digoxin and Thrombosis

Antibodies, long used as discriminating tools in immunoassay, are now being used in vivo, both in diagnosis and therapy. In cardiovascular medicine, applications that have reached the stage of clinical trial include the reversal of digitalis intoxication by digoxin-specific antibodies and the imaging of cardiac necrosis with monoclonal myosin-specific antibodies. An exciting future prospect, still in an early experimental stage, is the application of fibrin-specific monoclonal antibodies to both the visualization of thrombi and emboli and the targeting of fibrinolytic agents.

Topics: Adolescent; Adult; Animals; Antibodies, Monoclonal; Cells, Cultured; Child; Child, Preschool; Clinical Trials as Topic; Digoxin; Dogs; Fibrinolytic Agents; Heart Diseases; Humans; Immunoglobulin Fab Fragments; Infant; Male; Myocardial Infarction; Myocardium; Myosins; Necrosis; Rabbits; Thrombosis

Topics: Anemia, Macrocytic; Anti-Arrhythmia Agents; Anticoagulants; Azathioprine; Chemical and Drug Induced Liver Injury; Cholelithiasis; Clofibrate; Colitis, Ulcerative; Dextrans; Digoxin; Drug Therapy; Fibrinolytic Agents; Halothane; Heparin; Hepatitis B Antigens; Humans; Hyperthyroidism; Iodine Isotopes; Leukemia; Myocardial Infarction; Platelet Adhesiveness; Pulmonary Embolism; Thrombosis; Venoms

Antibodies, long used as discriminating tools in immunoassay, are now being used in vivo, both in diagnosis and therapy. In cardiovascular medicine, applications that have reached the stage of clinical trial include the reversal of digitalis intoxication by digoxin-specific antibodies and the imaging of cardiac necrosis with monoclonal myosin-specific antibodies. An exciting future prospect, still in an early experimental stage, is the application of fibrin-specific monoclonal antibodies to both the visualization of thrombi and emboli and the targeting of fibrinolytic agents.

Topics: Adolescent; Adult; Animals; Antibodies, Monoclonal; Cells, Cultured; Child; Child, Preschool; Clinical Trials as Topic; Digoxin; Dogs; Fibrinolytic Agents; Heart Diseases; Humans; Immunoglobulin Fab Fragments; Infant; Male; Myocardial Infarction; Myocardium; Myosins; Necrosis; Rabbits; Thrombosis

Atrial thrombosis is a relatively rare event in children. We report a case of a newborn with AFI who after restoration of sinus rhythm, developed atrial thrombus on a prominent Chiari network floating between the right and left atrium through the patent foramen ovale. The thrombus was resolved following treatment with heparin without events.. Atrial stunning was proposed as a key mechanistic phenomenon because the thrombus occurred after the cardioversion of AFI to sinus rhythm. Heparin may be effective in the resolution of atrial thrombus within a few days.

Topics: Amiodarone; Anti-Arrhythmia Agents; Atrial Flutter; Digoxin; Electrocardiography; Fibrinolytic Agents; Heart Atria; Heart Diseases; Heparin; Humans; Infant, Newborn; Male; Secondary Prevention; Thrombosis; Ultrasonography

To examine if appropriate antithrombotic therapy in atrial fibrillation is implemented nationally.. Using prescriptions for digoxin as a surrogate for atrial fibrillation, we identified its coprescription with antithrombotic therapy, aspirin or warfarin in a national prescribing database in 27 571 patients over 45 years old.. Proportionately significantly more men were on warfarin, and use in those >75 years old was three times less than in those <65 years. Reluctance to use antithrombotics was confirmed in a postal survey.. Data suggest a missed opportunity to prevent stroke with women and those >75 years old least likely to receive warfarin.

Topics: Age Factors; Aged; Anti-Arrhythmia Agents; Anticoagulants; Aspirin; Atrial Fibrillation; Cyclooxygenase Inhibitors; Digoxin; Female; Humans; Male; Middle Aged; Sex Factors; Thrombosis; Treatment Outcome; Warfarin

Topics: Anti-Arrhythmia Agents; Atrial Fibrillation; Blood Platelets; Digoxin; Endothelial Cells; Humans; Stroke; Thrombosis

Two patients with atrial fibrillation had abrupt onset of abdominal pain and massive small bowel distension suggesting mesenterial artery embolism. One patient had dilation of the left atrium and ventricle, the other a mitral value prolapse syndrome with a dilated left atrium. Both patients were treated conservatively and gradually recovered. A small bowel series performed several weeks after the acute episode showed loss of normal mucosa and narrowing of a long segment of the small bowel. A control examination in one patient one year later, still revealed jejunal mucosal abnormalities and stenosis, features similar to those occurring in Crohn's disease. Our observations suggest that analogous to ischemic colitis, an entity of acute ischemic small bowel enteritis exists. Mesenteric ischemia apparently can induce a clinical syndrome of "regional enteritis". The radiologic features should not be confused with those of Crohn's disease.

