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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Infective endocarditis is an uncommon manifestation of group B streptococcal disease. Seven cases of group B streptococcal endocarditis are reported herein. Another fifty-five cases published in the literature since 1962 are reviewed: the male to female ratio was 1.4:1. The average age was 53.8 years, and 45% of patients were 60 years of age or older. Two cases of nonsocomial endocarditis and two cases of polymicrobial endocarditis were identified. There were five cases of prosthetic valve endocarditis. Mitral and aortic valvular involvement were present in 48% and 29% of cases, respectively. Underlying heart disease was found in more than half of the cases. Rheumatic heart disease was the commonest underlying cardiac condition. Noncardiac underlying conditions included diabetes mellitus, alcoholism, pregnancy, intravenous drug abuse, and genitourinary disease. Onset was varied as was initial presentation of the disease. Large arterial thrombi were common. Overall mortality was 43.5%. Penicillin is the treatment of choice for group B streptococcal endocarditis. However, based on in vitro and in vivo studies as well as case reports, some authors feel that the combination of penicillin and an aminoglycoside is a superior regimen. Cephalothin or vancomycin are alternatives for patients who are allergic to penicillin.
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PMID:Group B streptococcal endocarditis: report of seven cases and review of the literature, 1962-1985. 351 20

Alcohol has been considered a cardiotoxin for over a century, but the pathogenesis and natural history of alcohol-related heart disease remains obscure. The diagnosis still rests on the coincidence of alcoholism and a dilated hypocontractile heart in the absence of any other cause of dilated cardiomyopathy. Advances have been made in our understanding of the effects of acute and chronic alcohol administration both at a haemodynamic and cellular level, and recent studies have indicated that preclinical changes in LV dimensions and function are common in alcoholics. It is not known whether clinical cardiomyopathy, which develops in only 1-2% of heavy drinkers, occurs because of genetic predisposition, or the presence of synergistic cardiovascular risk factors. Abstinence remains the mainstay of treatment, but the prognosis is poor after development of frank heart failure.
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PMID:Alcohol and dilated cardiomyopathy. 352 84

The Evatt Royal Commission Report on the Use and Effects of Chemical Agents on Australian Personnel in Vietnam has authoritatively rejected the substantive claims that were made by the Vietnam Veterans' Association of Australia about the adverse effects of exposure to phenoxy herbicides in Vietnam on the health of Vietnam veterans and their families. The Commission concluded that Vietnam veterans were not exposed to toxic levels of chemicals in Vietnam; that they are not at any increased risk of fathering children with birth defects, or contracting cancer; and that, although they have slightly higher rates of psychiatric disorder, heart disease, alcoholism and alcohol-related disease, these effects are unconnected with exposure to chemicals in Vietnam. The reasons for these findings deserve to be given the widest possible publicity. Only by doing so is there any prospect of dissolving the misapprehension that Vietnam veterans have been poisoned by herbicides.
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PMID:The Agent Orange controversy after the Evatt Royal Commission. 374 99

There is little evidence of autonomic dysfunction in PD, although autonomic disturbance was included in the original description by J. Parkinson. In addition, there are no data for de novo PD patients. We selected 14 de novo parkinsonians (seven men and seven women), aged 62.7 +/- 8.2 years, with mild disease (stage 1 through 2 on the Hoehn and Yahr's scale), without history of diabetes, heart disease, or alcoholism, and without neuropathy or orthostatic hypotension. Fourteen age- and sex-matched normal persons were controls. We found a highly significant difference in the respiratory sinus arrhythmias during deep breathing (p less than 0.01); the basal heart rate, the respiratory sinus arrhythmias during quiet breathing, and the Valsalva ratios did not differ statistically, however. In the absence of neuropathy and orthostatic hypotension and in the presence of normal Valsalva ratios, we believe that the abnormality found by us may apply only to parasympathetic dysfunction, perhaps at a central level. In addition, the abnormality seems to be independent of stage and therapy.
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PMID:Parasympathetic assessment in Parkinson's disease. 382 99

Peripartum heart disease is reviewed in the light of reports in the literature and personal experience from the University College Hospital, Ibadan. It is concluded that it is worldwide in distribution but appears most commonly in multiparous black women with a low socioeconomic background. The clinical features are the same as those of dilated cardiomyopathy, with the exception of cases from Zaria, northern Nigeria, where heart failure may be induced by high salt and fluid intake. The possible causes of peripartum heart disease are reviewed. Glomerulonephritis, toxemia of pregnancy, and malnutrition have not been shown convincingly to be causal, and infection, hypertension, and alcoholism have been suggested. Hypertensive heart failure and toxemia of pregnancy can induce peripartum heart disease. It is concluded that the myocardial disorder in peripartum heart disease is probably the same condition as dilated cardiomyopathy, and that infection may be an important element. However, diverse other factors may also play a part.
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PMID:Peripartum heart disease. 384 85

