Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The long-term acceptability of perindopril in mild-to-moderate chronic heart failure (CHF) was evaluated in a multicenter open study. A total of 320 patients with a mean age of 62 +/- 1 years and CHF of New York Heart Association (NYHA) class I (2 patients), II (204 patients), or III (114 patients) were included after a 2-week run-in period during which time vasodilators were stopped and diuretic and/or digoxin therapy stabilized. Perindopril treatment was started at 2 mg, increasing to 4 mg once daily after 2 weeks if supine systolic blood pressure remained > 100 mm Hg. After this dose titration period, follow-up visits were scheduled at monthly intervals for the first 3 months, then at 3-month intervals with a maximum period of follow-up being 30 months. At the time of analysis, mean duration of treatment was 276 days and 208 patients were treated > or = 6 months. Of the 320 patients, 10 (3.1%) died, 9 (2.8%) were withdrawn for worsening heart failure, and 38 (11.9%) for nonfatal adverse events, including cough (2.8%), dizziness or orthostatic discomfort (1.9%), angina pectoris (1.6%), and cutaneous signs (1.3%). Exercise test duration increased from 516 +/- 14 to 659 +/- 19 sec after 6 months of treatment (p < 0.01). At 6 months, 55.6% of patients improved by at least 1 NYHA class. Supine systolic blood pressure decreased slightly from 137 +/- 2 to 132 +/- 1 mm Hg (p < 0.01) and plasma creatinine levels remained stable from 100 +/- 2 to 102 +/- 2 mumol/liter after 6 months of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Acceptability of perindopril in mild-to-moderate chronic congestive heart failure. Results of a long-term open study in 320 patients. 832 69

It has long been recognised that patients with respiratory and cardiac disease suffer from symptoms during the night when they would normally be seeking respite. These disturbances include nocturnal dyspnea, cough, wheezing and angina. Until the advent of polysomnographic monitoring about 25 yr ago, however, the pathophysiology of these nocturnal disturbances remained elusive. Since that time, investigators have made significant advances in the understanding of the pathogenesis of many of these disturbances which will be briefly reviewed below. As the subject of this article is disturbances of sleep in patients who suffer from respiratory and cardiac disease, the sleep apnea syndromes which are unique to sleep, will not be discussed except as they may contribute to symptoms of respiratory and cardiovascular disease.
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PMID:Sleep disturbances in respiratory and cardiovascular disease. 844 82

Vascular hamartoma of the mediastinum is a rare benign vascular tumor. A 13-year-old girl presented with back pain, persistent coughing, palpitation, and angina pectoris. Preoperative investigations demonstrated an enlarging mass involving the superior mediastinum extending posteriorly (T6-T8). An encapsulated, 6x5x3 cm dark purplish mass adherent to the aortic wall was found. The main mediastinal mass was totally excised but limited resection was carried out in the paravertebral region. Microscopic examination revealed a vascular hamartoma.
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PMID:Vascular hamartoma of the mediastinum: a case report. 1077 Jun 89

Previous studies showed that increased QT dispersion (QTd) has been observed during episodes of myocardial ischemia or infarction and identify the patients at risk of arrhythmia or sudden death. The objective of this study is to investigate the relationship between coronary artery disease and QTd during the Valsalva maneuver. The study population included 85 subjects (21 with normal coronary arteries, 35 with stable angina pectoris, and 29 with unstable angina pectoris). Twelve-lead surface ECGs were recorded at 50-mm/sec paper speeds and were obtained before the Valsalva maneuver and during the strain phase. The results indicate a significant difference in mean time increase between the control group and the group with stable angina pectoris (mean difference = 16.10 milliseconds, p<0.000), and between the control group and the group with unstable angina pectoris (mean difference = 35.26 milliseconds, p<0.000). The mean difference in time between these groups was also compared (mean difference = 19.17 milliseconds), and was statistically significant (p<0.000). There are some conditions like constipation, severe coughing spells, nausea, vomiting, and carrying or lifting heavy objects that increase intrathoracic pressure and may increase QT dispersion. Therefore, all these conditions should be treated appropriately and carrying or lifting heavy objects is forbidden, especially in patients with coronary artery disease.
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PMID:Effects of Valsalva maneuver on QT dispersion in patients with ischemic heart diseases. 1171 25

