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- W2054194310 abstract "Impairment of the auriculoventricular conduction time was studied in twenty-two patients with acute rheumatic fever. Observations were made (1) after the intravenous injection of atropine sulphate, (2) during a period of acute emotional stress, (3) following the subcutaneous administration of epinephrine hydrochloride, and (4) after exercise. Atropine completely abolished the conduction defect in nineteen of the twenty-two cases studied. There was a marked diminution in the degree of block in the one case in which the drug was given intramuscularly. The effect was always transient. Since acceleration in ventricular rate did not necessarily parallel decrease in conduction time, it appears that these two effects are not directly related. In one of the two cases which did not show a reduction in the degree of block after atropinization, the impairment persisted for a year and was probably due to organic changes in the junctional tissues. Three cases, in addition to impairment of auriculoventricular conduction, also showed delay in intraventricular conduction. Atropine had no effect on this disturbance. In three individuals, who gave evidence of emotional stress at the time of the observations, marked reduction in the P-R intervals was noted, despite little or no acceleration of ventricular rate. Small doses of epinephrine, injected subcutaneously, in five cases produced a result similar to that observed in a control group. Larger dosage, however, exerted two opposite effects; it either diminished the conduction defect (two cases), or markedly increased it (three cases). The latter result was not seen in a control group under similar conditions. After moderate exercise, there was some decrease in the P-R interval, with slight increase in ventricular rate. It is concluded that, in cases of acute rheumatic fever, impairment of auriculoventricular conduction is due, in part at least, to an increase in vagal tone. The significance of this fact is briefly discussed. It is suggested that the focus of vagal irritation lies in the medulla." @default.
- W2054194310 created "2016-06-24" @default.
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- W2054194310 date "1937-04-01" @default.
- W2054194310 modified "2023-09-25" @default.
- W2054194310 title "The mechanism of impaired auriculoventricular conduction in acute rheumatic fever" @default.
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- W2054194310 doi "https://doi.org/10.1016/s0002-8703(37)90857-3" @default.
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