Chronic cigarette use is common in persons who habitually use other cardioactive agents that have been causally associated with heart disease. This study was undertaken to determine if cigarette use intensifies the abnormalities of myocardial function and composition observed in experimental alcoholism over an 18-month period. Young adult male beagles with tracheostomy were divided into four groups. There were 10 controls (group 1); 9 smoked seven cigarettes per day (group 2); 7 were fed ethanol as 20% of calories (group 3), and 6 received both ethanol and cigarettes (group 4). After a period of 18 months, left ventricular function was assessed under anesthesia. Heart rate, left ventricular end-diastolic pressures, and volumes (indicator dilution) did not differ in the four groups. An index of contractility derived by normalizing peak dP/dt for pre- and afterload was reduced significantly below the level of 2.41 +/- 0.7 cm/s in controls to 1.41 +/- 0.35 in group 2, 1.19 +/- 0.38 in group 3, and 1.28 +/- 0.17 in the ethanol cigarette group (each p less than 0.002). Arterial pressures were moderately elevated above group 1 in all three experimental groups without evidence of left ventricular hypertrophy. In contrast to smoking, which elicited no abnormalities of myocardial cation composition, ethanol reduced myocardial potassium and sodium in group 3 without a gain of water content. In group 4, no further decline of tissue cations was observed. Thus, cigarette use when combined with ethanol over a relatively long period produced no greater myocardial abnormalities than ethanol alone and may not be essential to the genesis of cardiomyopathy in alcoholics.
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PMID:Interaction of chronic cigarette and ethanol use on myocardium. 397 84

Although only about 2-3 percent of annual deaths are attributed to one of the four underlying causes linked to chronic alcohol use, research results suggest that the impact of alcohol is much greater. The recent issue of mortality multiple cause of death tapes from National Center for Health Statistics permit exploration of associations of chronic alcohol abuse with conditions coded as underlying cause of death and provide leads for case-finding. Data analysis is reported from certificates of resident deaths in the United States in 1978. There are 12 groups of underlying causes for which the percentage of pairings with chronic alcohol abuse ranges from 4-16 percent of the number of deaths from the underlying cause. Age, sex, and metropolitan status of residence are associated with a listing of chronic alcohol abuse among decedents of liver cancer, varicose veins, symptomatic heart disease, septicemia, and respiratory system disease. Planners concerned with secondary prevention can use these clues provided by logistic regression modelling as an aid in case-finding.
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PMID:The influence of alcohol abuse as a hidden contributor to mortality. 402 76

Early signs of alcoholic cardiopathy were studied spiroergometrically and electrocardiographically in 90 males, aged 25 to 40 years, with second-stage chronic alcoholism. A fairly high physical stress tolerance (600 kgm) was found in 75.6% of the patients. Some functional parameters (metabolic units, the "oxygen pulse" of exercise, oxygen debt liquidation time) were, however, disturbed in patients with a less than 5 years' history of the disease. In those cases where alcoholism had lasted for over 5 years, the aerobic reserve was more markedly decreased during exercise, while adaptation to exercise was delayed. Electrocardiographic changes brought out by exercise testing included the emergence of spiked and deformed P waves, a prolonged systolic index and extrasystole, and flattened T wave at rest, its duration showing a direct correlation to the magnitude of oxygen debt.
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PMID:[Early signs of alcoholic cardiomyopathy]. 408 77

Haemodynamic measurements before and after treatment are described in two patients with beriberi heart disease. The first patient had severe disease with a cardiac output of 17.3 litres per minute, which had returned to normal a month later. The second patient had moderate disease with a cardiac output of 7.4 litres per minute; a fall in this and a rise in systemic vascular resistance was found one and two hours after the intravenous injection of aneurine hydrochloride. The plasma pyruvate concentration was raised in the first patient but only slightly so in the second, in whom the pyruvate metabolism test was abnormal. The haemodynamic studies in both cases were of considerable help in making the diagnosis. The diagnosis of beriberi should be considered in any patient with heart disease who has a history of alcoholism, especially as prompt vitamin treatment is curative.
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PMID:Beriberi heart disease in London. 582 83

Massive cardiomegaly (heart weight above 400 g in females and 450 g in males) was studied in 26 Zambians examined post mortem. The aetiologies found were: hypertensive heart disease alone in six cases; hypertensive and alcoholic heart disease in two cases; alcoholic heart disease alone in five; alcoholic and pulmonary heart disease in one; alcohol with possible hypertensive heart disease in one. Eleven cases were classified as being idiopathic mainly due to lack of data and in five of these hypertension was suspected as being the cause. The series qualitatively represented the spectrum of non-rheumatic heart disease seen in patients admitted to the Central Hospital, Ndola, Zambia. Hypertension had a central role in the causation of massive cardiomegaly. Follow-up of several patients enabled observations on the cardiac effects of hypertension and alcoholism operating simultaneously and on the relationship between hypertension and congestive cardiomyopathy.
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PMID:Cardiomegaly in Northern Zambia: clinico-pathological observations. 622 32


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