Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

45 children with echocardiographically proven mitral valve prolapse are the basis to give a review about this syndrome (MVPS). Symptoms in this syndrome, like palpitations and fatigue are rare. Only half of the patients show the typical auscultatory findings: the midsystolic click and the late systolic murmur. The ECG abnormalities are disturbances of rhythm, left ventricular hypertrophy and left ventricular T-wave inversion. The hemodynamic is mostly normal or depends upon the degree of the mitral insufficiency. The angiocardiograms show often abnormalities of the contraction of the left ventricle. Echocardiographically one ought to obtain the pattern of the mid-systolic backward motion of the leaflet. As additional lesions we found in 11% of the patients with MVPS an ASD, in 16% an ASH or IHSS of different degrees corresponding to the echocardiographical sign of the ASH. The pathogenetic ideas of the valvular and myocardial theory are discussed. The prognosis is good. Complications are disturbances of rhythm, bacterial endocarditis and in case of a chordal rupture a mitral regurgitation.
 ...
PMID:[The mitral valve prolapse syndrome in childhood (author's transl)]. 55 79

Mitral valve prolapse (MVP) is due to a heterogeneous group of conditions that may affect the mitral valve or the mitral valve apparatus. Although MVP may progress later in life to frank mitral insufficiency requiring mitral valve repair or may predispose to bacterial endocarditis, in most cases it is a benign, idiopathic condition without serious consequences. However, many investigators have documented that MVP is often associated with a constellation of signs and symptoms, which appear to constitute a distinct syndrome. These associated findings include autonomic dysfunction, frequent complaints of chest pain, palpitations, orthostasis, fatigue, dyspnea on exertion and anxiety. Although the risk of significant myocardial dysfunction or bacterial endocarditis appears to be related to patient sex, age and the severity of valvular prolapse and insufficiency, there appears to be little or no relations between the extent of prolapse and the degree of autonomic dysfunction or the severity of symptoms of chest pain, palpitations, dyspnea on exertion and anxiety. The development of uniform diagnostic standards for mental disorders has helped to make it possible to identify several related entities, including generalized anxiety disorder, panic disorder and agoraphobia; patients with these disorders frequently somatize their anxiety and complain of many symptoms which may be seen in patients with MVP. Although several studies have reported an increased frequency of MVP in patients with anxiety disorders, recent studies suggest that the conditions are not linked. Iatrogenic cardiac neurosis is common in both groups of patients.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Mitral valve prolapse: from syndrome to disease. 332 70

The demographics and natural clinical history of canine congenital subaortic stenosis (SAS) were evaluated by retrospective analysis of 195 confirmed cases (1967 to 1991), 96 of which were untreated and available for follow-up evaluation. Of these, 58 dogs had left ventricular outflow systolic pressure gradients available for assessment of severity. All 195 dogs were used for demographic analysis. Breeds found to be at increased relative risk included the Newfoundland (odds ratio, 88.1; P < .001), Rottweiler (odds ratio, 19.3; P < .001), Boxer (odds ratio, 8.6; P < .001), and Golden Retriever (odds ratio, 5.5; P < .001). Dogs with mild gradients (16 to 35 mm Hg) and those that developed infective endocarditis or left heart failure were diagnosed at older ages than those with moderate (36 to 80 mm Hg) and severe (> 80 mm Hg) gradients. Of 96 untreated dogs, 32 (33.3%) had signs of illness varying from fatigue to syncope; 11 dogs (11.3%) developed infective endocarditis or left heart failure. Exercise intolerance or fatigue was reported in 22 dogs, syncope in 11 dogs, and respiratory signs (cough, dyspnea, tachypnea) in 9 dogs. In addition, 21 dogs (21.9%) died suddenly. Sudden death occurred mainly in the first 3 years of life, primarily but not exclusively, in dogs with severe obstructions (gradient, > 80 mm Hg; odds ratio, 16.0; P < .001). Infective endocarditis (6.3%) and left heart failure (7.3%) tended to occur later in life and in dogs with mild to moderate obstructions.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:The natural clinical history of canine congenital subaortic stenosis. 788 29

