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- Cardiovascular Journal of Africa
- OA African Journal Archive
- Volume 8, Issue 3, 1997
Cardiovascular Journal of Africa - Volume 8, Issue 3, 1997
Volumes & issues
Volume 8, Issue 3, 1997
Author H.M. Digenio, A.G. & JoughinSource: Cardiovascular Journal of Africa 8, pp 136 –144 (1997)More Less
Objective. To determine whether cardiac rehabilitation services are beneficial to patients and cost-effective. Design. Several recent publications are reviewed. The first of these, 'Cardiac Rehabilitation. Clinical Practice Guideline No. 17', is itself a review of original published research: 900 scientific reports were examined by a multidisciplinary panel and 334 of these were considered to be of sufficient scientific merit to be used as the references for the guideline. The other publications discussed are: The American Heart Association Consensus Panel Statement, 'Preventing heart attack and death in patients with coronary disease', the American College of Cardiology's recommendations on 'Matching theï¿½ intensity of risk factor management with the hazard for coronary disease events' and Recommendations of the Task Force of the European Society of Cardiology, the European Atherosclerosis Society and European Society of Hypertension, 'Prevention of coronary heart disease in clinical practice'. Results. Cardiac rehabilitation brought about substantial benefits in risk factor profiles, including improvement in exercise tolerance, blood lipids, psychosocial well-being, and reduction in cigarette smoking and stress levels. In addition there was well-documented proof of improvement of pathophysiological measures, such as relief of symptoms, less progression and greater regression of disease and a reduction in mortality. As an intervention, cardiac rehabilitation was shown to be as cost-effective as many pharmacological regimens and surgical interventions. Conclusion. The evidence in support of cardiac rehabilitation is so overwhelming that all patients should be educated about this form of treatment and have the ultimate choice of accepting or rejecting it.
Source: Cardiovascular Journal of Africa 8, pp 147 –148 (1997)More Less
Source: Cardiovascular Journal of Africa 8, pp 151 –156 (1997)More Less
Objectives. Because ischaemic preconditioning elicits a potent endogenous protective mechanism against the development of myocardial infarction, it is important to explore its utilisation in clinical situations. The aim of this study was to examine whether- the myocardium of rats with genetic hypertension could be protected by ischaemic preconditioning. Methods. Male New Zealand genetically hypertensive rats (GH-Wistar-derived) and normotensive Wistar controls (W AG-Wistar-derived), aged 12 months, were used. Isolated perfused hearts were preconditioned by 3 periods of 5 minutes global ischaemia, interspersed with S minutes' reperfusion, and subsequently subjected to 25 minutes global ischaemia, followed by 30 minutes' reperfusion. Results. Heart and body mass were significantly higher in GH rats. Although the heartlbody mass ratios of GH rats were higher than those of WAG rats, the difference was not significant. The reperfusion coronary flow pattern during the preconditioning protocol differed markedly between the 2 groups. Only normotensive WAG hearts demonstrated protective effects' of preconditioning on post-ischaemic function and tissue creatine phosphate content, while the GH hearts could not be preconditioned. Conclusions. An explanation for the failure of preconditioning in GH hearts is not yet available. The data caution against implementation of preconditioning in patients with angina pectoris and left ventricular hypertrophy.
Source: Cardiovascular Journal of Africa 8, pp 157 –160 (1997)More Less
The first documented epidemic of Sydenham's chorea was in 1418. In 1686 Thomas Sydenham was the first to descriptionbe the condition, but it was Richard Bright who in 1831 first made the association between chorea and rheumatic fever. Chorea is one of the major diagnostic criteria for rheumatic fever. Chorea is often considered a benign self-limiting condition. Little is known about the pathophysiological process. A link between the group A B-haemolytic streptococcus through an antibodymediated immune response targeting the basal ganglia has been descriptionbed. Special investigations have been done to ascertain the pathophysiology, but none is of diagnostic value. The aims of this study were to analyse the clinical findings, the role of special investigations in the management and course of Sydenham's chorea and to review the literature. Data on 27 patients were analysed. Special investigations in these patients can be divided into those necessary to assist in diagnosing acute rheumatic fever and those to exclude other causes that mimic chorea. None of these tests was helpful in diagnosing chorea due to other causes; neither did they influence the management of these patients. In conclusion, Sydenham's chorea remains a clinical diagnosis and extensive and expensive special investigations are seldom warranted.
Ruptured idiopathic left ventricular false aneurysm of the free wall associated with Takayasu's arteritis in a young childAuthor A.G. RoseSource: Cardiovascular Journal of Africa 8, pp 161 –163 (1997)More Less
The co-existence in a young child of long-standing Takayasu's arteritis, chronic myocarditis and a false aneurysm of the left ventricle raises the possibility that a common inflammatory process may have accounted for all three findings. The unique combination of pathology observed in this patient may provide further evidence that widens the spectrum of cardiac involvement associatd with Takayasu's disease to include the myocardium.