Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Myxoedema has been considered a major anaesthetic risk which could be increased by concurrent heart disease. Thyroid ablation with the production of myxoedema has, in the past, been used to control intractable angina. Eight ablated patients (Group I) and five patients with heart disease and incidental hypothyroidism (Group II) presented for open heart surgery. Management included diazepam-narcotic anaesthesia in generally reduced doses, careful monitoring and the use of digoxin, steroids and I-thyroxin given during or after operation. All patients survived. A number of the anaesthetic considerations and potential problems with myxoedema are discussed.
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PMID:Myxoedema and open heart surgery: anaesthesia and intensive care unit experience. 713 93

In 13 consecutive severely hypothyroid patients no sign of endocrine cardiomyopathy in the form of asymmetric septal hypertrophy (ASH) could be disclosed by M-mode and two-dimensional (2D) echocardiography on examination prior to thyroxine replacement therapy. In previous investigations ASH was demonstrated to be almost invariably present in untreated hypothyroidism irrespective of thyrotropin levels. Consequently application of positive inotropic and afterload reducing agents that may invoke deleterious effects in ASH has been considered hazardous in hypothyroidism even when indicated by concurrent other heart disease. Determination of exact confidence limits reveals that the proportional incidence of hypothyroid hypertrophic cardiomyopathy could not exceed 24.7% with 95% probability. We conclude that ASH is not necessarily inherent in hypothyroidism.
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PMID:Incidence of hypertrophic cardiomyopathy in hypothyroidism. 748 68

The infusion of dopamine, a hypophysiotropic catecholamine, which inhibits release of thyroid stimulating hormone (TSH), is the inotropic therapy of first choice in neonatal intensive care. Newborns with primary hypothyroidism are at increased risk of cardiocirculatory morbidity and are screened by measuring serum TSH concentrations. In an infant with both congenital heart disease and neonatal hypothyroidism, withdrawal of dopamine infusion was documented to evoke a doubling of serum TSH levels within 40 min, a finding suggestive of an inhibitory effect of dopamine administration on neonatal TSH hypersecretion. As a result, dopamine therapy may be a pitfall in TSH screening for neonatal hypothyroidism.
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PMID:Dopamine suppresses thyroid-stimulating hormone secretion in neonatal hypothyroidism. 775 13

Deletion of the short arm of chromosome 18 is more difficult to diagnose than most of other chromosomal abnormalities as the phenotypic picture is not specific enough to establish the diagnosis. Mental retardation, short stature, and hypertelorism were some of the prominent features of the syndrome. Some systemic diseases, such as congenital heart disease, hypothyroidism, IgA deficiency, were reported to be associated with this syndrome. We present a 14-month-old male baby with a round face, protruding tongue, hypertelorism, epicanthal folds, short stature, and psychomotor retardation to be a case of chromosome 18 p-. This was a de novo deletion and was not detected till the patient's second admission to our hospital. However, there was no other systemic disease could be found. The experience learned from this patient suggests that individuals with multiple congenital anomalies and psychomotor impairment, regardless of the severity, may warrant cytogenetic analysis.
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PMID:The 18 p- syndrome: report of one case. 817 47

A 57-yr-old male with atrial septal defect (ASD) was scheduled for the patch closure operation. The patient had a history of hyperthyroidism due to giant adenoma of the thyroid gland. The patient was controlled under euthyroid state by thiamazole for four years. With this treatment, his thyroid function became normal and he was doing well for over the last seven years. On the morning of the day of operation, thiamazole was given orally to this patient. When the ASD patch closure was performed, the examination of his thyroid gland revealed hypothyroidism, but the operation could be performed without any thyroidal trouble. After the operation thiamazole was given intramuscularly to this patient and from the next day it was continued orally. Thyroid storm did not occur after the operation until discharge. We conclude that in a case of heart disease with hyperthyroidism, it is important to keep the patient's thyroid function under normal for a long time before surgery.
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PMID:[Open heart surgery in patient with hyperthyroidism]. 818 84

The common underlying heart diseases were ischemic heart disease (39%), valvular heart disease (27%), hypertensive heart disease (10%) in 104 patients (mean age 79 yrs) with congestive heart failure (CHF). Cardiomyopathy (5%) and congenital heart disease (2%) such as atrial septal defect were less common. In addition, many extracardiac diseases including anemia, hypothyroidism, renal failure and pulmonary disease contributed to the etiology of CHF in the elderly. Cardiac amyloidosis should be considered as an uncommon cause of refractory CHF. While the precipitating factor was not found in half of the 104 patients with CHF, the most common factors were respiratory infection, myocardial ischemia and arrhythmia. In addition, inappropriate drug usage including poor drug compliance, the use of beta-blockers and excessive intake of sodium and fluid precipitated or exacerbated heart failure. Renal failure was a most important complication and predisposed to refractory CHF. Aged patients with mild CHF (NYHA class II) showed an insufficient production of cyclic AMP and GMP in proportion to the increases of norepinephrine and atrial natriuretic peptide in comparison with health aged subjects after the submaximal treadmill exercise test. This finding may suggest that an inadequate compensation of neurohumoral factors is prone to cause CHF in the elderly. Appropriate management of acute CHF in the elderly begins with recognition of the underlying heart disease, complications and the severity of cardiac function. In addition to medical management including loop diuretics, vasodilator, beta-receptor agonist and phosphodiesterase inhibitor, cases associated with respiratory and renal failure require mechanical ventilation and continuous hemofiltration.
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PMID:[The etiology and management of congestive heart failure in the elderly]. 820 67