Topics: Aged; Anticoagulants; Digoxin; Heart Diseases; Humans; Intestinal Obstruction; Intestine, Small; Ischemia; Male; Mesenteric Arteries; Mesenteric Vascular Occlusion; Radiography; Thrombosis

The primary goal of this study was to develop a method for evaluating fibrin-specific antibodies as thrombus detecting agents. The apparatus and assay conditions were chosen by testing antibody 64C5, which binds to the amino terminus of the fibrin beta chain, for its ability to bind to human blood clots. Using 125I-labeled antibody 64C5, the effects of antibody concentration, clot shape, clot mass, temperature, and flow rate were tested. Increased antibody binding was observed when antibody concentration, clot mass and temperature were increased. Under one set of conditions, six 125I-labeled monoclonal antifibrin antibodies (four specific for the beta chain, two specific for the alpha chain) were tested for their binding to retracted clots of human blood. Two radioiodinated antidigoxin antibodies were used as a control. Beta chain-specific antibody 59D8, which provided the highest level of binding to clot, bound 14-fold better than the control antidigoxin antibody. Neither alpha chain-specific antibody bound to clotted blood. To examine the in vivo relevance of the in vitro binding to clots, the uptake of antibody 64C5 was assessed for its binding to human fibrin clotted within the jugular vein of a rabbit. The correlation coefficient between in vitro and in vivo uptake as a function of clot weight was calculated to be 0.91. Thus, in vitro binding of monoclonal antifibrin antibodies to human blood clots was judged to be a realistic method for the comparison and selection of an ideal antifibrin antibody for detailed in vivo testing.

Topics: Animals; Antibodies, Monoclonal; Antibody Specificity; Binding Sites, Antibody; Digoxin; Evaluation Studies as Topic; Fibrin; Humans; Iodine Radioisotopes; Protein Conformation; Rabbits; Thrombosis

We present two cases in which thrombocytopenia developed during low-dose heparin therapy. They seem to represent the spectrum of heparin-associated thrombocytopenia described by Carreras. Because of the increasing use of low-dose heparin for thromboembolism prophylaxis, and because patient reexposure to heparin is not uncommon, the identification of even a modest fall in platelet count in association with heparin therapy is important.

Topics: Aged; Atrial Fibrillation; Collateral Circulation; Digoxin; Electric Countershock; Female; Heparin; Humans; Platelet Count; Thrombocytopenia; Thrombosis; Time Factors

Ten months after aortic valve replacement (Björk-Shiley prosthesis) a 57-year-old man had thrombotic encapsulation of his prosthetic valve. The only clinical manifestation of this serious complication was gross hemoglobinuria. The management of the patient is described. The slightest change in the condition of a patient after prosthetic valve replacement should be viewed as a possible sign of thrombosis.

Topics: Anticoagulants; Aortic Valve; Digoxin; Heart Valve Prosthesis; Hemoglobinuria; Humans; Male; Middle Aged; Postoperative Complications; Thrombosis

Topics: Abnormalities, Drug-Induced; Adult; Chondrodysplasia Punctata; Digitoxin; Digoxin; Female; Fetus; Heart Valve Prosthesis; Heparin; Humans; Infant, Newborn; Male; Placenta Diseases; Pregnancy; Pregnancy Complications; Radiography; Sulfisoxazole; Thrombosis; Warfarin

Topics: Adolescent; Adrenal Cortex Hormones; Brain Edema; Cardiomegaly; Central Venous Pressure; Cerebrovascular Circulation; Digoxin; Diuretics; Heart Arrest; Heart Atria; Heart Injuries; Hematoma; Humans; Male; Mediastinum; Oxygen Inhalation Therapy; Postoperative Complications; Radiography; Rupture; Thrombosis; Time Factors; Ventilators, Mechanical

Topics: Blood Gas Analysis; Blood Pressure; Cardiac Catheterization; Chronic Disease; Diagnosis, Differential; Digoxin; Electrocardiography; Female; Heart Failure; Heparin; Humans; Hypertension, Pulmonary; Middle Aged; Pulmonary Circulation; Pulmonary Embolism; Radiography; Radionuclide Imaging; Recurrence; Tetracycline; Thrombosis

Topics: Cardiac Surgical Procedures; Digoxin; Drug Therapy; Electrocardiography; Embolism; Heart Diseases; Humans; Mitral Valve Stenosis; Penicillins; Radiography, Thoracic; Rheumatic Heart Disease; Thoracic Surgery; Thrombosis; Vectorcardiography