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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinical, roentgenologic and laboratory findings in 124 patients with dissecting aneurysm of the aorta are reported. In 53 patients the dissection occurred in the ascending aorta ("proximal" dissection), and in 71 patients the site of origin was the descending thoracic aorta ("distal" dissection). Certain distinct clinical differences between the groups were apparent. Although hypertension was an important predisposing factor, it was significantly more common in distal dissection, as was atherosclerosis. Back pain and hypertension on hospital presentation characterized patients with distal dissection. Conversely patients with proximal dissection were younger and had a significantly higher incidence of Marfan's syndrome, cystic medial necrosis, anterior chest pain, pulse deficits, neurologic compromise, aortic insufficiency and congestive heart failure. In both groups, syncope appeared to correlate well with the occurrence of cardiac tamponade. Chest roentgenograms almost always showed an abnormal aortic contour. Aortic angiography, when performed, was usually confirmatory of the diagnosis.
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PMID:The clinical recognition of dissecting aortic aneurysm. 102 Jul 50

Health workers took blood samples from 41 black women living in the greater Harare area of Zimbabwe before they began taking a combines oral contraceptive (OC) with 30 mcg ethinyl estradiol and 150 mg desogestrel (Marvelon formulation) and 3, 6, 9, and 12 months after taking it to conduct metabolic tests. They also recruited 190 other black women from Harare and rural Chiweshe, Mazowe, and Domboshawa populations taking the same new generation progestogen-containing OC to determine the efficacy, acceptability, and safety of the OC. Only high density lipid (HDL) cholesterol levels rose considerably between pretreatment and 12 months (0.94-1.3 mmol/ml; p.05). Low density lipid (LDL) cholesterol levels remained basically the same. This accounted for the significant rise of the HDL cholesterol/LDL cholesterol ratio over 12 months from 0.41 to 0.61. Triglyceride levels did not rise significantly and always stayed within the normal range. No woman became pregnant during the clinical trial. 2% experienced minor side effects including backache, spotting, headache, and nausea. Body weight and blood pressure did not change significantly. Sociodemographic reasons accounted for the high dropout rate (60%). The leading reason was change of address since many women were migrant farm workers. Since HDL levels rose and LDL levels were the same, this OC appears to have a reduced risk of atherosclerosis and cardiovascular disease. The findings indicated that the Marvelon formulation OC did not adversely affect lipid metabolism and therefore did not increase the risk of atherosclerosis or cardiovascular disease among these women. It also effectively protected them from pregnancy and induced minimal side effects.
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PMID:Evaluation of a combined oral contraceptive pill in black Zimbabwean women. 180 54

Two cases of Salmonella aortitis were diagnosed by positive culture from the wall of aortic aneurysm. Common features in both cases included fever, abdominal/back pain and pulsatile abdominal mass with underlying severe atherosclerosis. The fatal outcome of both cases despite surgical and medical treatment was discussed and guideline of management was proposed.
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PMID:Salmonella aortitis at Ramathibodi Hospital, Bangkok, Thailand. 352 79

Penetrating atherosclerotic aortic ulceration is a unique disease with distinct management and prognostic implications. It is an important clinical entity that must be distinguished from classic aortic dissection and rapid expansion or contained rupture of a thoracic aortic aneurysm. Although symptoms of penetrating aortic ulceration may mimic dissection, the characteristic signs of dissection are absent. New imaging modalities have made it possible to establish the diagnosis of penetrating aortic ulceration with a high degree of accuracy and to tailor management according to the presence of complications. Physicians should be aware of the possibility of atherosclerotic aortic ulceration, particularly in elderly patients with systemic atherosclerosis and hypertension who have sudden onset of chest or back pain.
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PMID:Penetrating atherosclerotic aortic ulcers. 798 3

Twelve patients with rupture of the perivisceral abdominal aorta were admitted to the UCLA Medical Center between 1984 and 1996. Six patients had atherosclerotic thoracoabdominal aneurysms (TAA) which ruptured in the visceral segment of the aorta. The remaining 6 patients proved to have ruptured mycotic aneurysm (MA). Clinical presentation was different in the two groups. Whereas all 6 patients with TAA and < 24 hr history of abdominal, chest, or back pain, patients with MA had these symptoms for 2-5 weeks (mean 3.4 weeks). History of sepsis was present in 4/6 MA and in 0/6 TAA patients. No difference in risk factors for atherosclerosis were seen between these two groups. Clinical outcomes were also different. Operation consisted of in situ vascular grafting in all patients. Operative mortality for TAA was 33% (2/6), whereas all patients with MA survived repair with no operative mortality. Two patients had cardiac arrest prior to surgery. One of these had a TAA and died 5 days after surgery, whereas the other survived repair of an MA. Follow-up ranges from 1-84 months (mean 48 months). Four survivors in the TAA group are alive at 6, 8, 14, and 84 months, with the latter having a pseudoaneurysm of the visceral patch-graft anastomosis. All 6 patients with MA are alive at 1-73 months (mean 39 months) without evidence of graft sepsis or recurrent aneurysm. We conclude that rupture of the visceral portion of the aorta is often associated with a mycotic process, with important differences noted in clinical presentation when compared to atherosclerotic TAA. Surgical intervention is effective in both MA and TAA. Operative mortality, however, is significantly higher in patients with ruptured TAA. In situ prosthetic replacement for ruptured MA is associated with low mortality and excellent long-term results.
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PMID:Rupture of the perivisceral aorta: atherosclerotic versus mycotic aneurysm. 923 87