We report a 46-year-old man with bacterial endocarditis and cardiac failure, who developed status epileptics. The patient was apparently well until July of 1991 when there was a gradual onset of fever and general fatigue. He was hospitalized to the cardiology service of our hospital where diagnosis of bacterial endocarditis and aortic insufficiency was made. On October 9, 1991, he suddenly developed cardiogenic shock, and emergency replacement of the aortic valve was made; at the operation, the main trunk of the left coronary artery showed embolic occlusion, and the myocardial movement was markedly diminished; serum creatine kinase was 3.150 IU/l. His cardiac failure did not resolve, and renal failure developed in December 1991, for which peritoneal dialysis was necessary. On February 2, 1992, he suddenly developed a clonic seizure which started from his face with a transient post-ictal left hemiparesis; a cranial CT scan was unremarkable. He was treated with phenytoin and glycerol, however, he developed status epileptics on February 3; he developed cardiac arrest after the injection of phenytoin 750 mg. He was resuscitated, however, his status did not resolve. Neurological consultation was asked on February 4. On physical examination, his blood pressure was 80/40 mmHg heart rate 77/min and regular, and body temperature 39.1 degrees C. The palpebral conjunctiva were slightly anemic, however, the bulbar conjunctiva were not icteric. No cervical adenopathy was noted. Glade II systolic murmur was heard in the apex; the lungs were clear. The abdomen was flat and soft without organomegaly. No edema was present in the legs. On neurologic examination, he was comatose without response to painful stimuli. He repeatedly had convulsion lasting for 30 seconds every 2 to 3 minutes; his convulsions started with the conjugate deviation of the eyes to the left followed by turning of the head toward left, and then clonic convulsions started in this left upper limb extending to other extremities. The optic fundi were unable to visualize because of corneal clouding; light reflex was sluggish on the right side; no oculocephalic response was elicited; corneal reflex was also lost bilaterally. Extremities were hypotonic, and no automatic movement was seen. The triceps brachii reflex was diminished, but all the other deep reflexes were lost; no plantar response was elicited. Meningeal sign was absent. He was treated with intravenous diazepam; the interval of convulsions prolonged, however, blood pressure dropped to 40 to 40 mmHg. On February 4, intravenous thiopental anesthesia was instituted, and assisted respiration was started.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:[A 46-year-old man with cardiac failure and statues epileptics]. 794 26

Mitral valve prolapse is a pathologic anatomic and physiologic abnormality of the mitral valve apparatus affecting mitral leaflet motion. "Mitral valve prolapse syndrome" is a term often used to describe a constellation of mitral valve prolapse and associated symptoms or other physical abnormalities such as autonomic dysfunction, palpitations and pectus excavatum. The importance of recognizing that mitral valve prolapse may occur as an isolated disorder or with other coincident findings has led to the use of both terms. Mitral valve prolapse syndrome, which occurs in 3 to 6 percent of Americans, is caused by a systolic billowing of one or both mitral leaflets into the left atrium, with or without mitral regurgitation. It is often discovered during routine cardiac auscultation or when echocardiography is performed for another reason. Most patients with mitral valve prolapse are asymptomatic. Those who have symptoms commonly report chest discomfort, anxiety, fatigue and dyspnea, but whether these are actually due to mitral valve prolapse is not certain. The principal physical finding is a midsystolic click, which frequently is followed by a late systolic murmur. Although echocardiography is the most useful mode for identifying mitral valve prolapse, it is not recommended as a screening tool for mitral valve prolapse in patients who have no systolic click or murmur on careful auscultation. Mitral valve prolapse has a benign prognosis and a complication rate of 2 percent per year. The progression of mitral regurgitation may cause dilation of the left-sided heart chambers. Infective endocarditis is a potential complication. Patients with mitral valve prolapse syndrome who have murmurs and/or thickened redundant leaflets seen on echocardiography should receive antibiotic prophylaxis against endocarditis.
 ...
PMID:Current management of mitral valve prolapse. 1145 36

Primary care physicians have often to provide care to elderly patients presenting with non specific general complaints such as anorexia, weight loss and fatigue associated with biological inflammatory tests (increased erythrocyte sedimentation rate, increased CRP, anemia of inflammatory origin). In elderly patients, inflammatory diseases of unknown origin are most often related to an infectious illness (particularly bacterial endocarditis or tuberculosis), a systemic autoimmune disorder (temporal arteritis, polymyalgia rheumatica or ANCA positive vasculitis) or a neoplastic process. A methodological clinical approach is discussed and the most valuable complementary tests are proposed.
 ...
PMID:[Clinical approach to inflammatory syndromes in the aged]. 1110 92

