Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0012833 (dizziness)
 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Mitral Valve Prolapse (MVP) is a common cardiac disorder in our community. It is estimated that 4% to 15% of the general population have the anatomical defect of prolapsed mitral valve leaflets during ventricular systole. Patients with MVP that suffer from chest pain, dyspnea, fatigue, dizziness, syncope, palpitations, cardiac arrhythmias, anxiety, and panic attacks are diagnosed as having Mitral Valve Prolapse Syndrome. There is much controversy in the medical literature as to the causes of MVPS symptomatology. Some scientists believe that autonomic dysfunction, adrenergic, and vagal responsiveness are factors which appropriately explain the symptoms of MVPS. Pharmacological therapy, depending on the severity of the symptoms, is one option for treatment. Education on the etiology of their symptoms, instruction on lifestyle modifications, and reassurance from their physician are appropriate methods for the management of MVPS patients.
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PMID:Mitral valve prolapse. 186 Oct 97

A 66 year-old woman with chronic Chagas's heart disease, presented palpitations, dizziness and chest pain. The His bundle electrograms revealed sick sinus syndrome. The left cineventriculography showed apical and inferior aneurysms of mammillary morphological aspect.
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PMID:[Apical and inferior mammillary aneurysm in chronic Chagas cardiomyopathy]. 187 27

The purpose of this study was to clarify the difference of clinical and electrophysiologic characteristics between sustained ventricular tachycardia (SVT) and nonsustained ventricular tachycardia (NSVT). 40 patients consisting of 24 males and 16 females with an average age of 50.0 years (range from 19 to 83), who had shown ventricular tachycardia (VT) on electrocardiogram, were studied consecutively. The patients were divided into SVT group (19 cases) and NSVT group (21 cases). Ventricular stimulation was performed up to triple extrastimuli, and ventricular burst pacing was used when required. After VT was induced, R-R interval during VT was measured and an antiarrhythmic agent was given by bolus injection. Echocardiography was used for measurement of left ventricular ejection fraction (EF) and for evaluation of mitral valve prolapse (MVP). Palpitation and oppressive sensation were dominant in SVT (84.2%), while dizziness and syncope were prominent in NSVT (57.1%). Organic heart disease (OHD) was observed in only 42.1% of SVT, and in none of NSVT. MVP was observed in 6 patients of SVT and in 5 patients of NSVT. EF was significantly higher in NSVT (67.1%) than in SVT (56.9%) (p less than 0.02), while it was not significantly different in cases of NSVT and SVT where OHD was not present (64.4%). VT was induced and sustained in 17 out of 19 patients (89.5%) in SVT by ventricular stimulation. In NSVT, VT was induced in 6 of 21 patients (38.6%), but it was not sustained in any of them. The induction of VT in NSVT appeared to require more extrastimuli than in SVT. The R-R interval in SVT was longer than in NSVT (345.9 +/- 84.6 msec and 245.0 +/- 40.7 msec, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A study on clinical and electrophysiologic characteristics of ventricular tachycardia: comparison of differences on its sustenance]. 221 86

A sample of people aged 65 and over were interviewed at home and asked a series of questions aimed at identifying episodes of possible transient neurological dysfunction. During follow-up of respondents initially free from manifest cerebrovascular disease, no relationship was found between subsequent stroke and reported episodes of diplopia, transient numbness or weakness, non-rotatory dizziness or blackouts. There was an association of stroke with reported blurring or dimming of vision, statistically significant only for the sexes combined (relative incidence ratio 1.5), and a consistently increased risk in men and women reporting rotatory vertigo (relative incidence ratio 2.5). This relationship remained significant when adjusted for the association of rotatory vertigo with ECG evidence of heart disease. Thus rotatory vertigo is a risk factor for stroke but non-rotatory dizziness is not. Conversely a previous study of falling in the same population sample had shown an association with rotatory vertigo but not with non-rotatory dizziness.
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PMID:Transient neurological dysfunction and risk of stroke in an elderly English population: the different significance of vertigo and non-rotatory dizziness. 231 24

