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

To evaluate the mechanism of sudden death in childhood and the physical activity levels at the onset of sudden death, we studied the following items: (1) the incidence and the circumstances surrounding sudden death at school in Kanagawa Prefecture, (2) high risk heart diseases detected among healthy school children by heart disease screening, (3) sudden cardiac death or near miss seen in outpatients with heart disease except congenital heart disease. Among total 15,156,346 school children, sudden death was observed in 97 subjects (M:77, F:20). Annual incidence of sudden death was 6.4 per 10(6). Of the 97 subjects, acute heart failure of unknown etiology was found in 60 (62%), cardiovascular disease in 18 (19%), cerebral vascular accidents in 14 (14%) and heat stroke in 5 (5%). Of the 78 subjects (M:64, F:14) considered as sudden cardiac death, 62 (79%) died during sports activities, and 16 (21%) died at rest. Of the 62 subjects, 29 died during track and field activities and 7 while swimming, both in physical education classes. Eighteen died during athletic club activities and 8 during extracurricular activities. Consequently, 54 subjects (87%) died in the presence of a school teacher. Of the 18 subjects with cardiovascular disease, 9 (hypertrophic cardiomyopathy in 3, myocarditis in 3, Kawasaki disease in 2 and long QT in one) were diagnosed initially by the autopsy study. Latent high risk heart diseases, detected among presumably healthy school children by the heart disease screening program, were the following: hypertrophic cardiomyopathy, long QT syndrome, Kawasaki disease and some arrhythmias (ventricular tachycardia, sick sinus syndrome, A-V block and atrial fibrillation). Follow-up observations of outpatients with heart disease revealed the same results as the heart disease screening program. In order to prevent sudden death at school, the following recommendations should be observed: 1) sports directors should learn "sports medicine in childhood", including primary cardiovascular resuscitation, 2) an accurate heart disease screening program should be operated to detect latent high risk heart diseases, advise on adequate medical treatment, and help ensure an appropriate selection of sports activities, 3) comprehensive autopsy studies should be performed.
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PMID:Sudden cardiac death in childhood. 263 28

When cardiovascular disease in women is considered, the cardiovascular physiology and diseases related to pregnancy are clearly unique, particularly to young women. Toxemia and its associated hypertension are the major cardiovascular disorders arising during and secondary to pregnancy and may well increase in prevalence as women undertake childbearing at older ages. Although its pathophysiology is unknown and its outcome may be grave to both mother and child, toxemia is preventable, treatable, and curable. This is unlike the three other forms of heart disease occurring in pregnancy discussed here. Aortic dissection, pulmonary hypertension, and peripartum cardiomyopathy are not preventable and are unpredictable, difficult to treat, and incurable. These latter disorders carry on indefinitely for the duration of the patient's life and seriously limit future options, including those for more pregnancies. Among the disorders of the heart in pregnancy, toxemia and peripartum cardiomyopathy are the subjects of especially active investigation at present. Major advances in understanding these disorders could minimize cardiovascular risk to the pregnant woman.
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PMID:Heart disease arising during or secondary to pregnancy. 264 40

The prevention of cardiovascular disease antedates our current preoccupation with risk factors for coronary heart disease and hypertension. Indeed, earlier preventive efforts have in part been so successful that many people have forgotten that they existed. The almost forgotten entity, beriberi heart disease, was first prevented in 1883 by Takaki of Japan. With diphtheria, it was the identification of the causative bacillus by Klebs in 1883, leading finally to the development of diphtheria toxoid by Ramon in 1923, which resulted in the disappearance of diphtheritic heart disease. Success in the attack on syphilitic heart and vascular disease began with Bordet and Gengou in 1901 with the discovery of the phenomenon of complement fixation, and with the formulation of Salvarsan by Ehrlich in 1907. The story of the prevention of rheumatic fever has a large cast of characters, but special recognition must be given to Coburn for his observations confirming the role of the hemolytic streptococcus published in 1931 and showing the prophylactic value of sulfanilamide published in 1939. The important association of maternal rubella with congenital heart malformations was revealed by Gregg in 1941. Alcoholic heart disease was identified particularly by Brigden and Evans in 1957 and 1959, respectively. In relation to coronary and hypertensive heart disease, the names of Anitschkow (1933), Leary (1935), and Keys (1948) in relation to diet, of Freis (1967) in the field of hypertension treatment, of White (1927) in relation to physical exercise, and of English, Willius, and Berkson (1940) and Hammond and Horn (1954) in the role of cigarette smoking, deserve special recognition.
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PMID:Background of the prevention of cardiovascular disease. II. Arteriosclerosis, hypertension, and selected risk factors. 266 Oct 54

