Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This 5-year follow-up study includes all patients (n = 934; 50% females) treated for self-poisoning in Oslo during 1 year. Seventeen percent were considered suicide attempts upon admission, 25% among the nonabusers and 8% among the abusers. At follow-up, 122 patients were dead (61% males). The mortality rate was highest among the abusers. The mortality rate was similar (13%) among those who were considered to be suicidal on admittance and those who were not. The causes of death were suicide (28%), opiate abuse (16%), heart disease (14%), accidents or wounds (11%), alcoholism (9%) and others (22%). The standard mortality rate was highly increased in all groups (8 times on average), highest among the female opiate abusers, whose rate was 63 times higher than expected. The increased suicide rates (87 times for females, 27 times for males), however, may be a more relevant measure of mental morbidity than the standard mortality rate. Logistic regression analysis demonstrated that male sex, age above 50 years and the lowest social group were factors on admission associated with death in the follow-up period. Age above 50 years and suicidal attempt on admission were associated with subsequent suicide. The study strongly supports the idea of self-destructiveness and slow suicide in substance abuse.
 ...
PMID:Suicide and other causes of death in a five-year follow-up of patients treated for self-poisoning in Oslo. 188 94

To examine effects of chronic alcohol abuse on left ventricular function, 162 otherwise relatively healthy alcohol abusers, having been admitted to a rehabilitation program, underwent cardiac evaluation including chest X-ray, electrocardiogram, and radionuclide angiography after 2 weeks abstinence. Twenty-nine of the 162 alcoholic subjects (18%) with left ventricular dysfunction were identified. Twenty-two had regional wall motion abnormalities, suggesting a localized process, of whom 12 also had depressed ejection fractions. Seven others had a depressed ejection fraction alone with a more global myopathic process. Only 4 of these 29 patients had any history suggesting prior heart disease. Two of the 29 had Q-waves greater than or equal to 0.4 s and 8 had an abnormal cardiothoracic ratio on chest X-ray. Chronic alcohol abusers appear to be at relatively high risk for left ventricular dysfunction; most of which is unrecognized. Routine screening methods failed to identify 85% of our subjects who later were recognized by radionuclide angiography. Since historical and electrocardiographic abnormalities are often absent in this population, detection of left ventricular dysfunction by other methods such as radionuclide angiography must be used.
 ...
PMID:Unrecognized left ventricular dysfunction in an apparently healthy alcohol abuse population. 193 63

This study includes 3000 patients undergoing MR imaging, all of them conscious, with no history of alcoholism, drug addiction, heart disease, or schizophrenia. During the course of the MR study, panic attacks occurred in 46 subjects, which prevented continuation of the examination. An IV bolus injection of diazepam was administered, which enabled completion of the examination in all 46 cases. The expected effects of a high blood level of diazepam, such as somnolence, slow reactions, overrelaxation, and inhibition of breathing, were not observed. The panic attacks disappeared rapidly after the injection. The patients agreed to a repeat MR examination under similar conditions, if necessary.
 ...
PMID:Panic attacks during MR imaging: treatment with i.v. diazepam. 211 78

Systolic left ventricular dysfunction is relatively common in even asymptomatic alcoholics, but whether diastolic function is also altered is much less well-studied. We used M-mode and Doppler echocardiography to study left ventricular size, mass, systolic function and diastolic filling in 32 alcoholics free of clinically detectable heart disease and in 15 healthy control subjects. Left ventricular mass index and posterior wall thickness were higher in alcoholics than in controls, but there was no statistically significant difference either in end-diastolic size or in systolic ventricular function. More abnormalities were found in the Doppler indexes of diastolic function, however. The alcoholics had a prolonged relaxation time (200 +/- 6 vs 184 +/- 5 ms [mean +/- standard error], p less than 0.05), a decreased peak early diastolic velocity (52 +/- 2 vs 60 +/- 3 cm/s, p less than 0.05), a slower acceleration of the early flow (410 +/- 18 vs 552 +/- 43 cm/s2, p less than 0.01), and a higher atrial-to-early peak velocity ratio (0.74 +/- 0.04 vs 0.60 +/- 0.05, p less than 0.05). This pattern of changes suggests a primary abnormality in the relaxation of the left ventricle. In multivariate analyses, the abnormalities in the Doppler indexes were independent of the duration of alcoholism, the quantity of the most recent ethanol exposure and the increased mass of the left ventricle. Impaired early filling of the left ventricle due to delayed relaxation is common in asymptomatic alcoholics and may in fact be the earliest functional sign of preclinical alcoholic cardiomyopathy.
 ...
PMID:Left ventricular filling impairment in asymptomatic chronic alcoholics. 225 94

