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)

The diagnostic value of longterm ambulatory ECG recording (LTER) was determined in 63 patients referred for investigation of syncope, in 32 with dizziness and in 89 with palpitations. Among patients referred for syncope, dizziness or palpitations 8, 13 and 54%, respectively, had typical symptoms during the recording with concomitant arrhythmia explaining the symptom, and 6, 50 and 11% had a typical symptom without concomitant arrhythmia. In 12 and 3% of the patients referred for syncope or dizziness, respectively, arrhythmia was observed and probably explained their previous complaint, but no symptoms occurred during LTER. LTER was found to be of diagnostic value in 24% of the patients with syncope, in 66% of those with dizziness and in 65% of those with palpitations. In the latter two groups the presence of symptoms the week before the start of these recordings predicted the occurrence of symptoms during LTER. Only occasionally was there a higher yield of typical symptoms beyond 48 h of recording.
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PMID:Diagnostic value of longterm ambulatory ECG in patients with syncope, dizziness or palpitations. 270 15

Lyme disease, due to infection with Borrelia burgdorferi transmitted by ticks, is most frequently manifested by arthritis and neurological complications. In approximately 8% of cases, however, carditis, usually reflected in AV block, is the leading symptom. The case histories of 2 males and 1 female aged 23 to 37 years with AV block caused by Borrelia burgdorferi are presented. Main symptoms were exertional dyspnea, palpitations, dizziness and syncope. One patient was treated with diclofenac and two with penicillin. The course was uniformally benign and cardiac abnormalities disappeared within 1-3 weeks.
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PMID:[Atrioventricular block in Lyme carditis]. 271 Nov 58

Carotid sinus reflex hypersensitivity involves profound and intermittent changes in heart rate and blood pressure associated with symptoms of dizziness and syncope. This involves a reflex arc in which the main defect is believed to lie within the central nervous system. The discovery of classical and peptidergic neurotransmitters within the same neurone, and the presence of these peptides within the central nervous system raises the possibility that carotid sinus reflex hypersensitivity may be related to an abnormality of peptide distribution or function.
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PMID:Can central neuropeptides be implicated in carotid sinus reflex hypersensitivity? 273 93

Isosorbide dinitrate (ISDN) improves the clinical and hemodynamic state of patients with heart failure, but may cause dizziness and syncope. To characterize patients in whom cardiac output falls with high-dose nitrate therapy and to examine further the pathophysiology of the fall in cardiac output in these patients, we studies the effect of sublingual ISDN on forward cardiac output in 14 patients with severe cardiac failure (New York Heart Association grades 3-4). We examined systolic and diastolic left ventricular (LV) function from pressure and volume analyses of LV function. After administration of 15 mg ISDN, cardiac output was either unaltered or increased in 7 patients (Group 1) (11 +/- 12%, mean +/- SD), and decreased in 7 (Group 2) (-13 +/- 10%) (Group 1 vs. 2, p less than 0.002). Initial systemic arterial pressure, LV ejection fraction, wedge and LV transmural filling pressures were similar in both groups, but Group 2 patients had a lower systemic vascular resistance (p = 0.07) and tended to have a larger initial LV end-diastolic volume and increased end-diastolic compliance; following ISDN the decrease in LV filling pressure and end-diastolic volume was larger and the product of the changes greater (p less than 0.02). Thus ISDN decreases filling pressure and improves forward cardiac output in some patients with congestive heart failure, but large doses may decrease cardiac output in a subset of patients who have a lower systemic vascular resistance and a larger more compliant ventricle, maintaining forward blood flow predominantly by a preload reserve mechanism.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effect of isosorbide dinitrate on cardiac output in severe cardiac failure: relation to initial hemodynamics, ventricular volume, and the preload reserve mechanism. 279 73

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

This report reviews the gastrointestinal and central nervous system complaints and clinical course in 10 adult patients with abdominal epilepsy. Abdominal symptoms included paroxysmal pain, nausea, bloating, and diarrhea. Nervous system manifestations included dizziness, headache, confusion, syncope and transient blindness. Each patient had specific electroencephalographic abnormalities of a temporal lobe seizure disorder. Anti-convulsant therapy has resulted in the sustained abolition of symptoms in each case.
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PMID:The spectrum of abdominal epilepsy in adults. 280 81

