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

A new method for selection of the pacing mode in 60 consecutive patients with severe cardioinhibitory or mixed carotid sinus syndrome was prospectively validated. DDD pacing was preferred for 26 patients with: (1) the cardioinhibitory form and who had symptomatic pacemaker effect; (2) mixed type I form, (cardioinhibitory and vasodepressor) with symptomatic pacemaker effect, ventriculoatrial conduction or orthostatic hypotension; (3) mixed type II; or (4) severe bradycardia. VVI pacing was selected in the remaining 34 patients without these symptoms. During a 32 +/- 10 month follow-up period syncope and severe dizziness persisted in five patients in the VVI group (15%) and in three patients in the DDD group (12%). Symptomatic relief occurred in 87% (52/60) of patients. Minor symptoms persisted in 47% of the VVI group and 42% of the DDD group. No patient developed cardiac insufficiency or intolerance to pacing. During a 2-month duration a single-blind, randomized, cross-over study compared VVI and DDD pacing, 69% of the patients programmed from DDD to VVI suffered more frequent, severe, and intolerable symptoms. (1) Thirty four of 60 patients (57% of the entire group) in whom VVI pacing was satisfactory were identified prior to pacemaker implant. In the remainder, VVI pacing was contraindicated as it produced frequent side effects. (2) The preimplant predictive value that VVI pacing would be successful was 85% for those eventually receiving VVI pacemakers and the preimplant predictive value that VVI pacing would fail was 69% for those who underwent DDD implant.
 ...
PMID:Validation of a method for choice of pacing mode in carotid sinus syndrome with or without sinus bradycardia. 170 5

Cerebral hemodynamics were studied in eight nonpregnant women and 24 women in late pregnancy by internal carotid artery velocimetry with a 3.5-MHz continuous-wave Doppler system. Criteria for supine hypotensive syndrome were a mean blood pressure decrease of 15 mmHg and a 2-minute sustained increase in pulse of 20 beats per minute under postural change from the left lateral to supine position. Nonpregnant and normal pregnant controls not meeting these two criteria displayed decreases of 22.9 and 21.7%, respectively, in time-averaged mean peak velocity (mean velocity) in the supine position compared with the left lateral position. Five subjects with subclinical supine hypotensive syndrome who met one of the above criteria showed a 37.0% decrease in internal carotid artery mean velocity in the supine position. Two patients with supine hypotensive syndrome could not tolerate the supine position for more than 6 minutes, at which time internal carotid artery mean velocity fell below 10 cm/second, reverse flow was observed, and they complained of dizziness, nausea, and syncope. Internal carotid artery mean velocity in all women showed no change in the sitting position compared with the left lateral position. These results indicate that the supine position should be avoided in late pregnancy, especially by women with cerebrovascular complications.
 ...
PMID:Maternal cerebral hemodynamics in the supine hypotensive syndrome. 172 80

We reviewed the clinical characteristics and outcome of cases of acute myocardial infarction occurring from January 1, 1985, through December 31, 1987, in the population of a long-term care institution for the elderly. The total number of patients in the series was 43. Comparisons were made between those patients transferred to a general acute-care hospital and those who remained at the facility. The most common initial symptoms of acute myocardial infarction in 32 of 48 patients were, in order, dyspnea, dizziness or syncope, precordial pain, and abdominal pain. Nine (of 43) patients were asymptomatic. In the 14 (of 43) patients transferred to an acute-care hospital, cardiac failure, arrhythmias, and cardiogenic shock were much more frequent than among those retained in the long-term care facility. We concluded that a high index of suspicion for the diagnosis of acute myocardial infarction in the institutionalized elderly is indicated. Patients with mild infarction can be retained in long-term care institutions; resulting mortality from cardiac disorders should be low in adequately staffed and equipped long-term care institutions.
 ...
PMID:Acute myocardial infarction in a long-term care institution for the aged. 173 40

It is important to recognize patients with gastrointestinal bleeding who are at high risk of having angiodysplasia, because these patients should be evaluated by endoscopy rather than barium studies. Sixty-two clinical and epidemiologic parameters were compared between 47 consecutive patients bleeding from angiodysplasia and 47 consecutive controls bleeding from other lesions admitted to two university teaching hospitals from 1980 through 1989. This study demonstrated statistically significant differences between these two groups. The patients with angiodysplasia generally presented with symptoms and clinical findings compatible with hemodynamically well-compensated, chronic bleeding: they were more likely than other gastrointestinal bleeders to experience weakness or fatigue, less likely to experience dizziness or syncope, and less likely to be orthostatic or hypotensive. They had more prior admissions for gastrointestinal bleeding, particularly for gastrointestinal bleeding of undetermined etiology. They were more likely than other gastrointestinal bleeders to be smokers. Patients with angiodysplasia had a milder hospital course: they had fewer transfusions of packed erythrocytes, shorter hospitalizations, and a lower mortality. The in-hospital mortality of patients bleeding from angiodysplasia was 2.1%. Despite the futility of diagnosing angiodysplasia by barium studies, patients ultimately diagnosed as having angiodysplasia were more often initially evaluated by barium studies than the other gastrointestinal bleeders. The currently identified risk factors for bleeding from angiodysplasia should help to select which gastrointestinal bleeders should be evaluated initially by endoscopy.
 ...
PMID:Changing epidemiology of gastrointestinal angiodysplasia with increasing recognition of clinically milder cases: angiodysplasia tend to produce mild chronic gastrointestinal bleeding in a study of 47 consecutive patients admitted from 1980-1989. 173 98