Patients with a terminal illness, identified by palliative care teams working in Manchester, and patients attending a heart failure clinic, were asked to participate in a prospective survey to determine their main concerns. Data were collected from 213 palliative care (PC) patients (mostly with cancer) and 66 patients with heart failure (HF). The median ages of the two patient groups were similar, but the HF patients were more likely to be male and living with a partner; 13% of PC and 7% of HF patients reported that they had no carer. The PC patients had more district nurse, hospice, social work and physiotherapy input. The most frequently reported troublesome problems for PC patients were pain (49%), loss of independence (30%) and difficulty walking (27%). HF patients reported dyspnoea (55%), angina (32%) and tiredness (27%) as the most troublesome problems. From a checklist of symptoms, the frequency of tiredness (PC = 77%, HF = 82%) and difficulty getting about (PC = 71%, HF = 65%) were high in each group. Psychological problems were reported by 61% of PC and 41% of HF patients. Cardiac patients reported more breathlessness and cough than PC patients (83% vs 49% and 44% vs 26%, respectively). Reduced libido was more common in cardiac patients (42% vs 21%). Patient disclosure of troublesome problems to professional carers was high (>87% in both PC and HF patients). Documented action was greater for physical than social or psychological problems. For PC patients, documented action was recorded for 83% physical, 43% social/functional and 52% psychological problems. For HF patients documented action was recorded for 74% cardiac, 60% physical - non-cardiac, 30% social/functional and 28% psychological problems. Clearly many patients' troublesome problems were not being addressed. As a result of this study, specific action by health care professionals was taken in 50% of PC patients and 71% of HF patients. We plan to target specific educational events on the treatment of physical problems, psychological assessment and social service provision.
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PMID:The concerns of patients under palliative care and a heart failure clinic are not being met. 1205 45

Angiotensin II type 1 receptor blockers belong to a novel class of cardiovascular agents that is characterized by excellent tolerance. The overall rate of their side effects is similar to that of placebo. Specific nonproductive cough is much less common during treatment with angiotensin II blockers compared with angiotensin converting enzyme inhibitors. Nevertheless serious side effects very rarely occur with angiotensin II blockers and include cough, angioneurotic edema, anemia, liver damage, renal failure, aggravation of angina and migraine. The data of current literature concerning adverse effects of angiotensin II in different clinical situations are extensively reviewed. Angiotensin II type 1 receptor blockers are not considered to be safe in pregnancy, bilateral renal artery stenosis and severe renal or hepatic impairment.
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PMID:[Adverse effects of angiotensin II type 1 receptor blockers ]. 1249 95

In adults, several extra-digestive manifestations (cough, asthma, angina-like chest pain, ENT symptoms, dental erosions and even sleep disturbances) may be due to gastro-oesophageal reflux disease (GORD). In some cases, symptoms are triggered by an oesophageal reflex vagally mediated, while other symptoms are mainly related to the irritant effect of the refluxed material. The link with GORD is often difficult to establish because of the lack of typical digestive symptoms of GORD and of erosive oesophagitis in most of the cases. An empirical trial of double dose PPI therapy for 2 to 3 months can be done as the initial step in the diagnosis and treatment while oesophageal 24-hour pH monitoring is recommended by others to establish a temporal relationship between symptoms and reflux events. The optimal management algorithm remains to be determined. In some case, oesophageal luminal impedance monitoring could be useful to demonstrate a link between symptoms and a non-acid GORD. Traditionally, management of extra-oesophageal GORD manifestations relies on prolonged high doses of PPIs but the symptomatic efficacy of such treatment has been discussed recently. In case of adequate response, treatment can be tapered down to determine the minimal required maintenance dose. Anti-reflux surgery could be an alternative in some cases.
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PMID:[Extra-esophageal manifestations of gastroesophageal reflux disease in adults]. 1892 24

