Exercise testing is used in cardiac rehabilitation to assess patients before planning an exercise programme. In this study the reproducibility and accuracy of the Chung protocol was analysed and compared with the Bruce protocol. Eight cardiac subjects and 9 controls each performed two Chung protocol tests and one Bruce protocol test. The ventilatory, cardiovascular and metabolic parameters were determined and statistically analysed. The only significant difference between the Bruce and Chung protocols was in the ventilatory threshold (P < 0,05). There were no significant differences between the two protocols in respect of heart rate, peak oxygen uptake, ventilatory equivalent and respiratory quotient. The Chung test showed an essentially linear increase in both heart rate and oxygen uptake. The Chung protocol was found to be less anaerobic (P < 0,05) than the Bruce protocol, and is therefore better tolerated by cardiac patients in an exercise rehabilitation setting. The test is reproducible and can therefore be used as an effective means of monitoring patients' progress in cardiac rehabilitation.
Background. Congestive heart failure is a growing clinical problem, probably because of the increasing age of the population and longer survival of those with chronic heart disease. We evaluated heart failure in a hospital population. Methods. All patients with heart failure at a teaching hospital in Pretoria were prospectively examined for a 6-month period.
This is the first reported preterm neonate where the diagnosis of a myocardial infarction was confirmed with a technetium-99mpyrophosphate isotope scan. He is only the fifth reported neonate to survive a myocardial infarction.
A child presented with a non-tender mass in the right supraclavicular fossa. It was most obvious in the supine position, after coughing and when the Valsalva manoeuvre was performed. Investigations revealed an aneurysm of the internal jugular vein. The management of this unusual congenital vascular abnormality is discussed.
Since Grï¿½ntzig performed the first successful human percutaneous transluminal coronary angioplasty (PTCA) in 19771 this procedure has become widely used in the non-surgical management of patients with coronary artery disease. While the primary success rate of PTCA is in excess of 90%,2,3, up to 40% of procedures eventually fail as a result of the development of restenosis at the angioplasty site.2,4-6 The importance of this problem is obvious when one considers that, in the USA, more than 300 000 PTCAs are performed annually at a cost of over $15000 each with about 30% of these patients needing repeat angioplasty or bypass grafting within 1 year.7
Surface ECG and some intracardiac recordings from a patient with a manifest accessory atrioventricular pathway and recurrent palpitations (WPW syndrome). The pathway was localised to that part of the tricuspid annulus midway between the posterior area at the coronary sinus and anteriorly at the atrioventricular node. Radiofrequency (RF) current was delivered via a catheter and the pathway was ablated. The patient has been asymptomatic since then.