To evaluate the feasibility and the utility of an integrated service for the pre-hospital diagnosis and care of cardiovascular emergencies a new pre-hospital intensive care system has been developed. Such an emergency medical service relies on the telephone transmission of ECG and the conversation between the first aid service and the cardiologist of the hospital coronary care unit. It also implies early therapeutic intervention performed at home under the responsibility of the chief physician of the referring centre. From March '86 to December '88, 311 telephone ECG transmissions were obtained; the home diagnosis and the consequent proper therapeutic regimen were considered sufficient to avoid the transportation of the patient to the hospital emergency room in 43% of the cases. The symptoms were: precordial chest pain (54%); palpitations (10%); dyspnea (8.4%); hypertensive crisis (1.3%), dizziness or syncope (12.3%). Pre-surgical or organ transplantation controls totaled 13.5%. One-hundred-forty-eight patients were admitted to the coronary unit because of an acute myocardial infarction between June and December 1988. Forty-seven patients were sent by the family doctor (group I) and 30 patients by the first aid service (group II) without any electrocardiographic diagnosis or home therapy; 14 patients were sent by the first aid service after a telephone transmission of ECG and early therapeutic intervention (group III); 57 patients reached the hospital independently (group IV). The following differences among the groups were observed: only the patients of group III received proper early therapeutic regimen at home, and 85% were admitted within 4 hours of the onset of symptoms (vs 46% of the patients of the other groups).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Integration of the hospital coronary care unit with the first aid service for the domiciliary treatment of cardiovascular emergencies]. 280 98

To identify and measure the incidence of adverse effects of the angiotensin converting enzyme inhibitor enalapril 13,713 patients were studied for one year by prescription-event monitoring. Precise information about the duration of treatment was available for 12,543 patients. The frequency of many events was calculated, including dizziness (483 patients; 3.9%), persistent dry cough (360; 2.9%), headache (310; 2.5%) hypotension (218; 1.7%), and syncope (155; 1.2%). Less common reactions included angioedema, urticaria, and muscle cramps. Altogether 1098 (8%) patients died and the notes of 913 of them (83%) were obtained for detailed scrutiny. With the exception of a few patients with renal failure who deteriorated during treatment (reported on separately), no death was attributed to enalapril. Enalapril was considered to be effective, even in patients with advanced cardiac failure. These results for enalapril are reassuring and provide further evidence of the value of prescription-event monitoring.
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PMID:Postmarketing surveillance of enalapril. I: Results of prescription-event monitoring. 284 1

Antianxiety agents' effects on the reported frequency of fainting, dizziness, loss of consciousness, and bone fractures were studied in a large ambulatory elderly population. The frequency of these symptoms in participants using seven different antianxiety drugs and that of a control group were compared. Dizziness and episodes of loss of consciousness and falls were reported more frequently in women using these drugs compared with controls (p less than 0.04 and p less than 0.01, respectively). There was an increase in reported bone fractures (12.1 percent to 9.4 percent) in women using antianxiety agents when compared with controls. All central nervous system symptoms were reported more frequently in participants using these drugs when compared with controls. This study suggests that chronic use of antianxiety agents in elderly patients may result in disabling central nervous system side effects.
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PMID:Antianxiety drugs and central nervous system symptoms in an ambulatory elderly population. 285 21

Terazosin is a post-synaptic alpha 1-adrenoceptor antagonist with a similar pharmacodynamic profile to prazosin. It differs from prazosin in having a longer duration of action, with an elimination half-life some 2 to 3 times that of prazosin, allowing the convenience of once daily administration. Moreover, its absorption from the gastrointestinal tract is more complete and predictable than that of prazosin which may facilitate dose titration. Terazosin therapy results in a significant reduction in blood pressure in patients with mild to moderate essential hypertension, with little influence on heart rate. The drug is an effective antihypertensive when administered as monotherapy or in combination with a range of antihypertensive agents including beta-blockers, diuretics and combinations of the two. In the few patients with congestive heart failure studied, terazosin produced an increase in cardiac output with a reduction in ventricular filling pressure and systemic vascular resistance, but no studies have been performed to assess the therapeutic potential of terazosin in this indication. Reductions in total plasma cholesterol and low density plus very low density lipoprotein cholesterol fractions have been reported after terazosin therapy, while high density lipoprotein cholesterol concentrations have tended to increase. Should such beneficial changes be confirmed in long term clinical studies they would suggest a therapeutic advantage of terazosin over some other antihypertensive drugs, particularly diuretics, which have been reported to adversely affect the plasma lipid profile. The most common side effects associated with terazosin treatment are dizziness, headache, asthenia and nasal congestion, but these are usually mild and do not require treatment discontinuation. Terazosin is normally administered once daily, starting at a dose of 1 mg/day and gradually titrating upwards as the blood pressure stabilises at each new dose, until blood pressure is adequately controlled or to a maximum dose of 20mg daily. First-dose syncope occurs rarely after terazosin, and can largely be avoided by giving the first dose at bedtime. Thus, terazosin offers a useful alternative to the drugs currently available for the management of mild to moderate essential hypertension either as monotherapy or in combination with other antihypertensive drugs.
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PMID:Terazosin. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in essential hypertension. 288 69


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