We encountered 2 incidental cases of invasive thymomas at Jordan University Hospital, Amman, Jordan; during routine coronary artery bypass graft surgery between 2005 and 2008 with an incidence of 0.6%. Both patients presented with angina pain. None of the 2 patients had pressure symptoms (cough, shortness of breath or superior vena cava syndrome) or Myasthenia Gravis symptoms. Total thymectomy with dissection of perithymic fat was performed on both cases. No radiotherapy was given. No recurrence of the tumor was seen in 2 years follow up. These cases are presented to emphasize the occurrence of this tumor.
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PMID:Incidental invasive thymoma during coronary artery bypass surgery. 1913 88

The cardiovascular diseases are among the main death causes in the developed world. They have been increasing epidemically in the developing countries. In spite of several alternatives for the treatment of the coronary artery disease; the surgery of the myocardial revascularization is an option with proper indications of medium and long-term with good results. It provides the remission of the angina symptoms contributing to the increase of the expectation and improvement of the life quality. Most of patients undergoing myocardial revascularization surgery develop postoperative lung dysfunction with important reduction of the lung volumes, damages in the respiratory mechanism, decrease in the lung indulgence and increase of the respiratory work. The reduction of volumes and lung capacities can contribute to alterations in the gas exchanges, resulting in hypoxemia and decrease in the diffusion capacity. Taking this into account, the Physiotherapy has been requested more and more to perform in the pre as well as in the postoperative period of this surgery. This study aimed at updating the knowledge regarding the respiratory physiotherapy performance in the pre and postoperative period of the myocardial revascularization surgery enhancing the prevention of lung complications. The Physiotherapy uses several techniques in the preoperative period; such as: the incentive spirometry, exercises of deep breathing, cough, inspiratory muscle training, earlier ambulation and physiotherapeutic orientations. While in the postoperative period, the objective is the treatment after lung complications took place, performed by means of physiotherapeutic maneuvers and noninvasive respiratory devices, aiming at improving the respiratory mechanism, the lung reexpansion and the bronchial hygiene. Respiratory physiotherapy is an integral part in the care management of the patient with cardiopathy, either in the pre or in the postoperative period, since it contributes significantly to a better prognosis of these patients with the use of specific techniques.
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PMID:Respiratory physiotherapy in the pre and postoperative myocardial revascularization surgery. 2208 84

Hiatal hernia (HH) is a frequent entity. Rarely, it may exert a wide spectrum of clinical presentations mimicking acute cardiovascular events such as angina-like chest pain until manifestations of cardiac compression that can include postprandial syncope, exercise intolerance, respiratory function, recurrent acute heart failure, and hemodynamic collapse. A 69-year-old woman presented to the emergency department complaining of fatigue on exertion, cough, and episodes of restrosternal pain with less than 1 hour of duration. Her medical history only included some episodes of bronchitis and no history of hypertension. The 12-lead electrocardiogram demonstrated sinus rhythm with right bundle-branch block. Laboratory tests, including cardiac troponin I, were within normal reference values. Chest radiography showed no significant pulmonary alterations and revealed in mediastinum a huge abnormal shadow overlapping the right heart compatible with a gastric bubble.The gastroscopy confirmed a large HH. A 2-dimensional transthoracic echocardiogram, using all standard and modified apical and parasternal views, revealed an echolucent mass, compatible with HH, compressing the right atrium. Also, it showed an altered left ventricular relaxation and a mild increase of pulmonary artery pressure (35 mm Hg). Spirometry showed a mild obstruction of the small airways, whereas coronary angiography showed normal coronary arteries. We concluded that the patient's symptomatology was related to the compressive effects of the large hiatal ernia, a neglected cause of cardiorespiratory symptoms. The surgical repair of HH was indicated.
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PMID:Large hiatal hernia at chest radiography in a woman with cardiorespiratory symptoms. 2263 6


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