Subclinical hypothyroidism is defined by elevated concentrations of thyrotropin (TSH) and normal levels of serum thyroxine in the absence of overt symptoms. Autoimmune thyroid disease is the most frequent cause. Prevalence is between 2.5% and 10%, depending on the patient population. The disorder may not be as asymptomatic as previously thought; mild but consistent hypothyroid symptoms may exist in 25% to 50% of patients. Subtle cardiac defects may be present and are probably most clinically relevant in patients with existing heart disease. Mild disturbances in cholesterol metabolism are a more common finding. Treatment of subclinical hypothyroidism must be individualized. The lowest dose of levothyroxine sodium (Levothroid, Levoxine, Synthroid) required to normalize TSH levels and improve symptoms yet avoid unnecessary side effects should be used.
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PMID:Subclinical hypothyroidism. Understanding is the key to decision making. 832 88

In 1987 Young and Simpson reported a child with hypothyroidism, congenital heart disease, severe mental retardation, and striking facial dysmorphism. Two subsequent reports have described patients sharing some of the features of their case, although in both there were enough discordant features to make it uncertain that the same entity was being described. Here we present a female infant with virtually identical features to Young and Simpson's original case. Her Caucasian parents are first cousins, raising the possibility of autosomal recessive inheritance of this new syndrome.
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PMID:Parental consanguinity in the blepharophimosis, heart defect, hypothyroidism, mental retardation syndrome (Young-Simpson syndrome). 847 11

The long-term results of 68 cases of thyrotoxic heart disease (THD) treated with 131I were analysed. 17 of 68 patients have been followed for 2-4 years, 32 for 5-9 years, 7 for 10-14 years, 8 for 15-19 years and 4 for 20-33 years. The mean period of follow up was 9 years. Of the 68 patients, 47 did not respond to antithyroid drug (ATD) therapy. Before 131I therapy, all the patients suffered from one or more of cardiac abnormalities caused by hyperthyroidism such as paroxysmal or permanent atrial fibrillation, cardiac enlargement, cardiac failure, frequent atrial or ventricular extrasystoles, angina pectoris and so on. All patients were given individualized therapeutic 131I dose of 2.59-4.44 MBq per gram of thyroid weight. The total 131I dose for patients was 85.1 MBq to 462.2 MBq. The long-term results showed that 55 cases were cured and 11 cases achieved complete remission. The total effective rate was 97 percent. There was no relapse of hyperthyroidism. Except that 4 cases of early hypothyroidism and 5 of delayed hypothyroidism were diagnosed, there were no other complications. The incidence of postradioiodine hypothyroidism at 5-9 years was 7.4 percent and at 10-33 years 20 percent. Our results indicate that 131I is a simple, safe, economic and effective treatment for THD. Pre-treatment with ATD for hyperthyroidism with cardiac complications is not necessary. 131I should be considered as the treatment of first choice for hyperthyroidism with cardiac abnormalities.
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PMID:[Long-term results following 131I treatment of thyrotoxic heart disease: a report of 68 cases]. 869 23

Atrial fibrillation (AF) and primary hypothyroidism are most often diagnosed in middle-aged and older dogs of large and giant breeds. We hypothesized that the frequency of primary hypothyroidism may be higher in dogs with AF than in those without AF. Two groups were investigated. Group 1 (March 1987-June 1990) consisted of 128 dogs with AF. A thyroid-stimulating hormone (TSH) stimulation test was performed in dogs with a low voltage on the ECG and low uptake of pertechnetate on a thyroid scan. Group 2 (July 1990-July 1991) consisted of both dogs with AF (n = 38) and control dogs (n = 235) in which plasma thyroxine (T4) was measured. If T4 was below 15 nmol/l, a TSH stimulation test was performed. The frequencies of primary hypothyroidism in group 1 (8/128) and in the group 2 AF dogs (3/38) were not different, but were higher than in the control animals (3/235) (P < 0.05). The group 1 and the group 2 AF dogs were found to be comparable, and pooling of the data of the two groups enhanced the significance of the frequency of primary hypothyroidism in dogs with AF versus the control animals (11/166 versus 3/235) (P < 0.01). We concluded that the frequency of primary hypothyroidism in dogs with AF is higher than in the group of control dogs without AF. This may be due to the additional cardiovascular changes accompanying primary hypothyroidism in dogs that already have heart disease.
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PMID:Relationship between atrial fibrillation and primary hypothyroidism in the dog. 879 93


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