patients in the age group 80 to 89 years. The incidence of atrial fibrillation after coronary artery bypass surgery occurs in 20% to 40% patients. We examined the incidence atrial fibrillation in patients after coronary artery bypass surgery, most common risk factors for occurs atrial fibrillation. Prospective study was conducted on 100 patients, who were divided in two groups, which had similar age structure, gender and they had disease coronary artery which required coronary artery bypass surgery. We established that incidence atrial fibrillation after coronary artery bypass surgery was 24%. Age was one of main risk factors that is responsible for appearance of atrial fibrillation. Gender like risk factor at 60 year old persons does not have statistical significance, while at persons which are younger then 60 years male has greater statistical significance like risk factor. Patients with triple vessel disease after coronary artery bypass surgery had most common atrial fibrillation.
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