Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Takayasu's arteritis is a chronic inflammatory disease of the aorta and its main branches, and a well known cause of stroke. Pathogenesis of ischaemic stroke has been attributed to intracranial vasculitic involvement or emboli from either stenoocclusive extracranial vessels or cardiac disease such as aortic regurgitation. We present a patient with Takayasu's arteritis and recurrent cerebral infarctions associated with intracranial atherosclerosis. We postulate that the intracranial atherosclerotic process is an important mechanism in Takayasu's arteritis-related ischaemic stroke.
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PMID:Takayasu's disease presenting with atherothrombotic ischaemic stroke. 1894 42

Homozygous familial hypercholesterolemia (hoFH) is caused by mutations in the low-density lipoprotein receptor gene and is characterized by severe hypercholesterolemia from birth and onset of premature cardiovascular disease (CVD) during childhood. The onset and progression of CVD using currently available testing methods in children with hoFH have not been fully characterized. A large cohort of patients with hoFH referred to our subspecialty clinic was studied. Thirty-nine patients (22 aged < or =16 years) underwent extensive cardiovascular, lipid, and genetic evaluation. Sixteen children < or =16 years without known CVD when first evaluated were followed up longitudinally for up to 8 years. CVD was clinically evident in 88% of subjects aged >16 years and 9% of those < or =16 years. Markers of atherosclerosis correlated significantly with age at which lipid-lowering treatment was initiated (abnormal coronary angiogram, abnormal aortic valve using echocardiography, and high calcium score using electron beam computed tomography; all p <0.01; abnormal carotid Doppler result; p = 0.03). Twenty of 22 children had no clinical evidence of coronary artery disease, yet 7 of these children had angiographically confirmed mild coronary artery disease (<50%) and 8 had mild to moderate aortic regurgitation using echocardiography. Of noninvasive tests, only evaluation of aortic valve regurgitation using echocardiography predicted the presence of angiographic coronary stenosis (p <0.001). During follow-up, 7 children developed progression of coronary and/or aortic valvular disease during their teenage years and 4 required surgical interventions. In conclusion, in these patients aggressive lipid-lowering treatment initiated in early childhood is warranted. Careful coronary and valvular surveillance strategies and coronary revascularization when appropriate are also warranted in this high-risk population.
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PMID:Longitudinal evaluation and assessment of cardiovascular disease in patients with homozygous familial hypercholesterolemia. 1902 92

The aim of the study was to identify factors related to heart valve calcification (HVC) and effect of HVC on intracardiac hemodynamics in patients with chronic kidney disease (CKD). 377 CKD patients of the control group and 132 ones treated by hemodialysis (HD) were examined using echocardiography, cardiomonitoring, measurement of the carotid intima-media thickness and mineral bone density, X-ray imaging of calcified abdominal aorta. HVC was diagnosed in 38.9 and 27.3% of the CKD patients on hemodialysis and without it respectively. In both groups, patients with HVC were older than HVC-free ones, more of them had coronary heart disease, cardiac insufficiency, aortic calcinosis, and biochemically identifiable inflammation. In the absence of hemodialysis, patients with HVC had thicker intima-media compex, lower glomerular filtration rate, higher arterial pressure, and increased occurrence of diabetes mellitus. In HVC patients receiving hemodialysis, its duration was longer, blood PTH and calcium levels higher, forearm MOC lower. HVC associated with stenosis of mitral and aortic valves, aortic regurgitation, enlarged left and right atrium, thickened left and right ventricular wall. Multifactor analysis showed that HVC in patients receiving hemodialysis was related to the age, disbalance of phosporus and sodium, and duration of hemodialysis; in its absence, it was related to intima-media thickness and diabetes mellitus. Thus, in patients of the latter group, HVC was in the first place associated with atherosclerosis aggravated by a decrease of glomerular filtration rate and with the presence of diabetes. In patients receiving hemodialysis, HVC correlated with phosporus/sodium disbalance and atherosclerosis. The study revealed negative effect of HVC on intracardiac hemodynamics and for the first time demonstrated decreased MOC in patients with HYC.
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PMID:[Heart valve calcification in patients with chronic kidney disease]. 1967 Jul 13

Bicuspid aortic valve is one of the most common congenital heart valve disorders. We present the development of acute myocardial infarction (AMI) in an 18-year-old male patient with unrecognized bicuspid aortic valve and moderate aortic regurgitation. He presented with chest pain. The electrocardiogram showed ST-segment elevation in leads V2 to V6. Creatine kinase-MB level was elevated to 97 U/l and troponin I was very high (45,000 ng/ml). The diagnosis was made as anterior wall AMI. Following treatment with intravenous rt-PA, ST-segment elevation completely returned to normal. Transthoracic echocardiography showed a bicuspid aortic valve, moderate aortic regurgitation, and apical wall hypokinesia; left ventricular global systolic function was normal. The patient had no risk factors for coronary atherosclerosis, nor a history of substance addiction or a family history of coronary artery disease. Protein C, protein S and homocysteine levels were normal. He refused any further intervention. Two weeks after discharge, he presented again with chest pain. Electrocardiography, cardiac markers, and coronary arteriography were normal. He was discharged on appropriate medical treatment. The presented case is the first report of AMI in a patient with bicuspid aortic valve.
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PMID:Acute myocardial infarction in a young patient with bicuspid aortic valve. 2120 14