Key safety parameters of sotalol were examined in 1,288 patients entered into recent controlled trials of ventricular (85% of patients) or supraventricular arrhythmias (15%). Most patients were middle-aged male Caucasians with significant heart disease. The most serious adverse event was proarrhythmia, occurring in 56 patients (4.3%). Of these, 27 had hemodynamic compromise due to malignant ventricular arrhythmias. Most had a history of sustained ventricular tachycardia, myocardial infarction, congestive heart failure (CHF) or cardiomyopathy, or a combination of these. The other 29 had nonsevere events; 38% continued taking sotalol. Proarrhythmia was manifested by torsades de pointes in 24 of the 56 patients. No universal causal relation was found with commonly associated factors such as bradycardia, hypokalemia and long QT interval. The mean QT and QTc at baseline within 1 week of a severe proarrhythmic event were greater than those of patients not having proarrhythmia. Nineteen patients (1%) discontinued therapy with sotalol because of drug-related CHF. Predisposing conditions included low initial baseline ejection fraction, history of CHF, cardiomyopathy or cardiomegaly, or both, male gender and age greater than 65 years. Heart failure usually occurred within 7 to 30 days of initiating therapy. The most common reason for premature discontinuation of the drug in patients treated for sustained ventricular tachycardia was ineffectiveness (39%), whereas adverse effects were the most common reasons among patients treated for complex ventricular ectopy (21%). Dyspnea and bradycardia were the most common cardiovascular effects, and fatigue, dizziness and asthenia the most common noncardiac, adverse effects. Although frequently reported, these adverse effects resulted in discontinuation of only 1 to 4% of the patients at risk.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Clinical safety profile of sotalol in patients with arrhythmias. 240 37

Encainide is a class IC antiarrhythmic agent having little or no effect on action-potential duration or maximum diastolic potential but decreasing the maximum rate of phase O depolarization as well as increasing atrial and ventricular effective refractory periods. In intact animals or humans, encainide increases the AH, PR, QRS, and H-V intervals while not affecting the sinus node cycle length or JT interval. QT interval increases only by the concomitant increase in the QRS interval. Encainide is metabolized to O-demethyl encainide (ODE) and 3-methoxy-ODE (MODE), both of which are also antiarrhythmics with similar pharmacology to encainide. Encainide and its metabolites have little negative inotropic activity and ancillary pharmacology. Consequently, encainide has little or no effect on hemodynamic variables in patients with either normal or compromised cardiac function. The drug is well tolerated, with side effects being mainly those associated with its local anesthetic activity such as blurred vision and dizziness. Encainide is particularly effective in patients with excessive premature ventricular complexes (PVCs) and less so in patients with sustained ventricular tachycardia (VT). Like all antiarrhythmics, encainide may aggravate or precipitate new arrhythmias (proarrhythmia). The overall incidence of proarrhythmia is about 10%, with less occurring in patients with PVCs and more in those with sustained VT; also, the incidence of proarrhythmia is higher in patients with underlying heart disease. Encainide is also effective for the treatment of supra-ventricular arrhythmias, including atrial fibrillation, PSVT (both PAF as well as reentry of the nodal or W-P-W type), and ectopic atrial tachycardia. Its dosage and role in antiarrhythmic therapy are discussed.
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PMID:Encainide. 251 80

A 34 year old female had a history of dizziness and presyncope. She had many risk factors for atherosclerosis including smoking 30 packs of cigarettes/year, using oral contraceptives (OCs) for almost 10 years, somewhat elevated blood sugars, strong family history of heart disease and diabetes, and hypertension. During an examination in 1983, she had an elevated blood pressure in the right arm but a reading could not be found in the left arm. The physician heard a grade III rough, blowing systolic bruit over the right subclavian artery moving into the right carotid artery. Pulses of both carotid arteries were normal. Heart sounds were normal. While the right brachial and radial pulses were fine, there were none on the left side. Laboratory tests showed a serum cholesterol of 258 mg/dl, a fasting blood sugar of 92 mg/dl, a white blood cell count of 8400, and a normal differential count. The arch aortogram showed a 50-60% stenosis beginning at the innominate artery and a completely occluded left subclavian artery at its origin. Physicians performed an aortoinnominate bypass operation using a Dacron prosthetic graft. This operation alleviated the symptoms, but 2 years later she had bilateral dysesthesias in her upper arms and vertigo returned. Her right arm became more and more limp while her left arm did so mildly. The aortoinnominate graft and the left subclavian artery were occluded. Physicians did coronary angioplasty using the right transfemoral route and corrected both lesions in her brachiocephalic system. they used a technique which eased safe crossing of the occluded subclavian segment (covering the catheter tip with a J curve guidewire). Following the operation, the patient had superb brachial and radial pulses in both arms. Physicians advised her to discontinue using OCs and tobacco products. At months 1 and 5, the symptoms were gone and vital signs were fine.
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PMID:Percutaneous transluminal angioplasty for innominate artery stenosis and total occlusion of subclavian artery in Takayasu's-type arteritis. 256 38