We report a case of multiple signal loss lesions detected by T2* weighted image associated with bacterial endocarditis. A 23 year-old woman, who had undergone surgical closure of ventricular septal defect at age 2, suffered headache and general fatigue after dental treatment. She was admitted to another institution, and examinations revealed bacterial endcarditis. She was transferred to our hospital, and underwent aortic valve replacement. After the valve replacement, CT revealed parenchymal hematoma in the left frontal lobe. CT angiography (CTA) and cerebral angiography (CAG) demonstrated an aneurysm at the distal branch of the left middle cerebral artery. T2* weighted image demonstrated multiple signal loss lesions, which were not revealed by CAG and CTA. We speculated that these signal loss lesions were thrombosed mycotic intracranial aneurysms. She underwent left frontotemporal craniotomy, and the aneurysm was resected. Mycotic aneurysms are rare neurovascular lesions but their mortality and morbidity are high, so careful follow-up examinations are required. T2* weighted image was useful to detect mycotic aneurysms and plan the surgical strategy.
 ...
PMID:[Case of specific MRI T2* weighted image associated with bacterial endocarditis]. 1880 Jun 33

We report a case of bacterial aneurysm complicated by severe infectious endocarditis. A 34-year-old man developed idiopathic fever and general fatigue persisting for a month. He was admitted to our institution, and examinations revealed severe bacterial endocarditis with vegetation at the mitral valve and mitral incompetence. Right after admission, he suddenly developed acute cardiac infarction and cardiac arrest due to occlusion of the coronary artery by emboli from vegetation of the mitral valve. After achieving a good recovery, magnetic resonance (MR) imaging demonstrated an unruptured bacterial aneurysm at the distal branch of the left middle cerebral artery (MCA) supplying the left parietal lobe 5 days after admission, and T2* weighted images demonstrated multiple signal loss lesions, which were suspected of being thrombosed bacterial micro-aneurysms or micro-vasculitis. Although there was a risk of aneurysm rupture, we decided to proceed with mitral valve replacement by an artificial heart valve made of carbon, and repeatedly observed an unruptured bacterial aneurysm by serial MR imaging and angiography. Due to the preceding cardiac surgery, we were able to completely cure the severe infection and prevent new embolic showers. Under administration of antibiotics, the bacterial cerebral aneurysm did not increase over a period of 4 weeks, and finally the aneurysm disappeared about 6 weeks after admission. Although the timing of treatment of an unruptured bacterial aneurysm and cardiac surgery for infectious endocarditis associated with a bacterial cerebral aneurysm are controversial, we think that proceeding with cardiac surgery and observing the unruptured bacterial aneurysm by repeated MR imaging and angiography under administration of antibiotics was an appropriate strategy in this case.
 ...
PMID:[A case of bacterial aneurysm complicated by severe infectious endocarditis]. 1966 40

A 28-year-old Cambodian man with a history of congenital heart disease presented with a 6-month history of increasing fatigue, night sweats, and weight loss. His surgical history included two Blalock-Taussig shunts, ventricular septal defect closure, and placement of a pulmonary valve conduit via a Rastelli procedure. Echocardiographic and cardiac computed tomographic studies revealed a vegetation in the pulmonary homograft. Blood cultures grew gram-negative rods that were eventually identified as Suttonella indologenes. The patient underwent a prolonged course of intravenous antibiotics, which was complicated by septic pulmonary embolism that clinically resolved. Bacterial endocarditis caused by aerobic gram-negative organisms is uncommon. The authors report the first case of S. indologenes endocarditis in a patient with complex congenital heart disease.
 ...
PMID:Pulmonary embolus caused by Suttonella indologenes prosthetic endocarditis in a pulmonary homograft. 2083 8

The patient was an 87-year-old man whose initial symptom was general fatigue and inappetence. His laboratory data revealed a rise in C-reactive protein (CRP) and white blood cell count (WBC), and CT scan showed suspicious pneumonia. Antibiotics were given to the patient, but his fever and laboratory data were sustained. Follow up examination revealed a high titer (107 U/ml) of myeloperoxidase specific anti-neutrophil cytoplasmic autoantibody (MPO-ANCA). He was diagnosed with MPO-ANCA associated vasculitis. Steroid pulse therapy was started. The patient's clinical symptoms and laboratory data thereafter significantly improved, but after one week the patient's symptom was aggravated and he died. An autopsy was performed, and necrotizing arteritis of the interlobular arteries were found in the kidneys. We found bacterial infective vegetation attached to the aortic valve. Infected thromboembolus and microabscesses were also found in many organs. We report a case of subacute microscopic polyangiitis associated with bacterial endocarditis.
 ...
PMID:[An autopsy case of microscopic polyangiitis associated with bacterial endocarditis]. 2085 21


1 2 Next >>