We describe four patients aged 14 to 21 years who developed acute aortic dissection. In three of the four patients, the course was fatal, despite aggressive medical and surgical intervention. All four patients had sustained systemic hypertension related to chronic renal insufficiency. The patients had no other identifiable risk factors for aortic dissection, including congenital cardiovascular disease, advanced atherosclerosis, vasculitis, trauma, pregnancy, or family history of aortic dissection. Although aortic dissection is rare in individuals younger than 40 years of age, young patients with sustained systemic hypertension are at increased risk for this serious and often fatal condition. Physicians must be aware of this rare complication of hypertension and consider aortic dissection in the differential diagnosis of unusual chest, abdominal, and back pain in hypertensive children, adolescents, and young adults.
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PMID:Aortic dissection in young patients with chronic hypertension. 1002 53

Ischemic cerebrovascular diseases are commonly induced by atherosclerosis and cardiogenic embolization but rarely they occur in association with Takayasu's arteritis and aortic lesion such as aortic dissection and aneurysm. Here we experienced two cases of acute aortic disease complicated by ischemic cerebrovascular disease (CVD). Patient 1 was a 77-year-old male. He complained of dyspnea and left hemiparesis. He was brought to our hospital by ambulance. Left hemiparesis and dyspnea improved soon. The patient only complained of left lower extremity pain and physical examination revealed hypotension. Brain CT showed no abnormality but chest CT revealed aortic dissection. The resection of the intimal tear and replacement of ascending aorta and aortic arch with 28 mm Hemashield graft were performed under hypothermia and selective cerebral perfusion. The postoperative course was uneventful and he has been doing well. Patient 2 was a 67-year-old female. She was found lying unconscious and brought to our hospital by ambulance. Physical examination revealed right hemiparesis and hypotension. Brain CT demonstrated low density area in the left corona radiata and ruptured aortic aneurysm was seen in abdominal CT. Just after the examination, the patient suddenly complained of severe back pain and died despite cardiopulmonary resuscitation. Aortic lesions can manifest ischemic symptom involving multiple organs following their vascular disorder. Aortic dissection rarely occurs in association with ischemic CVD and in that case it is likely to be seen by neurologists. Aortic dissection and aneurysm deteriorate so suddenly that immediate diagnosis and proper treatment are needed.
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PMID:[Two cases of acute aortic disease complicated by ischemic cerebrovascular disease]. 1076 48

An aortic disease patient is typically an older male with a history of atherosclerosis and hypertension. He might have Marfanoid characteristics, a history of cocaine or methamphetamine abuse or history of syphilis. Alternatively, suspect dissection in a pregnant female with complaints consistent with possible aortic problems. During your assessment, zero in on the patient's anatomy. Include aortic phenomena in your differential for chest and back pain. Take blood pressures in both arms. Search the abdomen for pulsatile masses, and be wary of hoarseness and Horner's syndrome.
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PMID:If the bubble bursts.... EMS response to aortic aneurysms & dissections. 1184 62

Infected aortic aneurysms are uncommon, and only rarely have their surgical pathological features been described. Clinical and histopathologic features were evaluated in patients undergoing surgical repair of infected aneurysms of the descending thoracic or abdominal aorta over a 24-year period. Findings were compared with observations (primarily from autopsy studies) from the previous 25-year period (1950 to 1975) and other more recent reports. Of the 29 patients in our study, 79% were men, 90% had risk factors for atherosclerosis, and 72% had an identifiable risk or source of infection. Fever was present in 76%, and abdominal or back pain was seen in 66%. Among the 20 cases with an identifiable causative organism, staphylococcus accounted for 30%, streptococcus for 20%, salmonella for 20%, Escherichia coli for 15%, and other organisms for 15%. Aneurysms were saccular in 59% and infrarenal in 42%, and had a mean diameter of 5.6 cm. Microscopically, 6 patterns were recognized: acute inflammation superimposed on severe chronic atherosclerosis (55%), atherosclerosis with chronic inflammation (20%), acute inflammation without atherosclerosis (7%), chronic adventitial inflammation (7%), pseudoaneurysm formation (7%), and necrotizing granulomatous inflammation (4%). Special stains for organisms were positive in only 38% of the cases. Pathological findings of this series of surgical specimens spanning the fourth quarter of the twentieth century were not appreciably different from those described in autopsy series from the preceding years, although the causative microorganisms and agents used to treat them, preoperative diagnostic modalities, and surgical approaches have evolved.
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PMID:Surgical pathology of infected aneurysms of the descending thoracic and abdominal aorta: clinicopathologic correlations in 29 cases (1976 to 1999). 1534 14

Fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) has evolved from a research imaging modality assessing brain function in physiologic and pathologic states to a pure clinical necessity. It has been successfully used for diagnosing, staging, and monitoring a variety of malignancies. FDG-PET imaging also is evolving into a powerful imaging modality that can be effectively used for the diagnosis and monitoring of a certain nononcological diseases. PET has been shown to be very useful in the diagnosis of osteomyelitis, painful prostheses, sarcoidosis, fever of unknown etiology, and acquired immunodeficiency syndrome. Based on recent observations, several other disorders, such as environment-induced lung diseases, atherosclerosis, vasculitis, back pain, transplantation, and blood clot, can be successfully assessed with this technique. With the development and the introduction of several new PET radiotracers, it is expected that PET will secure a major role in the management of patients with inflammatory and other benign disorders.
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PMID:Evolving role of positron emission tomography in the management of patients with inflammatory and other benign disorders. 1549 8


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