In the previous discussion, emphasis has been placed on the detection of cardiac disorders that might lead to sudden death. Cardiac crises result from congenital structural defects in athletes aged 35 years or younger, and from acquired diseases in older individuals. Detection implies preparticipation screening, which, in order to be effective, requires considerable financial resources impractical for community-wide athletic programs. In young asymptomatic individuals, the prevalence of congenital heart disease is estimated at 0.5 per cent. Perhaps 1 per cent of these athletes has congenital lesions that could potentially result in sudden death and of these, only 10 per cent will, indeed, die suddenly. Identification of a group of 1000 athletes who have congenital cardiovascular disease of whom perhaps only one will die suddenly requires screening of 200,000 competitors. It is rather unlikely that any community would consider this type of undertaking economically feasible, especially considering that the most useful test for the younger age group, the echocardiogram, is also one of the most expensive. Noninvasive screening on an individual basis, in most instances, will identify those athletes at risk for sudden death if appropriate financial resources can be applied. History and physical examination, chest roentgenogram, 12-lead electrocardiogram, echocardiography, and exercise stress testing are useful tools in the recognition of those conditions associated with acute cardiac emergencies.
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PMID:Acute cardiac emergencies in the injured athlete. 266 80

Application of NMR technology to the evaluation of the cardiovascular system is still in its infancy. NMR can frequently yield information equivalent to echocardiography or angiography but cost, long imaging times, and lack of portability have discouraged widespread use. To date, NMR has not replaced standard imaging modalities in the evaluation of most cardiovascular disease states, although it appears to have a unique role in the delineation of great vessel pathology, the evaluation of congenital heart disease, and the delineation of cardiac and paracardiac masses. Appearance of tissue and flowing blood and contrast between structures are highly dependent on magnetic field strength and the imaging pulse sequence used. Published comparisons between NMR and other imaging modalities have to be interpreted and extrapolated with caution, and sensitivity and specificity of NMR imaging in different disease entities should be further validated. With technological improvements, shortening of examination times and data processing times and true three-dimensional imaging may be possible in the near future. Ultimately, however, the clinical importance of NMR will depend on the development of unique applications such as examination of regional cardiac metabolism, noninvasive coronary and peripheral angiography, myocardial perfusion imaging, and improved tissue characterization.
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PMID:Overview of cardiovascular nuclear magnetic resonance imaging. 267 Feb 30

Diabetes mellitus is a significant condition affecting major segments of all population groups studied. With the introduction of insulin and oral hypoglycemic therapy, and with better understanding of diet and weight control over the past half century, the primary causes of diabetic morbidity and mortality have shifted in varying proportions from metabolic derangements, infection, and renal insufficiency to different types of cardiovascular disease. Despite extensive clinical and laboratory research on the etiology, pathogenesis, and even the existence of cardiovascular disease associated with diabetes mellitus, however, considerable debate is still apparent in this field. Our purpose is to present an overview of the subject of diabetic heart disease, with a critical analysis of epidemiologic, clinical, and pathological data. Some of this material will be addressed from the perspective of research in this area over the past decade by one of us (SMF), particularly in experimental hypertensive and diabetic cardiomyopathy. However, overall, an attempt will be made to provide an objective and balanced analysis, in order to answer the question: does diabetic heart disease exist?
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PMID:Diabetic heart disease: the clinical and pathological spectrum--Part I. 268 Jan 99

