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 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The causes, clinical indications and diagnosis and differential diagnosis of cardiac disorders which may lead to cerebral symptoms are illustrated on the basis of a review of the present day level of scientific research. Principally involved are cerebral ischaemias arising from cerebral embolisms or from reduction of cardiac output in cardiovalvular and myocardial disorders. The incidence of all embolisms of cardiac origin makes up 10% of all ischaemic cerebral infarcts, with auricular fibrillation, irrespective of its origin, mitral stenosis, myocardial infarct, mitral insufficiency and combined mitral valve defects, and, in younger patients, mitral valve prolapse, being, in this order of frequency, of primary clinical significance. The other cardiovalvular and myocardial disorders have, in comparison, a relatively low incidence of cerebral embolisms. Haemodynamically induced cerebral ischaemias frequently occur in the form of complications following acute cardiac arrest, in myocarditis and in case of primary cardiomyopathies resulting from cardiac insufficiency or complicating bradyarrhythmia. They are clinically apparent in the form of syncope, and other impairments of consciousness of various levels of seriousness with and without indications of cerebral origin, extending up to coma. In view of the high incidence of 25% of acute cerebral ischaemias in cases of cardiac disease, not only neurological but also detailed cardiological investigation is vital in all cases for a correct diagnosis and for the selection of a suitable course of treatment. Cerebral complications in bradyarrhythmia and endocarditis are discussed in the context of a review of the relevant literature together with consideration of their epidemiology, aetiology, pathophysiology and clinical profile. Pathological sinus-bradycardia, bradyarrhythmia absoluta, sinu-atrial and atrio-ventricular blockages, carotid-sinus and sick-sinus node syndrome, paroxysmal atrial tachycardia, AV-node tachycardias, and auricular fibrillation and flutter, taken as a whole, lead to cerebral complications affected patients in 5 to 10% of afflictions of the central nervous system occur in 50% of patients suffering from complete AV blockage and, at a not precisely definable frequency, in patients suffering from other bradyarrhythmias. In addition to transitory, uncharacteristic symptoms such as dizziness, vertigo, impairment of vision and balance, presyncope, syncope and Adams-Stokes syndrome dominate the clinical profile. Endocarditis, with an incidence of 0.01 to 0.05% in the overall population, results in central nervous system complications in 12 to 25% of cases on average.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Heart diseases as a cause of cerebral symptoms and syndromes]. 222 59

We studied six patients with atrial myxoma, 5 occurred in left atrium and one in the right atrium, the diagnosis was verified with echocardiogram and surgery, we determined the clinical, electrocardiographic and radiological differences between the mitral stenosis and myxoma. We found that patients with atrial myxoma have no history of rheumatic fever, the dyspnea was less severe of shorter and duration, patient had paroxysmal dyspnea. In contrast dizziness, faintness, hemiparesis and/or angina were the more frequent symptoms. A diastolic mitral snap was a very frequent finding, less frequent was the diastolic rumble no patient had pre-systolic murmur. The left atrium was generally not dilated and the left atrial appendage as well as the pulmonary artery were not prominent in chest X-Rays. The P wave in lead II was not more than 0.11 sec and the ventricular complex in VI did not show tall R ware. With the previous elements it is possible to suspect the diagnosis of left atrial myxoma. The diagnosis should, of course, be confirmed by echocardiography.
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PMID:[Clinical diagnosis of left auricular myxoma based on its echocardiographic and surgical verification]. 295 58

In a medical out-patient clinic, over a period of several years, atrial myxoma was diagnosed in four patients with ages ranging between 32 and 69 years. With the exception of one patient referred for assessment of ventricular premature beats, presentation was not primarily attributable to cardiac causes. In all patients, there was a latency period of years between the onset of symptoms and establishment of the diagnosis. The history of patients with atrial myxoma includes symptoms such as dizziness, syncope, transient cerebral ischemia, weight loss and malaise. The differential diagnosis may encompass consideration of neoplastic disease since laboratory findings can reveal evidence of an inflammatory reaction, accelerated sedimentation rate, anemia, abnormal electrophoresis, hypoproteinemia as well as elevated alkaline phosphatase. One patient had undergone numerous examinations to rule out the presence of malignant disease. Symptoms related to the cardiovascular system include exertional dyspnea, premature beats, tachyarrhythmias and nonspecific chest pain. Auscultatory findings are consistent with those of mitral stenosis. M-mode and two-dimensional echocardiography established the diagnosis in all patients and confirmed the usefullness of this examination technique in the assessment of patients in a general medical clinic.
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PMID:[Atrial myxoma in the patients of a general and internal medicine outpatient clinic]. 666 80

We present the case of a 72-year-old woman with permanent atrial fibrillation and contraindication to long-term oral anticoagulant therapy who underwent left atrial appendage (LAA) occlusion. A 24-mm Amplatzer Cardiac Plug (St Jude Medical) device was deployed. The inferior part of the external disc of the device appeared to be over the posterior leaflet of the mitral valve but no significant mitral stenosis or mitral regurgitation was detected before deployment. After the procedure the patient suffered several syncopes when she tried to stand up. A transesophageal echocardiography (TEE) was performed and no significant differences on the device position were detected, it was not possible to perform the TEE in a stand-up position due to the patient symptoms (hypotension, tachycardia, dizziness, and loss of consciousness). After discussion with the surgical team, surgical removal of the device and surgical exclusion of LAA was performed. The symptoms disappeared and the patient was discharged. In the best of our knowledge, this is the first time that recurrent syncope has been described as a complication of LAA occlusion.
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PMID:Recurrent syncope after left atrial appendage occlusion. 2504 97