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

The importance of metals in normal and pathologic cardiovascular function has been recognized. Significant derangements in myocardial Ca2+, Mg2+, and Cu2+ have been reported in ischemic heart injury. We studied 3 groups of hearts: 1) fifteen specimens obtained from patients who had no heart disease, 2) nine specimens from patients who had expired from cyanotic congenital heart disease, and 3) ten specimens from patients who had expired from acute rheumatic heart disease with carditis and severe heart failure. None of the patients had undergone cardiac surgery. Left ventricular lateral wall Mg2+, Ca2+, Cu2+, and Zn2+ contents were measured by atomic absorption spectrometry. The results showed a significant decrease in myocardial Mg2- (Group I 177.06 +/- 32.71; Group II 155.66 +/- 14.79; Group III 149.00 +/- 13.29, p less than 0.05 and p less than 0.01, respectively), and Cu2+ contents (Group I 3.22 +/- 0.37; Group II 2.94 +/- 0.22; Group III 2.56 +/- 0.32, p less than 0.02 and p less than 0.001, respectively), and a rise in myocardial Ca2+ content (Group I 36.06 +/- 10.72; Group II 43.22 +/- 7.01; Group III 46.30 +/- 4.85, p = not significant, and p less than 0.01, respectively). The myocardial Zn2+ content did not change significantly (Group I 26.53 +/- 3.99; Group II 26.00 +/- 4.15; Group III 26.40 +/- 3.53). The myocardial Mg2+/Ca2+ ratio was reduced markedly in both groups (Group I 5.328 +/- 1.879; Group II 3.685 +/- 0.735; Group III 3.135 +/- 0.291, p less than 0.001 for both Groups II and III vs Group I). The latter results correlated closely with the myocardial Mg2+/Ca2+ ratios reported in experimental models in peri-infarction zones. Thus, the myocardium of patients who had expired from cyanotic congenital heart disease and acute rheumatic carditis is jeopardized by ischemia, with metal contents similar to the border areas in myocardial infarction.
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PMID:Myocardial metal content in patients who expired from cyanotic congenital heart disease and acute rheumatic heart disease. 717 80

Electrocardiographic monitoring of 406 patients undergoing intravenous urography was performed before, during, and after the examination. Major cardiac arrhythmias and ischemia were encountered frequently (18%) in those with cardiac disease but also occurred (5%) in the healthy individual with no history of heart disease. Rapid higher dose (28-g iodine) bolus injections result in more cardiac alterations than the slower but larger (42-g iodine) infusion method, whereas the smaller (14-g iodine) bolus injections have the least cardiac effect. Ectopic ventricular beats, the most common abnormality, are usually transient but remain the most potentially lethal of the effects of intravenous contrast media on the heart.
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PMID:Cardiovascular radiology. Cardiac alterations during intravenous urography. 720 29

During a period of slightly over 25 years, 949 new patients with aortoiliac atherosclerotic occlusive disease--409 (43%) with associated distal disease--were submitted to various reconstructive operations for claudication in 719 and rest ischemic problems in 230 patients. The ages ranged from 21 to 91 years with a medial age of 59. Men outnumbered women 2.5 to 1. Associated diseases were present in 695 (75%); heart disease and diabetes were most common. The mortality rate from operation--50% of which was from heart disease--8% in first 5 years and 3% during the last 15 years. Good function, i.e., restoration of femoral pulses, leg salvage, and relief of symptoms, was achieved in 95% of cases early after treatment. Early results were best in patients with claudication and those without associated distal disease. The long-term survival rates were significant--50%, 30%, and 15% at 10, 15, and 20 years, respectively--and successful function was maintained in survivors in 79%, 70%, and 56% at the same intervals. Amputation was performed in only 23 (3%) patients with claudication and 33 (14%) with rest ischemia during the period of study. Survival, functional results, and incidence of amputation varied with the numerous factors described in detail herein.
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PMID:Aortoiliac occlusive disease: factors influencing survival and function following reconstructive operation over a twenty-five-year period. 731 40

In a 1 year old child, cyanotic congenital heart disease was complicated by a severe obstruction of the abdominal aorta between the renal arteries and the bifurcation. The surgical treatment consisted of relief of the obstruction in the aorta and a Blalock-Taussig shunt. The general progress was good but there was a ischemia of the left leg for which amputation of the forefoot was required.
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PMID:[Obstruction of the abdominal aorta and cyanotic heart disease in a 1 year old child (author's transl)]. 740 43

Angina pectoris and asymptomatic myocardial ischemia are part of the spectrum of coronary heart disease. Not the presence or absence of angina determines the future of the patient, but repeated ischemia and the progression of the coronaropathy. This progression is neither linear with time, nor is the moment of plaque rupture foreseeable. Silent myocardial infarctions increase with age and are very frequent in diabetics. In patients without neuropathy but with asymptomatic myocardial ischemia the central pain threshold is higher than in patients with angina pectoris. The best noninvasive test for the detection, localization and estimation of extension of myocardial ischemia, be it pain-free or symptomatic, is 201-thallium scintigraphy, combined with the exercise ECG. The fight against all amendable cardiovascular risk factors and pharmacotherapy are the first steps, if asymptomatic myocardial ischemia is suspected. Augmented dyspnea on effort and rhythm disturbances are indicators of advanced multivessel heart disease. Under these circumstances coronary angiography is indicated, and further treatment should follow the generally accepted rules such as for patients with angina pectoris.
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PMID:[Asymptomatic ischemia--an important part of the spectrum of coronary disease]. 748 31

