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)

Noninvasive carotid artery testing was performed in 73 patients with nonvalvular atrial fibrillation who were referred because of symptoms or signs of cerebrovascular disease. Thromboembolism related to atrial fibrillation without valvular heart disease was the probable source of cerebral ischemia in 25 (80%) of 31 patients with stroke and coexisting atherosclerotic disease at the carotid artery bifurcation in six (20%). Nonvalvular atrial fibrillation was the probable source of symptoms in nine (70%) of 13 of patients with transient cerebral ischemia, while coexisting carotid artery disease was present in four (30%). Nonvalvular atrial fibrillation accounted for the symptoms in four of five patients with amaurosis fugax, with atherosclerotic carotid artery disease present in one. The remaining 24 patients had nonhemispheric symptoms of cerebrovascular disease, including vertebrobasilar insufficiency, dizziness, and syncope, and only one had a carotid lesion. A significantly higher proportion of patients with focal hemispheric symptoms had coexisting carotid disease than patients with nonfocal symptoms had, suggesting that atherosclerotic cerebrovascular disease contributes to stroke in patients with nonvalvular atrial fibrillation. Noninvasive carotid artery testing may be helpful in identifying atherosclerotic lesions at the carotid artery bifurcation in patients with atrial fibrillation and cerebrovascular disease, because different therapeutic modalities may be appropriate when two potential sources of cerebral ischemia are present.
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PMID:Noninvasive evaluation of the extracranial carotid arteries in patients with cerebrovascular events and atrial fibrillations. 230 22

The value of echocardiography in the evaluation of dizziness was studied in 151 consecutive patients. Twenty-two patients, on further review, were found to have related complaints, seizures and syncope mainly, but not dizziness. Twenty-four patients had vertigo, 67 had nonvertiginous dizziness, and in 38 patients, there was insufficient information to categorize the dizziness as being vertigo or nonvertiginous dizziness. When the 22 nondizzy patients were compared with the 129 dizzy patients, the only statistically significant differences were that there were more blacks in the nondizzy group and that the aortic root dimension was, on average, 0.4 cm larger in the nondizzy group. These findings, although statistically significant, appeared to be clinically insignificant. There was, however, a high prevalence of valvular heart disease in both the nondizzy and two of the three dizzy subgroups. In most cases, the valvular abnormality had not been suspected clinically. But in no case was significant information added by echocardiography that helped in patient management. Thus, in the dizzy patient, echocardiography should be reserved for specific cardiac indications and not used as a routine screening test.
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PMID:Should echocardiography be used to screen dizzy patients? 317 55

Preoperative characteristics of 964 patients in the Veterans Administration Cooperative Study on Valvular Heart Disease undergoing single valve replacement were examined to determine predictors of operative mortality. The operative mortality rate was 8.3% in 661 patients having isolated aortic valve disease and 7.5% in 239 patients having isolated mitral valve disease, but 12.5% in 64 patients with multivalve disease undergoing single valve replacement. For the aortic valve replacement subgroup, three-vessel coronary artery disease, left ventricular systolic pressure, prior cardiac operation, body surface area, and cardiac index were related to operative mortality. In the mitral valve replacement group, there was a strong association of operative mortality with advanced age, exertional dizziness, reduced cardiac index, left ventricular contraction grade, ST segment depression on the resting electrocardiogram, and pleural effusion. The risk of operative death for an individual patient undergoing aortic or mitral valve replacement may be estimated with the use of independent risk factors.
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PMID:Clinical, hemodynamic, and angiographic predictors of operative mortality in patients undergoing single valve replacement. Veterans Administration Cooperative Study on Valvular Heart Disease. 357 98

The incidence of AF, the most common sustained arrhythmia in clinical practice, increases with age and coronary artery disease, hypertension and valvular heart disease are common underlying substrates; however, occasionally, AF may occur without any underlying heart disease. The most widely accepted theory of its mechanism is Moe's multiple wavelet hypothesis, although recent studies are helping to shed light on other mechanisms, including the focal origin of AF in some patients. Most patients experience palpitations, but fatigue, dyspnoea, and dizziness may also occur. Therapy includes prevention of thromboembolism, control of rate, and restoration and maintenance of sinus rhythm. The risks and benefits of each treatment modality need to be assessed according to each patient's circumstances. Unlike other arrhythmias, there is still no highly successful therapy for treating AF. However, significant advances are being made using non-pharmacological approaches to either prevent or cure this troublesome arrhythmia.
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PMID:Atrial fibrillation: epidemiology, mechanisms and management. 1089 90

