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

This report reviews the clinical features of 80 patients with roentgenographically proved mitral annular calcification. The mean age of the group was 73 years, and there was a 2.5 to 1 female to male ratio. Evaluation for underlying cardiovascular disease revealed six patients with severe calcific valvular aortic stenosis; five patients with hypertrophic cardiomyopathy, 11 with mitral prolapse and 33 with significant arterial hypertension (blood pressure greater or equal to 150/96 mm Hg). Eighty-five per cent of the group (68 of 80 patients) had an underlying cardiac disorder associated with either chronically increased left ventricular systolic pressure or abnormal leaflet motion. Other cardiovascular abnormalities occurring as complications secondary to the mitral ring calcification included subacute bacterial endocarditis (three cases), arterial emboli (five episodes) and high grade atrioventricular block (16 cases). Twelve patients had severe mitral regurgitation; successful mitral valve replacement was carried out in four patients (all with myxomatous mitral tissue). Evidence of diffuse conduction system disease, not limited to the area of the cardiac fibrous skeleton, was found frequently (44 patients). Nine patients had sinus node dysfunction and 35 patients had electrocardiographic evidence of distal intraventricular (fascicular) block. Twenty-one patients eventually required pacemakers for management of symptomatic bradyarrhythmias. Atrial fibrillation was present in 23 patients. In this review it was found that calcification of the mitral annulus is frequently associated with or induces serious cardiovascular disease. Since some of these disorders may be modified by appropriate therapy, calcification of the mitral annulus should no longer be ignored as a benign marker of the elderly heart.
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PMID:Calcification of the mitral annulus: etiology, clinical associations, complications and therapy. 15 99

A 23-year-old Japanese male with no evidence of previous heart disease was presented with bicuspid aortic valve and a life threatening acute aortic regurgitation due to subacute bacterial endocarditis. By echocardiographic techniques, a precise diagnosis was made based on the following findings: 1) premature mitral valve closure, 2) snowfall-like echoes between the systolic aortic cusps, 3) eccentricity of a diastolic aortic valvular echo. The echocardiographic diagnosis was confirmed on surgery, in which aortic valve replacement was performed with satisfactory postoperative results.
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PMID:Acute aortic regurgitation with congestive heart failure due to bacterial endocarditis: diagnosed by echocardiogram and treated successfully by surgery (a case report). 44 16

The early diagnosis of heart disease during or better before pregnancy is one of the most important problems, as cardiac diseases are the most common cause for maternal deaths throughout the world. The knowledge of hemodynamic alterations in circulatory and respiratory physiology during pregnancy complicated by heart disease is a prerequisite for their management. The following indications for therapeutic abortion of pregnancy complicated by heart disease can be concluded according to our own observations: 1. history of significant heart failure (more than grade IV according to the classification of the New York Heart Association), frequent attacks of angina pectoris and longstanding cyanosis: 2. in spite of the most careful heart treatment with digitalis, diuretics and salftree diet cardiac-thorax-rate of more than 55% in congenital heart disease, cardiac-thorax-rate of more than 60% in acquired heart disease, significant signs of heart failure, namely more severe than grade III, tachycardic atrial fibrillation, pulse deficit of more than 30/min, active inflammatory processes of the heart (rheumatic fever, subacute bacterial endocarditis, Takayasu's disease); 3. especially severe metabolic disorders, i.e. diabetes mellitus, malignant hypertension, kidney diseases; 4. primiparae of an age of more than 35 years with any heart disease. Commissurotomy can be accomplished during pregnancy if it is too late for therapeutic abortion. Pregnancy in case of artificial valves is not recommended in general because of impending hemorrhagic diathesis.
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PMID:[Indication for pregnancy interruption in patients with heart diseases]. 85 89

In a 10-month-old infant with purulent pneumococcal meningitis without structural heart disease acute infectious endocarditis developed. Echocardiographic examination revealed vegetations on both cusps of the mitral valve. With regard to the age and critical condition of the infant, in the acute stage surgical removal of the vegetations, was not indicated. During long-term intravenous antibiotic therapy the vegetations on the mitral valve and clinical and laboratory manifestations of endocarditis disappeared. The valve was, however, devastated and the child developed severe mitral insufficiency. Because of progressive cardiac failure which could not be controlled by drugs, at the age of 19 months a plastic operation of the mitral valve had to be performed after which the haemodynamics and clinical condition improved markedly.
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PMID:[Pneumococcal infectious endocarditis in an infant (case report)]. 228 69