A 4-year-old boy was evaluated for severe hypercholesterolemia (cholesterol: 831 mg/dL) and disseminated xanthomas. Both parents had hypercholesterolemia: mother (cholesterol: 308 mg/dL) and father (cholesterol: 281 mg/dL). There was no family history of cardiovascular disease. Skin examination showed: intertriginous xanthomas of feet and hands, tuberous xanthomas in knees and elbows, tendinous xanthomas in Achilles tendon and xanthomas in the gluteal region, associated with corneal arc bilaterally. Laboratory work-up excluded secondary causes of hypercholesterolemia and a diagnosis of homozygous familial hypercholesterolemia was made. Echocardiogram showed bicuspid aortic valve and mild aortic insufficiency. Doppler ultrasound of carotid arteries and computerized tomography of the thorax for assessment of calcium scoring were normal. The patient's serum lipids were reduced by approximately 40% after a diet, atorvastatin and ezetimibe. Homozygous familial hypercholesterolemia is an important risk factor for atherosclerosis and premature coronary artery disease in children and young adults. Early diagnosis and treatment with screening of first-degree relatives is essential to minimize the progression of cardiovascular disease in these patients.
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PMID:Homozygous familial hypercholesterolemia: case report of a rare cause of dyslipidemia. 2202 71

A rise in the incidence of latent and late forms of neuro- and visceral syphilis significantly complicates diagnostics of the disease in patients admitted to emergency medicine clinics. Syphilis is believed to be a cause of roughly 0.5% of all cardiopathies. Late syphilitic lesions of the cardiovascular system (cardiovascular syphilis) occur in 0.25-0.96% patients in need of therapeutic treatment, 93.4% of them present with mesaortitis but its life-time diagnosis is possible only in 10% of the cases. Syphilitic lesions in the aorta are especially well apparent at the points of its branching into coronary arteries of the heart and aortic arch. One of the main consequences of syphilitic aortitis is the narrowing of coronary arteries frequently complicated by atherosclerosis, coronary thrombosis, and the resulting myocardial infarction. Another severe complication of syphilitic aortitis is progressive aortic valve insufficiency (in 25-50% of the patients) related to dilatation of the valve ring affected by inflammation. Some patients develop bacterial endocarditis of the aortic valve. Close localization of the coronary artery junction and the aortic valve account for a combination of aortic valve insufficiency and coronary insufficiency in patients with syphilitic process in the initial part of aorta. A case report is presented.
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PMID:[Syphilitic mesaortitis]. 2256 47

A 46-year-old woman with homozygous familial hypercholesterolemia was referred due to aortic regurgitation. The patient was introduced selective low density lipoprotein cholesterol(LDL)apheresis 20 years ago. Echocardiogram revealed severe aortic regurgitation, and computed tomography revealed thoracoabdominal aortic aneurysm. We considered 2 staged operations were necessitated. Firstly, aortic valve replacement was performed. Emergent coronary artery bypass grafting was also done because intraoperative myocardial ischemia was strongly suspected from left ventricular hypokinesis. One year later, replacement of thoracoabdominal aorta was performed. Post-operative course was uneventful and the patient was discharged at post-operative day 21. The patients with homozygous familial hypercholesterolemia must be strictly followed up because systemic atherosclerosis frequently exacerbates despite selective LDL apheresis.
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PMID:[Successful surgical treatment for aortic valve regurgitation and thoracoabdominal aortic aneurysm in a patient with homozygous familial hypercholesterolemia; report of a case]. 2338 64

We describe aortic root dilatation, severe aortic regurgitation, and pulmonary artery stenosis that were accidentally diagnosed 23 years after the arterial switch operation for transposition of the great arteries in situs inversus. We successfully performed the modified Bentall procedure and pulmonary artery reconstruction. The pathology of the dilated aortic root revealed intimal atherosclerosis and linear necrosis of the tunica media, suggesting the vulnerability of the pulmonary artery to systemic pressure.
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PMID:Late complications and pathological findings of the arterial switch operation. 2338 18

Dyspnea is a subjective sensation of difficult or uncomfortable breathing caused by increased excitation of brain respiratory centres,(1) and is usually secondary to pulmonary or cardiac disease.(2) Heart failure is a serious public health problem in industrialised countries, with an increasing prevalence and incidence. It is more common in the elderly, and is usually caused by a defect in myocardial contraction, coronary atherosclerosis, or less frequently, valvular disease.(3) Aortic insufficiency (AI) is one of them. It may originate from infective endocarditis, congenital or valvular heart disease, or rheumatic fever. It may lead to a medical emergency due to the inability of the left ventricle to adapt to the rapid increase in the end-diastolic volume caused by regurgitation of blood from aorta to left ventricle. If not corrected, the AI can lead to acute cardiogenic shock.(4.)
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PMID:[Dyspnea caused by Coxiella Burnetii]. 2372 34

Acute coronary syndromes in the setting of infective endocarditis may be the result of coronary compression secondary to periannular aortic valve complications, coronary embolism, obstruction of the coronary ostium due to a large vegetation, coronary atherosclerosis, and severe aortic insufficiency. External coronary artery compression as a result of infective endocarditis is a rare and lethal finding with few reported cases available in the medical literature. We present a rare occurrence of an acute coronary syndrome occurring in the setting of a bioprosthetic aortic valve abscess in which there was no complete coronary occlusion visualized and given the patient's recent unremarkable catheterization and findings of diffuse tapering of the proximal left coronary system, the most likely etiology was external compression secondary to the known aortic root abscess, which caused myocardial ischemia, and was confirmed during surgery. Although uncommon, external compression should be considered in the differential diagnosis of acute coronary syndrome in this setting and coronary angiography can be diagnostic of this entity.
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PMID:External coronary artery compression due to prosthetic valve bacterial endocarditis. 2466 Feb 23


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