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

The authors report a case of infectious spondylodiscitis revealing a staphylococcal endocarditis in a patient with a Carpentier aortic heterograft. This case, along with 60 descriptions from the literature, has enabled them to specify the characteristics of occurrence of endocarditis during a spondylodiscitis. The clinical factors in favor of this association are: a pre-existing cardiopathy, an oral port of entry, occurrence of other rheumatoid manifestations, even more the presence of complications of endocarditis. The laboratory factors in favor of an association are: discovery of an inflammatory anemia, of circulating immune complexes, of a cryoglobulinemia, of a rheumatoid factor, of hematuria. But it is mostly the demonstration of streptococcus in blood cultures and other samples that should be an indication to search for an endocarditis, the course of which dominates the prognosis.
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PMID:[Spondylodiscitis disclosing bacterial endocarditis. Apropos of a case. Review of the literature]. 266 Jul 30

Cardiovascular instability is the cause of almost 50% of postoperative complications and raises postoperative mortality far above that intraoperatively. The aged patient with pre-existing heart disease represents a high postoperative risk. These patients are very susceptible to hypoxia, anemia, hypovolemia, the negative inotropic effects of certain anesthetics, and increased oxygen consumption due to shivering. The reversal of anesthetic agents is also rather debatable in these cases. Hypertension and arrhythmias are common phenomena in the recovery room. They may be aggravated by a number of factors such as metabolic and respiratory imbalances, incorrect fluid substitution, pain, or excitation. The frequency of postoperative myocardial infarction (MI) depends upon pre-existing coronary artery disease and hypertension. A medical history of heart failure or previous MI also plays an important role hemodynamic course as do the surgical procedure and the intraoperative. Postoperative hemodynamic monitoring should be performed according to the standards suggested by the American Society of Anesthesiologists. Medical treatment basically consists of symptomatic therapy and the avoidance of risk factors. Specific treatment is rarely required.
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PMID:[Postoperative disorders of cardiovascular function]. 329 48

Serum erythropoietin levels were measured by radioimmunoassay in 146 children and young adults with congenital heart disease to assess the relationship between erythropoietin and clinical factors (heart failure, anemia, cyanosis) and hemodynamic variables affecting oxygen delivery and utilization. Erythropoietin values were in the normal range (10 to 30 microU/mL) in 73% (58 of 80) of the patients with and 82% (54 of 66) of those without cyanosis. Elevated erythropoietin values in cyanotic patients were associated with lower mixed venous oxygen saturation and tension than in cyanotic patients with normal erythropoietin levels, even though the degree of polycythemia was similar. In contrast, most of the acyanotic patients who had elevated erythropoietin levels were anemic. Of the blood oxygen measurements, mixed venous oxygen saturation and tension had the closest inverse correlation with erythropoietin values. The normal erythropoietin values in most patients are in accord with other observations that show that an elevation in erythropoietin level in response to hypoxia will be transient if it results in a rise in hemoglobin concentration "appropriate" to the degree of hypoxia. Persistent elevation of erythropoietin in patients with congenital heart disease may indicate harmful impairment of hemoglobin production that is potentially correctable.
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PMID:Serum erythropoietin levels in patients with congenital heart disease. 355 1

Among 195 patients with pulmonary embolism admitted to our hospital, three men and three women, 16 to 65 years old, developed a pericardial syndrome five to 15 days after the onset of pulmonary embolism and infarction. Other known causes of pericarditis were ruled out by clinical history and ancillary methods. The six patients had a pericardial rub, fever, anemia, leukocytosis, and increasing sedimentation rate; four had a pericardial effusion; two had a pleural effusion. One patient, with coexisting heart disease, died after another episode of pulmonary embolism; in the other five, oral corticosteroids induced complete remission of the pericardial syndrome. This type of pericarditis deserves wider recognition.
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PMID:Dressler-like syndrome after pulmonary embolism and infarction. 359 22

The diagnostic and prognostic features of 44 episodes of infective endocarditis in 42 children with congenital heart disease were reviewed. Endocarditis occurred in 18 patients who had not had surgical correction or palliation of the defect (non-operated group). There were 26 episodes in 24 patients who had been treated surgically (operated group) (16 open and eight closed cardiac operations). Endocarditis occurred soon after open heart surgery in eight patients and as a late complication in the other 16. It recurred in two patients (operated group). Invasive monitoring and low cardiac output were consistent features in those patients who had endocarditis soon after open heart surgery whereas dental treatment was a common feature in non-operated cases and after closed cardiac operations. Late cases of endocarditis after open heart surgery had various microbiological features that were not typical of infection after dental problems. Gram positive infections occurred in non-operated patients and in those who had had closed cardiac operations. The group that had open heart surgery had infections caused by Gram positive, Gram negative, and anaerobic bacteria and fungi. Fever, anaemia, leucocytosis, and positive blood cultures were the only consistent findings. Vegetations were seen in nine of 12 patients at cross sectional echocardiography. All 12 (four non-operated, one closed, and seven open cases) needed acute surgical treatment. The mortality from infective endocarditis was 17% for non-operated cases, 0% for those who had had closed heart surgery, and 50% for those who had had open heart surgery. Infective endocarditis after open heart surgery differs from that in the other subgroups in terms of microbiology, source of infection, and outcome and its early diagnosis depends on a thorough investigation of minimal symptoms and signs.
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PMID:Infective endocarditis in children with congenital heart disease: comparison of selected features in patients with surgical correction or palliation and those without. 362 Feb 43