The purpose of this study was to investigate, if besides the hypocontractility, which is the main finding in Primary Cardiomyopathy (PDC) there was some other mechanism in the development of heart failure and if this fact could influence in it's prognosis. We studied 13 patients with PDC in the hemodynamic cardiac laboratory from January 1982 to January 1988, these with systemic arterial hypertension. Coronary heart disease, myocarditis, primary valvular lesion, infiltrative disease, nephropathy, congenital heart disease, diabetes and alcoholism, were excluded. The control group was formed by 12 healthy subjects, which were studied for another purpose. We analyzed nine variables, including ejection fraction, peripheral vascular resistance, systolic and diastolic circumferential stress, left ventricular mass, left ventricular end diastolic and systolic volumes as well as force-velocity and force-fiber length relationship. The patients were followed up from 8 to 60 months (average 39 months). The cases with PDC were divided in two groups, "compensated" and "decompensated". The last ones with low ejection fraction and significantly increases systolic stress. We investigated which was the mechanism of compensation and decompensation through the force-velocity and force-fiber length relation. We found that compensation is associated with great increase of the after-load forces, the more end systolic volume at the end of the systole is not only controlled by the "force", but the decompensation is developed when the hypocontractility is added to the incompetence to compensate the after load. We found that the three deaths in this study had these hemodynamic characteristics, being the cause of death: the presence of heart failure in two patients and ventricular fibrillation in one.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Prognostic indexes in primary dilated cardiomyopathy]. 234 26

Heart failure is the final state of virtually all forms of primary or secondary heart disease. In this abnormal pathophysiological syndrome, a wide spectrum of clinical physiological cardiac states (congenital, valvular, rheumatic, hypertensive, coronary and cardiomyopathic) as well as some hyperkinetic circulatory/metabolic states leads to a low, normal or even high cardiac output--inadequate, however, in front of the requirements of the metabolizing tissues. In this revision article the A.A. successively consider the main causes of cardiac-circulatory failure, pointing out, at the end, the usefulness of recognizing the underlying and the precipitating causes of heart failure, in order to rapidly establish the appropriate therapeutic and preventive approaches. Four clinical cases are presented illustrating some of the underlying "treatable" causes of heart failure systemic hypertension, iatrogenic hypophosphatemia, chronic alcoholism and hemochromatosis.
 ...
PMID:[Congestive heart insufficiency as the end-stage of several nosologic entities]. 269 99

Foetal and neonatal consequences of exogenous intoxications are nowadays better apprehended especially regarding alcohol. Alcoholism during pregnancy is the cause of the syndrome of foetal alcoholism described in France by Lemoine in 1968 and then by Jones and Smith in 1973. The prevalence of the table is 1 out of 700 to 800 deliveries for the severe forms and concerns especially by not exclusively the most underprivileged sections of the population and shows in: -- a very specific dysmorphy of skull and face and other abnormalities which give to the face a singular and persistent aspect; -- various and frequent malformative abnormalities with a pronounced tendency for cardiopathy. Most of them are latent or of late discovery; -- a constant growth lateness which is also part of the table as well as prematurity and spontaneous abortion. Hypotrophy is moderate, total, and cerebral; -- effects on central nervous system: it is the third overall cause of mental lateness after trisomy and deficiency of neural canal. Other causes and themselves to alcohol to produce these effects that show themselves on badly affected children or dead in utero because of macroscopic and microscopic alterations of numerous cerebral structures. From a clinical view point, they show themselves by abnormalities of the neural canal, a decreasing of the crane perimeter, neonatal neurologic troubles due to deficiency in the first hours of life, followed during the second and third day by a table evoking a weaning syndrome. The evolution on a medium term is characterized by the persistence of the crane and skull dysmorphy modified by parents phenotype, a persistence of the growth lateness leading to dwarfism in the severe forms. In the moderate and medium form thinness and paleness are spectacular and malformations exist in 2/3 of the cases. The neurologic and behaving evolution is documented by some prospective studies. They tend to indicate the persistence for the severe forms of troubles concerning hyperactivity, lack of attention and decreasing of the crane perimeter as well as a main mental lateness in half of the cases. The study made in Roubaix shows that behaving and intellectual troubles are more pronounced when the dysmorphy is marked. The effects of alcohol lead to a syndrome of foetal alcoholism when the level of alcoholization is high which correspond to K. Sulik's experimental data in 1982. On the other hand, a relation dose-effect has not been yet demonstrated except for hypotrophy. This is the same for threshold-dose. There is no residual effects confirming that alcoholism and its intensity during pregnancy have a direct effect upon descendants. As a matter of fact after weaning and recovery children are again normal and normotroph. Pregnancy and especially delivery are privileged period for detection of maternal alcoholism and beginning of a prevention in a view to avoid. These effects during a later pregnancy.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:[Clinical aspects, epidemiologic progression of fetal alcoholism: a current daily problem]. 280 13