Diabetes mellitus is a significant condition, affecting major segments of all population groups studied. With the introduction of insulin and oral hypoglycemic therapy, together with better understanding of diet and weight control gained over the past half century, the primary causes of diabetic morbidity and mortality have shifted in varying proportions from metabolic derangements, infection, and renal insufficiency to different types of cardiovascular disease. Despite extensive clinical and laboratory research on the etiology, pathogenesis, and even the existence of cardiovascular disease associated with diabetes mellitus, however, considerable debate is still apparent in this field. Our purpose is to present an overview of the subject of diabetic heart disease, with a critical analysis of epidemiologic, clinical, and pathological data. Some of this material will be addressed from the perspective of research in this area over the past decade by one of us (SMF), particularly in experimental hypertensive and diabetic cardiomyopathy. However, overall, an attempt will be made to provide an objective and balanced analysis in order to answer the question: does diabetic heart disease exist?
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PMID:Diabetic heart disease--Part II: The clinical and pathological spectrum. 268 60

Although the majority of American women believe that oral contraceptives can cause serious health problems such as cancer or heart disease, the scientific literature does not support these beliefs. Oral contraceptives actually protect against endometrial and ovarian cancer. The increased incidence of cardiovascular disease in oral contraceptive users, including myocardial infarction, appears to be caused by thrombosis and not atherosclerosis. The studies suggesting an increased risk of cardiovascular disease in oral contraceptive users were published in the late 1970s and therefore used a data base of women ingesting formulations containing 50 micrograms of estrogen or more. More recently published data involving healthy women taking mainly lower estrogen dose preparations suggest that there is no increased incidence of myocardial infarction or stroke. Nearly all published studies indicate that there is no increased risk of myocardial infarction in former users of oral contraceptives. Animal data actually suggest that oral contraceptives may have a protective effect against atherosclerosis, even in the presence of lowered high-density lipoprotein levels. The low-dose triphasic and monophasic formulations are effective, safe methods of contraception that can be used by most healthy women of reproductive age.
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PMID:Correcting misconceptions about oral contraceptives. 268 52

Coronary heart disease (CHD) is now recognised as a paediatric problem despite the fact that clinical symptoms of this disease do not become apparent until much later in life. Epidemiological studies of risk factors in children have now been conducted. These studies suggest that the risk factors for cardiovascular disease in adults, which include a family history of heart disease, elevated blood lipids (serum cholesterol and triglycerides), obesity, hypertension, smoking, diabetes mellitus and inadequate physical activity, can be identified in children. Several investigators have reported the existence of one or more risk factors in more than 50% of the children they have examined. It is now clear that we can detect most children who are potentially at risk for CHD. The notion of 'tracking' some of the most common CHD risk factors in children has been used in several studies. Results from this type of research indicate that children who are at the extreme end of the distribution and have high levels of blood pressure, adverse lipid levels and are obese will continue to exhibit these coronary risk factors as they grow. The research completed at present does not answer the question of whether children who exhibit a coronary-prone risk factor profile will exhibit this same profile at an age when one is most likely to develop the clinical manifestations of CHD. It does make sense, however, to identify those children who may be at risk for developing premature CHD and to initiate safe interventions such as behaviour modification, changes in diet and increases in physical activity. These have all been shown to alter risk factors which are associated with increased relative risk of CHD in adults. It should be noted that in adults regular aerobic exercise often may alter all risk factors for CHD, including hypertension and diabetes. Whether regular aerobic exercise will induce similar changes in children is not fully understood.
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PMID:The effects of exercise on coronary heart disease risk factors in children. 269 Feb 66

Coronary heart disease, a major cause of morbidity and death, is the leading cause of death in older women, with an incidence that approaches that in men of comparable age. Estrogen favorably alters lipid metabolism and should therefore diminish the risk for coronary heart disease in estrogen users. Epidemiologic data from case-control and prospective cohort studies have suggested that estrogen use may confer protection from cardiovascular disease and decrease all-cause mortality rates in postmenopausal women. Because the age-adjusted mortality rate due to heart disease among American women is approximately four times the combined mortality rate due to endometrial and breast cancers, even modest changes in the risk of fatal heart disease after estrogen use would dramatically impact the overall risk-benefit equation.
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PMID:Estrogen replacement and cardiovascular disease: serum lipids and blood pressure effects. 269 Jun 37


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