Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In patients with valvar heart disease detection of coronary artery disease by conventional non-invasive methods may be difficult. The usefulness of thallium-201 exercise scintigraphy for detecting coronary artery disease was evaluated in 16 patients with aortic stenosis, 17 with aortic regurgitation, nine with mitral stenosis, and six with mitral regurgitation who were investigated by coronary angiography. Only two of 21 patients with greater than or equal to 50% coronary artery obstruction had normal thallium images. Three patients without angiographic evidence of coronary artery stenoses had perfusion defects demonstrated by thallium scintigraphy. Only one patient with greater than or equal to 75% coronary stenosis had a normal thallium scan. Angina pectoris or ST segment depression evoked by exercise test were not useful in distinguishing patients with coronary artery disease from those with normal coronary vessels. These data suggest that thallium exercise scintigraphy may be a useful non-invasive test for detecting coronary artery disease in patients with valvar heart disease.
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PMID:Detection of coronary artery disease by thallium scintigraphy in patients with valvar heart disease. 373 Feb 15

Three-dimensional transesophageal echocardiography is a new and evolving cardiac imaging technique. We reported our experiences of its clinical applications in 59 patients. A series of special temporal longitudinal views were selected by the frame grabber. Then the computer connected each digitized endocardial surface of the longitudinal views according to their spatial position and reconstructed the three-dimensional, cardiac shaded picture with gray scale. The three-dimensional transesophageal echocardiographic images were divided into three areas. The right area was right anterior to the esophagus and included such structures as the superior vena cava, right atrium, interatrial septum, and left atrium; the size, shape, and location of an atrial septal defect could be clearly shown. In the middle area the origin and the course of the two great arteries could be visualized, thus facilitating the diagnosis of transposition of the great arteries; in patients with obstruction of the right ventricular outflow tract, the circular ridgelike narrowing in the right ventricle was clearly visualized. In the left area the contour and size of the left ventricle and left atrium and the shape and point of coaptation of the mitral valve could be demonstrated; in patients with mitral valve prolapse, part of either leaflet protruded into the left atrium and appeared as a spoonlike depression in the mitral valve. Other entities subjected to three-dimensional transesophageal echocardiographic reconstruction included cor triatriatum, left atrial myxoma, aneurysm of sinus of Valsalva, dissecting aortic aneurysm, mitral stenosis, mitral regurgitation, and mitral valve prolapse.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Clinical application of three-dimensional transesophageal echocardiography. 803 6

Sixty-eight patients with valvular diseases (VD) were subjected to maximal, symptoms limited, exercise testing (ET) using a cycloergometer. The exercise was limited in 82% of the valvular patients by dyspnea attributed to pulmonary capillary pressure rising, even if in the 20 patients with mitral stenosis the relation between the effort intensity and mitral valve area (MVA) (echo) was absent (r = 0.26). Myocardial aerobic impairment (MAI) was absent in 17%, mild in 41%, moderate in 39% and severe in 3% of the patients with VD. It was considered overestimated, the effort being stopped, in 2/3 of the patients, before a heart rate of 85% of maximal heart rate (MxHR) was reached. This suggests that the patients with VD unlike coronary patients, still have a reserve of increasing MVO2 when exercise is stopped. Even in the above condition, the average difference between functional aerobic impairment (FAI) and MAI was 6% for NYHA I, 10.6% for NYHA II and 17% for NYHA III showing a physical deterioration in patients above the limit imposed by the valvular disease itself. ST segment depression of 1 mm or more at 0.08 s after J point was registered in 30% of the patients. Due to the insufficient rise of the heart rate (HR) in the majority (2/3) of the patients with VD, these data probably underestimate the myocardial ischemia. Consequently other stress testings whose main action is not the increase of HR and MVO2 i.e., dypiridamole and adenosine, are preferred in the investigation of myocardial ischemia in the patients with VD.
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PMID:Exercise testing in patients with valvular diseases. 808 7

An 80-year-old woman presented with an embolic stroke secondary to atrial fibrillation and mitral stenosis. She was initially on intravenous heparin and was subsequently maintained on oral warfarin. She was also given digoxin for atrial fibrillation and colchicine for gouty arthritis as well as fluvoxamine in her fourth week in hospital, to treat her depression. However, her INR (international normalised ratio) became markedly elevated within a week. Fluvoxamine and warfarin were stopped immediately. When warfarin was reintroduced 6 days later, her INR value increased again. The coagulation profile only became stable after 2 weeks of cessation of fluvoxamine. Low dose fluvoxamine can interact significantly with warfarin in the elderly and the effect may persist for up to 2 weeks of stopping the antidepressant.
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PMID:Interaction of fluvoxamine with warfarin in an elderly woman. 1056 Feb 76

Mitral valve stenosis can lead to a range of symptoms that affect daily life. As many of the people with this problem are elderly, the difficulties resulting from age can be exacerbated by illness. A pilot descriptive study was designed to examine the differences in anxiety, depression and functional capacity in women with mitral valve stenosis who were aged over 60 years when compared to a similar group of volunteers who did not have any cardiac disease. Measurement was undertaken using the Hospital Anxiety and Depression scale, the SF-36 Health Status questionnaire and the Functional Limitations Profile. Forty women were recruited to the study: 20 women with mitral valve stenosis and 20 volunteers. Each person was asked to complete the three questionnaires on one occasion only. Non-parametric statistics were used for analysis. Patients fared worse than volunteers with significant differences between groups in respect of anxiety (P = 0.03), depression (P = 0.02) and overall function (P < 0.001), but not in physical (P = 0.52) or mental health (P = 0.32). Future research could focus on strategies that would help alleviate anxiety and depression and improve functional capacity in older women with mitral valve stenosis.
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PMID:Anxiety, depression and functional capacity in older women with mitral valve stenosis. 1181 30

Symptom-limited cardiopulmonary exercise testing was performed in 37 patients with mitral stenosis (MS) without significant coronary artery stenosis to evaluate factors affecting ST depression in exercise electrocardiograms. The degree of ST depression was not associated with gender or exercise tolerance. The incidence of significant ST depression was higher in the patients receiving than in those not receiving digitalis (P < 0.05). In addition, the patients with atrial fibrillation and a higher heart rate response were more likely to have a high prevalence of significant ST depression than those with sinus rhythm and a lower response (P < 0.05). We concluded that atrial fibrillation, a higher maximum heart rate, and oral digitalis administration were involved in ST depression during exercise testing in patients with mitral stenosis without coronary heart disease.
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PMID:Factors affecting ST depression during cardiopulmonary exercise testing in patients with mitral stenosis without significant coronary lesions. 1509 Jul 1


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