In summary, a shift to the right in the O2-Hb curve in patients with anemia and decreased cardiac output and normal PaO2 will increase PvO2. This shift is mediated through increases in red cell 2,3-DPG. The stimulus for the increase in 2,3-DPG is most likely due to the decrease in SvO2. In hypoxemia caused by a decreased PAO2 (altitude), an increase in P50 may have no effect on PvO2 and in fact if the PaO2 is low enough, a left shift may increase the PvO2. Animals and man most successful at adapting to high altitudes reflect this fundamental physiological effect and have a left-shifted curve. This decrease in P50 is probably related to an intrinsic property of the hemoglobin and not to changes in 2,3-DPG. In hypoxemia caused by shunt, an increase in P50 increase the PvO2 regardless of the PaO2. Patients with congenital cyanotic heart disease have an increased P50 mediated through an increase in 2,3-DPG.
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PMID:Clarification of the effects of changes in P50 on oxygen transport. 391

Two children with congenital heart disease developed persistent fever, anemia, and hepatosplenomegaly. Both were shown to have intracardiac vegetations and evidence of infection with Coxiella burnetti. Thus, the same clinical manifestations of Q fever may develop in both children and adults.
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PMID:Chronic Q fever endocarditis with massive splenomegaly in childhood. 395 26

Blood from patients with erythrocytosis secondary to arterial hypoxemia due either to congenital heart disease or to chronic obstructive pulmonary disease was shown to have a decreased affinity for oxygen; the average oxygen pressure required to produce 50% saturation of hemoglobin with oxygen was 29.8 mm Hg (average normal, 26.3 mm Hg). Such a displacement of the blood oxygen equilibrium curve promotes the release of oxygen from blood to the tissues. Studies were also performed upon blood from a man with complete erythrocyte aplasia who received all of his red cells by transfusion from presumably normal persons. With mild anemia (hematocrit, 28%), the affinity of his blood for oxygen was slightly diminished (an oxygen pressure of 27.0 mm Hg was required to produce 50% saturation of hemoglobin with oxygen). With severe anemia (hematocrit, 13.5%), however, his blood had a markedly decreased oxygen affinity (an oxygen pressure of 29.6 mm Hg was required to produce 50% saturation of hemoglobin with oxygen). We conclude that patients with various conditions characterized by an impairment in the oxygen supply system to tissues respond with a diminished affinity of their blood for oxygen. Although the mechanism which brings about this adaptation is not known, the displacement of the oxygen equilibrium curve is associated with an increase in heme-heme interaction. The decrease in blood oxygen affinity need not occur during erythropoiesis, but may be imposed upon mature circulating red cells.
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PMID:Improved oxygen release: an adaptation of mature red cells to hypoxia. 566 14

The chest X-rays of 15 hypoglycaemic small-for-gestational-age infants showed cardiomegaly in 10 infants, 4 had heart failure. None of the infants had respiratory distress syndrome, congenital heart disease, septicaemia, anaemia or polycythaemia; infants of diabetic mothers were excluded. Cardiomegaly disappeared with the normalization of blood glucose in most of the cases. The cause of the cardiomegaly and heart failure might be related to insufficient cardiac energy substrates in small-for-gestational-age infants. This condition should also be considered in the differential diagnosis of cardiomegaly and heart failure.
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PMID:Cardiomegaly in hypoglycaemic small-for-gestational-age infants. 621 92

Thirteen children, aged 18 months to 14 years and presenting with sickle cell anemia and cardiomegaly (Cardiothoracic ratio greater than or equal to 0.55) were investigated by echocardiography and radio-isotopic measurement of the cardiac output. Eight children presented with one or several criteria of anemic cardiopathy: left ventricular dilatation and hyperkinesia, increased cardiac index. On the contrary, 2 children presented with left ventricular dilatation and decreased contractility, without increase in the cardiac index; 3 children presented with echocardiographic findings similar to those of controls and a normal cardiac index, which is unusual in cases with chronic anemia. These results show that the cardiovascular system of children with sickle cell anemia does not always behave as one would expect in chronic anemia. They also suggest the possible early occurrence of cardiomyopathy, as already described in adults with sickle cell anemia.
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PMID:[Sickle-cell cardiomegaly in children. Study of 13 cases]. 622 1


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