Ultrasound research methods were applied in 32 children with the clinical signs of infectious endocarditis (IE). The patients' age varied from 3 to 16 years. In 5 patients, IE turned out primary in the intact valves whereas in 27 patients, it superadded on different congenital heart disease. In 10 patients, IE had developed before surgical correction of the diseases and in 17, within different times after operation. The direct and indirect echo-signs of IE were delineated. The direct echo-signs included vegetations which were discovered in 22 out of the 32 patients. The indirect echo-signs included the signs of regurgitation in the externally unchanged or minimally changed cusps of the valves and blood drop at the level of the ventricles in connection with the defect reshunting in the interventricular septum. The data obtained are in good agreement with the clinical picture, surgical and morbid anatomy data.
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PMID:[Ultrasonic methods of diagnosing infectious endocarditis in children]. 258 73

A case of pulmonary infarction secondary to subacute bacterial endocarditis of pulmonary valve which is associated with subpulmonary VSD is presented. The jet stream of blood through the subpulmonary VSD made damage to the pulmonary valve, which may be one of the reasons why subacute bacterial endocarditis was associated with the subpulmonary VSD. Echocardiography of the right-sided valves will be very useful in order to detect the pulmonary valve endocarditis in congenital heart disease presenting with fever.
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PMID:[A case of pulmonary infarction secondary to subacute bacterial endocarditis with subpulmonary VSD]. 273 96

Better understanding of the mechanisms of the development of subacute bacterial endocarditis following stomatological procedures in the patient with heart disease implies the more rational use of prophylactic measures. Preventive antibiotics, often given empirically, decrease the unavoidable bacteremia threshold and hence the threat of endocarditis. After reviewing the risks factors linked with the cardiac problem and with the stomatological procedure, the authors justify the choice of a simple prophylactic protocol, linked both to the microbial types encountered as well as to commonly used effective antibiotics.
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PMID:[Prevention of bacterial endocarditis in heart patients during dental procedures]. 386 5

Mitral valve prolapse is the most common form of heart disease, as it occurs in 4 to 6 per cent of the population. It has a benign course in the majority of cases, but 5 types of severe complication can occur in 15 per cent of cases. Mitral incompetence occurs in 14.8 per cent of cases. It may develop gradually or suddenly, following rupture of the chordae, which requires rapid surgical repair. Mitral valve prolapse is complicated by infectious endocarditis in 2.9 per cent of cases, hence the need for antibiotic prophylaxis prior to dental treatment or surgery in patients with a pan-systolic or end-systolic murmur. The only arrhythmias which should be considered as complications and treated as such are frequent ventricular extrasystoles of more than 30 per hour, usually associated with bigeminy, runs or polymorphism, ventricular tachycardia and ventricular fibrillation. Treatment consists, primarily, of beta-blockers. Sudden death is of course the major complication, occurring in 1.4 to 2.4 per cent of cases. The patients at risk of this complication are middle-aged women (40 years) with a past history of syncope or faintness due, in most cases, to episodes of ventricular tachycardia or ventricular fibrillation. Apart from arrhythmia, coronary artery spasm has also been found to be a cause of sudden death in these patients. Transient or definitive ocular and cerebral ischaemic episodes can also complicate mitral valve prolapse. Mitral valve prolapse is found in 20 to 30 per cent of patients with neurological accidents before the age of 45. Preventative treatment consists of anti-platelet aggregation agents and anticoagulants in recurrent cases.
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PMID:[Complications of idiopathic mitral valve prolapse. Prevention and treatment]. 614 Aug 95

Children with cardiac disease who undergo noncardiac surgical procedures may encounter risks beyond those usually associated with surgical procedures. In this article, several complicating factors seen in children with heart disease are discussed, including arrhythmias, cyanosis, congestive heart failure, pulmonary hypertension, and subacute bacterial endocarditis.
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PMID:Evaluation of the pediatric surgical patient with congenital heart disease. 635 16

The study has revealed that active forms of infectious endocarditis constitute 30-50% of all septic diseases in hospitals. It is the normal cusps of the valvular apparatus of the left cardiac portion that are predominantly damaged, deformed or destroyed. Endocardial involvement of the right portion of the heart and the pulmonary artery occurs very rarely. Infectious patients develop sepsis more frequently than patients with non-infectious diseases but it takes the form of acute infectious endocarditis less commonly. Currently the clinical course of acute infectious endocarditis is characterized by predominantly ulcerous thrombotic damage of the normal valves with the formation of heart disease, the development of congestive insufficiency of the circulation and thromboembolic complications and the lethal outcome in the first weeks of hospitalization in 95.6% of patients with acute endocarditis in infectious and 56.6% in non-infectious hospitals.
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PMID:[Characteristics of acute infectious endocarditis in various types of hospitals]. 652 Dec 41


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