Carotid sinus massage was carried out on 130 consecutive patients referred for investigation of dizziness, syncope or unexplained falls. Carotid sinus syndrome was diagnosed in 33 for whom no other cause of symptoms was identified. Right-sided hypersensitivity was more frequent than left-sided. Thirty per cent identified a prodrome before syncope and 30% had retrograde amnesia for the event. In 52%, symptoms were precipitated by head movement and in 48% by vagal stimuli. Seven described 'drop attacks' but symptoms were reproduced with carotid sinus massage during head-up tilt. Injuries, including fractured neck of femur, were sustained by the majority. Carotid sinus massage should be performed routinely on all elderly patients who have symptoms of unexplained dizziness, falls or syncope. Cardiac pacing relieves syncopal symptoms in those with a predominant cardio-inhibitory response and recurrent syncope.
 ...
PMID:Carotid sinus syndrome--clinical characteristics in elderly patients. 177 96

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.
 ...
PMID:Mitral valve prolapse. 186 Oct 97

To determine the implications of dizziness as a symptom in patients with syncope, we analyzed responses to a standardized battery of questions about dizziness in 121 consecutive patients referred for evaluation of syncope. Associations were sought between final diagnosis (dependent variable) and clinical predictor variables. Dizziness was found in 70% of the patients with syncope. Dizzy patients were younger (mean ages, 47 vs 56 years, respectively), more often female (75% vs 42%), and more likely to be assigned a psychiatric diagnosis. Multivariable logistic regression analysis identified young age and rotatory dizziness (vertigo) to be associated with a psychiatric diagnosis. Dizziness and syncope frequently coexist and in many cases may represent the same pathophysiologic process. A careful dizziness history may guide the initial evaluation of syncope patients in clinical practice.
 ...
PMID:Clinical significance of a dizziness history in medical patients with syncope. 187 67

The main symptoms of aortic stenosis (AS), angina pectoris, dyspnoea, and syncope/effort dizziness, are thought to reflect the severity of AS. This assumption is based on studies in relatively young patients, and may not apply to older age groups. Thus, in 100 consecutive adults (age 41-79 years) referred to cardiac catheterization with suspected AS, clinical and haemodynamic variables were assessed in relation to significant (less than or equal to 0.50 cm2 m-2) (n = 70) and nonsignificant AS (n = 30), and to symptoms. Prevalence of symptoms, functional class, and systolic murmur grade greater than or equal to 3, was similar in the groups. However, patients with significant AS more often had an abnormal second heart sound, electrocardiographic left ventricular (LV) hypertrophy with strain, severe echocardiographic aortic valve calcification, and increased LV wall thickness. Multivariate analysis identified an abnormal second heart sound, and aortic calcification grade, as independent predictors of significant AS. When the Doppler mean gradient was added to the analysis, it became the best predictor. Angina pectoris (n = 74) was related to coronary artery disease, but not to severity of AS. However, 31% of patients without angina also had coronary artery disease. Dyspnoea (n = 69) was only related to age, and syncope/effort dizziness (n = 26) was more frequent in women. Functional class grade was not related to severity of AS. Thus, in adults with assumed symptomatic AS, clinical symptoms do not predict severity of AS. Therefore, the decision for valve replacement should rely on Doppler assessment of the severity of AS. Furthermore, in adults with AS, coronary artery disease cannot be excluded without selective coronary angiography.
 ...
PMID:Clinical and haemodynamic features in relation to severity of aortic stenosis in adults. 162 99

Within a half-year period, we encountered six cases of patients harmed by the adverse effects of self-administered nitroglycerin--syncope, delayed definitive medical care, and the worsening of nonischemic symptoms. We therefore surveyed 112 patients after a remote myocardial infarction, and 121 cardiologists and internists, regarding the use of sublingual nitroglycerin. Of the physicians, 84 percent routinely prescribed nitroglycerin to patients after a myocardial infarction, and 79 percent of the patients had the tablets available (83 percent of these, at all times). Most patients used the tablets less than once per month, and 37 percent of the patients who always carried nitroglycerin had not used it at all during the preceding year. Although 89 percent of the patients claimed to know when to use the drug, 57 percent had used it or would use it for symptoms such as dizziness, rapid heartbeat, or presyncope. All patients having nitroglycerin claimed it relieved their symptoms, even if the relief was only partial, the time elapsed until relief could not be specified, and the symptoms were of a type unlikely to be relieved by the drug. We suggest that the practice of routinely prescribing nitroglycerin to patients after a myocardial infarction should be reassessed.
 ...
PMID:Defining the proper role for self-administered sublingual nitroglycerin. A survey of physicians and patients. 190 18

After one day of dizziness a 28-year-old man experienced a syncope on getting up. ECG revealed a 3 degrees atrioventricular (AV) block unresponsive to drug treatment. A temporary pacemaker was implanted. Erythema migrans 4 weeks before admission suggested Lyme carditis, and the diagnosis was confirmed serologically (ELISA increased polyvalently, IgM antibody titre 1:64, IgG antibody titre 1:512). On antibiotic treatment with amoxicillin (1 g three times daily) and prednisolone (initially 80 mg daily, with gradual dose reduction) the sinuatrial block regressed within 10 days. Holter monitoring still demonstrated occasional sinoatrial conduction disturbances for some days, until sinus rhythm was permanently re-established. This case illustrates that transitory AV block can be the sole manifestation of sporadic Lyme disease in Europe and should therefore be included in the differential diagnosis of any acute cardiac disease.
 ...
PMID:[Transitory AV block as a cardiac manifestation of Lyme disease]. 191 33


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>