The efficacy and safety of intravenous propafenone for conversion of recent-onset and chronic atrial fibrillation was assessed in 46 patients. 40 with atrial fibrillation associated with or without structural heart disease (mean age 63 +/- 14 years) and 6 patients with atrial fibrillation related to the Wolff-Parkinson-White syndrome (mean age 34.8 +/- 13 years). Propafenone treatment was administered at 2 mg/kg over 15 minutes under continuous electrocardiographic monitoring. In 28 of 32 (87.5%) patients with paroxysmal and/or recent-onset atrial fibrillation a stable sinus rhythm was restored within 1 hour after propafenone (mean 17 +/- 11 minutes) and in only 3 of 8 (37.5%) with chronic atrial fibrillation (p < 0.05). Conversion to sinus rhythm was obtained in 5 of 6 (83.3%) patients with atrial fibrillation related ventricular preexcitation, mean time 21 +/- 12 minutes. Propafenone had an additional effect reducing mean heart rate (141 +/- 21 to 102 +/- 15 beat per minute, p < 0.05) and the shortest preexcited R-R intervals was increased, mean 231.6 +/- 27.8 to 355 +/- 37.2 milliseconds (p < 0.001) in cases associated with ventricular preexcitation. Dizziness, hypotension and transient conduction disturbances occurred in only one patient with rheumatic valvular heart disease: EF 40%. Propafenone is an effective and safe antiarrhythmic drug for converting paroxysmal and/or recent-onset atrial fibrillation of various origins with a more limited efficacy in chronic atrial fibrillation.
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PMID:[Pharmacological cardioversion with intravenous propafenone in atrial fibrillation]. 1093 1

Between 1991 and 2013, we evaluated the demographics, presentations, and final diagnosis of patients hospitalized with acute cardiac events and left bundle branch block (LBBB). Of 50 992 patients, 768 (1.5%) had LBBB. Compared with non-LBBB patients, patients with LBBB were mostly older, female, diabetic, and had hypertension and chronic kidney failure (CKF; P < .001 for all). Dyspnea (P < .001) and dizziness (P = .037) were more frequent in patients with LBBB. The most frequent cause of admission with LBBB was congestive heart failure (CHF; 54.2%), followed by ST-elevation myocardial infarction (STEMI; 13.3%), valvular heart disease (9.4%), unstable angina (8.3%) and Non-STEMI (7.7%). On multivariate analysis, CKF (odds ratio [OR]: 2.02, 95% confidence interval [CI]: 1.09-3.70) and LBBB (OR: 2.96, 95% CI: 2.01-4.42) were predictors of in-hospital mortality in the entire study population. Further analysis of patients with LBBB showed that CKF (OR: 2.93, 95% CI: 1.40-6.12) was the only predictor of in-hospital mortality. Regardless the presenting symptoms, CHF was the final diagnosis in most cases with LBBB.
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PMID:Left Bundle Branch Block in Acute Cardiac Events: Insights From a 23-Year Registry. 2558 15

Introduction. Carcinoid tumors are rare neuroendocrine malignancies that secrete multiple bioactive substances. These bioactive substances are responsible for the carcinoid syndrome characterized by diarrhea, flushing, syncope, and right-sided valvular heart disease. Previous case reports have described carcinoid syndrome associated with coronary vasospasm and the well-characterized carcinoid heart disease. Case. Our patient is a 73-year-old female with complex past medical history most notable for metastatic carcinoid tumors diagnosed in 2013-05. She initially presented in 2014-09 with syncope and dizziness associated with sinus pause on an event monitor. She received a pacemaker given normal left ventricular function and was discharged. However, she was readmitted with similar symptoms corresponding to multiple episodes of ventricular tachycardia. She was started on high-dose beta blockade and has had no recurrence of arrhythmia over a follow-up period of 12 months. Conclusion. We hypothesize that the patient's ventricular tachycardia was mediated by the multiple bioactive substances secreted by her carcinoid tumors. Her carcinoid tumor biomarkers were elevated and other explanations for arrhythmia were investigated and ruled out. To our knowledge, this is the first case of ventricular tachycardia mediated by carcinoid syndrome and suppressed by beta-blocker. Further investigation into this relationship is needed.
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PMID:Carcinoid Syndrome-Induced Ventricular Tachycardia. 2708 17