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

The prevalence of stroke was investigated in a Finnish population study. The results were based on cross-sectional data from a follow-up examination of a prospective study conducted in 1973-1976. The study population drawn from four regions of the country comprised 11,103 men and 11,096 women aged 20 years and over. The age-adjusted prevalence of stroke was 10.3/1000 in men and 5.8/1000 in women. The prevalence was significantly higher in non-attendants at the examination than in attendants. In 15 per cent of the prevalence cases the stroke was caused by subarachnoid hemorrhage, in six per cent by cerebral hemorrhage and in the remainder by cerebral infarction or the type could not be specified. Over half (57 per cent) of the survivors of stroke had no or only slight disability; eight per cent were totally disabled. Some form of organic heart disease and hypertension was significantly more common in the prevalence cases than in the others.
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PMID:Prevalence of stroke in Finland. 373 52

In a retrospective study the reports of 211 cases of cardiogenic cerebral embolism--diagnosed on the base of neurological and cardiological findings--were analyzed in view of signs and findings of prognostic value. There were 21 patients with TIA, 39 cases of RIND and 151 patients with cerebral infarction, 60 of which showed mild and 91 severe neurological symptoms. 38 patients died during the period of hospitalization. While sex of the patients as well as vascular risk factors (hypertension, diabetes mellitus, cigarette smoking) did not influence the clinical course of the disease, patients with TIA or RIND in general were younger (about 5 years) than those with severe stroke. Prognosis of cardiogenic cerebral embolism depended to a great degree on the underlying heart disease. Cerebral embolism after myocardial infarction showed a better remission of symptoms than embolism in atrial fibrillation. In the group of valvular diseases the course of embolic strokes in mitral lesions was worse than in aortal valve disease. Prognosis was worst in endocarditis, both in view of neurological deficit and of mortality. Mostly, the cardiogenic emboli lead to infarctions of the middle cerebral artery territory (78 per cent) with a predilection for the left hemisphere. In media-syndromes the clinical course was significantly worse in patients with additional homonymous visual defect compared to incomplete infarctions. Initial disturbance of conscience reduced prognosis quoad vitam et restitutionem significantly. Of the neuroradiological findings, the detection of arterial occlusion or circulatory disturbance in angiography as well as the finding of an ischemic lesion in computed axial tomography (CAT) was correlated with a severe course of the embolic stroke. While 7 patients with hemorrhagic infarction in CAT-Scan showed no differences in the clinical course, the 14 patients with pathological cerebral spinal fluid findings in embolism had an unfavourable prognosis. The development of epileptic seizures did not influence the further course of the infarction to a significant extent. Results are compared with the current world literature.
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PMID:[Prognosis of cardiogenic cerebral embolism]. 374 66

We evaluated factors affecting mortality and quality of life in 1,013 patients with acute stroke followed for 2 to 8 years. In cerebral infarction, the major determinants for short-term mortality were impaired consciousness, leg weakness, and increasing age. The major determinants for long-term mortality were low level of activity at hospital discharge, advanced age, male sex, heart disease, and hypertension.
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PMID:Prognosis of acute stroke. 380 2

Hypertension, heart disease, and diabetes are not only the major risk factors for stroke, but they tend to cluster in families. It is unknown, however, whether these conditions occur more frequently among relatives of patients with specific types of stroke as compared to non-relatives. The frequencies of stroke and its major risk factors in two groups of subjects were compared. One group consisted of 76 siblings of 41 patients hospitalized with cerebral infarction and transient ischemic attacks in an investigative stroke unit; the other consisted of 55 siblings of the patients' spouses. The occurrence of these conditions in the relatives was determined from a questionnaire completed by the relatives and supported by information from the relatives' family physicians. When considered separately, hypertension, heart disease, and stroke occurred in a small but not statistically significant excess among the relatives in-law. However, various combinations of two or three diseases, (including diabetes), occurred in 20.9% of the patients' siblings as compared to only 3.6% of the relatives in-law (p less than 0.001). These results suggest that living siblings of patients with cerebral infarction and transient ischemic attacks may have an increased risk of stroke and cardiovascular disease as a result of multiple risk factors operating simultaneously. Prevention programs among this high risk population may be particularly worthwhile.
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PMID:Aggregation of multiple risk factors for stroke in siblings of patients with brain infarction and transient ischemic attacks. 381 Jul 26

For a clear definition of the influence of cardiac disorders on the development of cerebrovascular diseases in the Japanese, we reviewed 1,162 consecutive autopsy records aged 20 years and over in the Department of Pathology, Kyushu University, Japan. All autopsies had been done between Nov. 1971 and Oct. 1981. Cerebral infarction was found in 101 out of 196 with any type of cardiac disorder. Frequencies of cerebral infarction in those with myocardial infarction, rheumatic heart disease, non-bacterial thromboendocarditis, and atrial fibrillation were higher than in those with no heart disease. These differences can be ascribed to the higher incidence of large and medium-sized cerebral infarction, including many cases of cerebral embolism originating from the heart. Only 3.4% of those with small cerebral infarction were assessed to be cases of embolism. Non-embolic cerebral infarction was more frequently noted in those with myocardial infarction and atrial fibrillation than in those with no heart disease. These differences were probably linked to concomitant progression of arteriosclerosis of the cerebral and coronary arteries. In this consecutive autopsy study, cerebral embolism was found in 35 cases, 10.9% of the total number of those with cerebral infarction.
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PMID:Cardiac disorders predisposing to development of cerebrovascular diseases in the Japanese. Data obtained at autopsy. 402 40