Arterial hypertension can cause left ventricular hypertrophy and consequent hypertensive cardiopathy, a condition that is associated with the development of heart failure, arrhythmia and ischemia. Electrocardiography is the oldest and simplest method for diagnosing left ventricular hypertrophy: nevertheless, though established electrocardiographic criteria are highly specific, their sensitivity is low, far below that of echocardiography. There are, however, new electrocardiographic criteria with improved sensitivity; moreover, the presence of electrocardiographic signs of hypertrophy in a hypertensive patient makes a diagnosis of hypertrophy highly probable. The Holter monitor has many applications in the assessment of hypertensive patients. It identifies auricular and ventricular arrhythmias in terms of anatomical patterns, and can be used to evaluate drug response and detect the presence of silent ischemia and sudden death. In conclusion, electrocardiography is an easily accessible tool and a highly useful one in the management of hypertensive patients, in spite of its limitations.
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PMID:[Complementary tests: conventional and Holter electrocardiography]. 749 27

Ischemic heart disease remains a leading killer in industrialized nations. A significant cause of the morbidity and mortality in patients with ischemic heart disease is ventricular dysrhythmic events. There is a continued search for safe and effective treatment for patients with ventricular dysrhythmias. In this article, the author discusses current understanding of the mechanisms for dysrhythmias in the setting of acute ischemia and in the chronically infarcted ventricle. Therapy for patients with ventricular tachycardia and ventricular fibrillation is reviewed. Nurses caring for cardiac patients are continually involved in rhythm monitoring and dysrhythmia interpretation. The nurse is often the first responder present when a fatal dysrhythmia occurs. In addition, nurses can be involved at all levels of care, from prevention of heart disease to assisting the patient cope with a sudden cardiac death episode.
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PMID:Ventricular dysrhythmias in ischemic heart disease. 762 89

Acute colonic ischemia is the most common form of intestinal ischemia. Nonocclusive ischemic colitis contributes to some of these disorders. Heart disease, such as congestive heart failure, myocardial infarction, arrhythmias, aortic valve disease, and atherosclerotic cardiovascular disease, account for many of its risk factors. The majority of cases are associated with severe congestive heart failure with low cardiac output, or disease states resulting in dehydration, or the splanchnic vasoconstrictive effect of some medications. Reactive splanchnic vasoconstriction is responsible for nonocclusive ischemic colitis. Ischemic colitis induced by a cleansing enema has been reported once before. The authors present a case of coronary artery disease complicated by colonic ischemia following glycerin enema in preparation for coronary bypass surgery. Reactive inferior mesenteric artery spasm in response to the enema was noted in this case, rather than diffuse mesenteric artery spasm in response to low cardiac output state and vasoconstrictive drugs.
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PMID:Nonocclusive ischemic colitis following glycerin enema in a patient with coronary artery disease. A case report. 763 24

Myocardial blood flow is heterogeneous, whether considered by chamber, by layers of the ventricular walls, or by microregions within layers. There is also variability of myocardial flow reserve, particularly in layers and microregions, even when the heart is arrested. The variability of flow during arrest may be associated with the resistance pathways to each region, but the variability of flows in the beating heart with vascular tone is probably due to regional differences in work and thus oxygen demand. Heterogeneity by layer may be responsible for the subendocardial ischemia that is common to many forms of heart disease. Microheterogeneity may account for the patchy necrosis that occurs with chronic ischemia.
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PMID:Heterogeneity of myocardial blood flow. 764 14

The survival of infants with congenital heart disease has improved dramatically. However, the incidence of neurological injury in infants surviving cardiac surgery remains considerable. These neurological sequelae are attributable at least in part to hypoxia-ischemia/reperfusion, which inevitably accompanies infant heart surgery with deep hypothermia, cardiopulmonary bypass, and circulatory arrest. To begin to identify mechanisms of brain injury during infant cardiac surgery, we used near-infrared spectroscopy to study the relationship between cerebral intravascular (hemoglobin) and mitochondrial (cytochrome aa3) oxygenation in 63 infants (aged 1 day to 9 months) undergoing deep hypothermic repair of congenital heart defects, throughout the intraoperative period. Moreover, we assessed the effect of postnatal age on these changes. The cerebral concentration of oxidized cytochrome aa3 decreased from the onset of deep hypothermic cardiopulmonary bypass, despite apparent abundant intravascular oxygenation manifested by a simultaneous increase in the cerebral concentration of oxyhemoglobin. During this interval infants older than 2 weeks had a greater decrease in oxidized cytochrome aa3 than did infants 2 weeks old or younger. During deep hypothermic circulatory arrest, cerebral levels of oxidized cytochrome aa3 remained depressed while those of oxyhemoglobin declined. With reperfusion following circulatory arrest, the recovery of oxidized cytochrome aa3 was delayed, despite a rapid recovery of intravascular oxygenation (HbO2). After rewarming and 60 minutes of reperfusion, only 46% of infants recovered to the baseline level of cerebral oxidized cytochrome aa3. These findings demonstrate a paradoxical dissociation of changes in intravascular and mitochondrial oxygenation during hypothermic cardiopulmonary bypass; a pronounced decrease of mitochondrial oxygenation is established during induction of hypothermia and a delay in recovery of mitochondrial oxygenation occurs following circulatory arrest. These effects were more pronounced in infants older than 2 weeks than in younger infants. The data suggest potentially deleterious impairments of intrinsic mitochondrial function or of delivery of intravascular oxygen to the mitochondrion or both, effects previously undetected and apparently influenced by cerebral maturation.
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PMID:Cerebral oxygen supply and utilization during infant cardiac surgery. 771 85


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