Denial of alcoholism is a serious obstacle to the successful treatment of an alcoholic. If clinicians can conceptualize and focus on this denial, they may be able to make more effective interventions with alcoholics. Denial in alcoholism, as in other illnesses such as cancer and heart disease, may encompass denial of the entire illness or only denial of some aspect, such as the loss of control over alcohol consumption. The Denial Rating Scale (DRS) has been developed to aid in the identification of denial of alcoholism, as well as to help specify which aspect of alcoholism is being denied. The present report describes the DRS and presents early reliability and validity data in support of its use. Preliminary interrater reliability is adequate, and construct and predictive validity appear promising. Several case studies were included to demonstrate the use of the scale.
 ...
PMID:A rating scale for alcoholic denial. 318 44

The ability to induce alcoholic cardiomyopathy has been tested in a variety of animal species. Myocardial alterations consistent with subclinical heart disease have been produced in many of these studies through a direct effect of ethanol or its metabolites upon the heart or a neurohumoral mechanism. In the rat most studies have, however, failed to finding diminished contractility in the basal state. In long-term animals the acute left ventricular responses to isoproterenol and calcium as well as pacing were reduced. Long-term studies in mongrel dogs fed 36 per cent of calories as ethanol produced an early decrease in left ventricular diastolic compliance related to interstitial collagen accumulation. Diminished contractility developed by four years. In addition to the morphologic evidence of distorted sarcoplasmic reticulum, in vitro experiments suggest important acute effects. Each mole of ethanol is bound tightly to each mole of protein comprising the Ca-ATPase pump, which is inhibited. Impaired uptake and binding of calcium by the sarcoplasmic reticulum has been observed in chronic alcohol models at one to two day intervals following the last exposure to ethanol. In addition, the flux of calcium ion does not appear normal in terms of access to contractile protein, where the calcium regulated inhibition of the troponin interaction with myosin is impaired. Experimental studies in a canine model of alcoholism revealed that the ventricular fibrillation threshold was moderately reduced in the basal state after 18 months and was diminished further after acute exposure.
 ...
PMID:Experimental models for studying the effects of ethanol on the myocardium. 331 64

Disopyramide is an oral antiarrhythmic drug which reduces conduction velocity, prolongs duration of action potential and the effective refractory period, and exerts vagolytic properties. The drug is usually well absorbed orally. The principal use of the drug is to suppress ventricular extrasystoles with usual oral dosage of 100 to 200 mg every 6 h, until blood levels of 2 to 4 micrograms/mL are attained. The use of the drug for suicide is uncommon as it is a prescription drug. Two cases of fatal disopyramide intoxication seen at the Los Angeles County Medical Examiner's Office will be discussed followed by a review of the literature of fatal suicidal disopyramide overdose. Case 1 was a 31-year-old male pharmacist with known history of depression and no history of heart disease. His decomposed remains were found with a suicide note and with several disopyramide tablets. At autopsy the blood level for disopyramide was 146 micrograms/mL. Case 2 is a 40-year-old male with history of alcoholism and prior suicidal attempts who regularly took disopyramide to control ventricular arrhythmias. He apparently ingested 36 100-mg tablets of disopyramide before his final collapse. At autopsy his blood level of disopyramide was 63 micrograms/mL.
 ...
PMID:Fatal disopyramide intoxication from suicidal/accidental overdose. 332 13


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