Access to ambulatory electrocardiography would enable general practitioners to investigate certain patients with cardiac symptoms without the need for hospital referral. An analysis has been made of the results in 200 consecutive patients referred to a pilot open-access service based at three health centres. Twenty-two GPs used the service, although there was a wide range (1-48) in the number of patients each referred. In 72 patients aged under 50 years, abnormalities other than extrasystoles were detected in only six; major significant arrhythmias were found in three patients, although treatment was required in only one case. Arrhythmias were frequent in patients aged over 50 years but were usually minor; 16/128 (13 per cent) showed major significant arrhythmias. Pacemakers were implanted in two patients. Palpitation and/or dizziness were reported during the period of monitoring by 39 per cent of patients (and were equally common in both age groups), but in neither age group did these symptoms correlate with the occurrence of a significant arrhythmia. In primary care, palpitation and dizziness are rarely due to significant arrhythmias. To increase the cost-effectiveness of the service, ambulatory monitoring could be restricted to patients over 50 years of age, except when there is other evidence of heart disease.
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PMID:Ambulatory electrocardiography: an open-access service for general practitioners. 262 31

We examined the hypothesis that clinical presentation in patients with sustained ventricular tachycardia/fibrillation (VT/VF) predicts clinical, electrophysiologic (EP) findings and long-term outcome. We included in the study 121 consecutive patients seen in our EP laboratory with documented and inducible sustained VT/VF. Patients were categorized into three groups according to their clinical presentation: (1) cardiac arrest (CA)-53 patients; (2) syncope (S)-20 patients; (3) palpitations/dizziness (P)-48 patients. There were no significant differences in age, sex, or prevalence of underlying heart disease between groups. The left ventricular ejection fraction (LVEF) was significantly lower for patients with CA (mean +/- S.D.; 31 +/- 14%) or S (30 +/- 11%) when compared with P (39 +/- 15%) (p less than 0.05). Induction of VT/VF required a more aggressive stimulation protocol (three extrastimuli) in patients with CA (53%) when compared with patients with S (30%) or P (29%) (p less than 0.05). The cycle length of the induced VT was shorter for CA (239 +/- 64 msec) patients as compared with the S (294 +/- 67 msec) or the P (319 +/- 94 msec) patients (p less than 0.01). Polymorphic VT or VF was induced in 28% of CA patients, in 9% of S patients, and in 12% of P patients (p less than 0.05). There were significantly more sudden deaths observed during the 4-year follow-up interval in patients presenting with CA compared to the P group (p less than 0.05). The 4-year survival was 67 +/- 8% for P, 45 +/- 15% for S, and 45 +/- 10% for CA patients (N.S.).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Significance of the clinical presentation in ventricular tachycardia/fibrillation. 280 76

A data base of 1,245 patients treated for ventricular arrhythmias, most of whom had serious cardiac disease, was reviewed. Only 2.9% of these patients had benign ventricular arrhythmias without structural heart disease. The overall incidence of proarrhythmia in this population was 9.2% (115/1,245), but was as frequent as 16% in patients with a history of cardiomyopathy. The proarrhythmic form was new sustained ventricular tachycardia in 22 patients (1.8%). Only 2 of 71 patients (2.8%) with primary arrhythmia had a proarrhythmic event. The incidence has decreased markedly over the past years as reduced doses and gradual titration have been used. There were 137 deaths in the data base of which 82 were sudden, all in patients with advanced (79) or moderately severe (3) cardiac disease. High initial doses, prior myocardial infarction and congestive heart failure (CHF) were positively associated with sudden cardiac death. There were no deaths among the 71 patients with benign arrhythmias. Death rates were related to the severity of the arrhythmia being treated. Comparisons with published survival curves indicated modest improvement; in no case was survival decreased. Invasive and noninvasive measures of left ventricular function indicated no adverse hemodynamic effects. There was only 1 case of new and 3 cases of worsened CHF probably related to encainide. Only 5 patients discontinued for CHF or related signs and symptoms. The most frequent drug-related noncardiac adverse reactions were dizziness (26%), abnormal or blurred vision (19%), QRS interval prolongation (5%), taste perversion (4%) and tremor (3%). In conclusion, the use of reduced doses and gradual titration of encainide has markedly decreased the incidence of proarrhythmia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Safety of encainide for the treatment of ventricular arrhythmias. 309 26


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