The observation of apparent dural sinus opacification in a polycythemic patient with cerebral infarction prompted a review of 300 computed tomographic scans for the significance of dense dural sinuses. Fifteen patients including 11 neonates, were identified; each of them had dense dural sinuses and elevated hematocrit or red blood cell indices or both. With only one exception, computed tomography also showed various low attenuation parenchymal abnormalities. A typical cerebral infarction pattern was seen in six and parenchymal hemorrhage in one. Nonthrombotic dural sinus opacification is a sign of increased blood viscosity in patients with congenital heart disease, hemoconcentration states, polycythemia of the newborn, and polycythemia rubra vera. These patients are at high risk for hypoxemic cerebral insult, which can be detected by cranial computed tomography.
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PMID:Radiodense dural sinuses: new CT sign in patients at risk for hypoxemic insult. 679 79

Two patients with cyanotic congenital heart disease (CHD) and erythremia were seen for abrupt onset of focal neurologic deficits and/or seizure without signs of infection or increased intracranial pressure. Clinical features and initial computed tomography (CT) in both cases suggested stroke. Subsequent CT scans demonstrated cerebral abscess, proved at operation. Review of records of patients with CHD at the University of Rochester (NY) Medical Center from 1965 to 1981 disclosed 12 cases with brain abscess but only two cases with aseptic cerebral infarction. All but one patient with abscess were cyanotic. One third of patients with abscess had a clinical picture suggesting stroke. Clinical or radiologic features of half the cases indicated that cerebral infarction may have led to abscess formation. Diagnosis of brain abscess and immediate antibiotic therapy should be strongly considered in patients with cyanotic CHD who suffer a suspected cerebral infarction.
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PMID:Cyanotic congenital heart disease with suspected stroke. Should all patients receive antibiotics? 683 Apr 69

A child who presented with hemiparesis secondary to a delayed non-hemorrhagic pontine infarction following mild head trauma is described. The results of the child's workup, including computed tomography (CT), were negative. The diagnosis of nonhemorrhagic pontine infarct was made by magnetic resonance imaging (MRI). The diagnostic evaluation excluded other possible etiologies of cerebral infarction, including vasculitides, CNS infection, congenital heart disease, hypercoagulable states, and demyelinating diseases. Although trauma cannot be proven as the cause of the infarct, other known causes of infarct were excluded. There are few cases of traumatic nonhemorrhagic cerebral infarction among children in the literature; none describes diagnostic MRI findings. MRI is important in these cases, because it may reveal delayed infarction from small-vessel injury, which is not apparent on CT. This article discusses the etiology of and the diagnostic evaluation of pediatric cerebrovascular accidents and suggests the need for emergency physicians to consider trauma as a potential cause of delayed nonhemorrhagic cerebral infarct in children.
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PMID:Nonhemorrhagic pontine infarct in a child following mild head trauma. 749 54

The average incidence, prevalence and mortality rates of cerebrovascular disease (CVD) in China were markedly increased with increase of age and were much higher in senile stage and males than those in presenile stage and females. The constituent ratio of CVD consisted cerebral infarction for 67.5% and cerebral hemorrhage about 24.8%. There was no difference between the characters of lesions confirmed by CT scan in senile and presenile groups. The majority of CT lesions in the two groups was lacunar infarction, being 76.3% and 85.9% respectively. There were more cases of lobar hemorrhage in the senile group. The most important risk factor for CVD was hypertension (65.8%). Heart disease and diabetes mellitus take second place, accounting 19.0% and 10.7% respectively. The incidence of mixed type of hypertension was high in CVD especially the isolated systolic hypertension. The incidence of cerebral stroke was obviously higher than myocardial infarction in China. The percentage of positive findings of atherosclerosis in extracranial portion of carotid artery system in elderly patients with thrombosis and transient ischemic attacks was 60-100% and 55-100%.
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PMID:Study on cerebrovascular disease of the elderly in China. 761 18

Transient ischaemic attacks (TIA) are defined by the focal and sudden loss of a cerebral function or the vision of one eye, resolving without sequelae within 24 hours and related to a vascular cause, thromboembolic much more frequently than haemodynamic. TIA represent between 9% and 25% of all cerebrovascular accident (CVA) with a variable global incidence from one study to another, between 0.2 and 3.3/1,000/year. The natural history of TIA is characterized by an excess mortality and an increased risk of cerebral infarction and myocardial infarction. It is therefore essential to recognize these events in order to prescribe effective preventive treatment. The clinical picture is characterized by a usually brief focal deficit (2 to 30 min, on average) and a normal clinical examination. The diagnosis is therefore exclusively based on the clinical interview. Complementary investigations have a dual objective: 1) to eliminate other diseases likely to cause transient neurological manifestations, and 2) to detect the mechanism and cause of cerebral ischaemia; the commonest causes are atheromatous stenosis and emboligenic heart disease. In addition to the routine laboratory examinations, basic complementary investigations consist of cerebral CT scan, cervical ultrasound and echocardiography. Conventional angiography is performed less and less frequently due to the progress in ultrasound and vascular imaging (helicoidal CT scan and magnetic resonance angiography). The treatment of TIA is designed to prevent cerebral and myocardial infarction, and to decrease the cardiovascular mortality [2]. In the short-term, it is essentially based on heparin, while waiting for the results of the aetiological assessment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Transient cerebral ischemic complications. The neurologist's point of view]. 763 3


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