International journal of cardiology
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Relation of ECG changes to neurological outcome in patients with aneurysmal subarachnoid hemorrhage.
Electrocardiographic (ECG) alterations occurring during the course of subarachnoid hemorrhage (SAH) have been described frequently, but the incidence, patterns, and prognostic significance are not well defined. This study was designed to investigate these features. ⋯ In patients with acute aneurysmal SAH, repolarization abnormalities are the commonest ECG alterations, and ST depression is more common in patients with poor outcome. However, ECG alterations are not independently related to outcome.
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Letter Case Reports
Fistulous connection between internal mammary graft and pulmonary vasculature after coronary artery bypass grafting: a rare cause of continuous murmur.
A 58-year-old male who had undergone coronary artery bypass grafting (CABG) using left internal mammary artery and a sequential saphenous vein graft 2 years ago presented with new onset angina. His initial physical examination revealed an unexpected continuous murmur over the left sternal border, and two-dimensional echocardiography has failed to identy the cause. Cardiac catheterization then performed and revealed patent left internal mammary artery and saphenous vein grafts. ⋯ A new heart sound, especially a continuous murmur, may be detected during physical examination. Surgical correction is indicated in the event of refractory angina, growing fistula causing heart failure or endarteritis. Otherwise, a conservative approach with instruction of the patient for prophylactic precautions of subacute bacterial endocarditis may be recommended for asymptomatic patients.