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

Radiation-induced cardiotoxicity is a factor not to be neglected, especially after mediastinal irradiation in Hodgkin's disease and Non-Hodgkin-Lymphoma. Caused by primary and secondary radiation lesions, cardiopathy may develop up to several years after treatment. Clinically, acute pericarditis is prevalent. To reduce cardiac long-term side effects, adequate radiation technique is crucial. Diagnosis and therapy in radiation-induced cardiopathy are presented.
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PMID:[Side effects of percutaneous radiotherapy in the area of the thorax: cardiac toxicity of mantle field irradiation]. 179 41

In order to identify predictive risk factors of poor outcome following heart transplantation in children, we performed a retrospective analysis of our pediatric recipient population: 31 children, aged 15 days to 15 years (mean = 5.2 +/- 4.9 years). The preoperative diagnosis was cardiomyopathy in 17 (55%), congenital heart disease in 13 (42%) and end-stage valvular disease in 1 (3%). There were 5 operative deaths: hyperacute rejection (2), low cardiac output syndrome (3); 4 in-hospital deaths: infection (2), multiorgan failure (2) and 4 late deaths: acute rejection (1), chronic rejection (1), lymphoma (1), unknown (1). The actuarial probability of survival (+/- SE) was 62% +/- 10% at 1 year and 53% +/- 12% at 2 years. Univariate analysis was used to evaluate the following risk factors: age, diagnosis, hemodynamic decompensation, previous cardiac surgery, ischemic time of the graft, technique of graft preservation, preoperative pulmonary artery pressure, occurrence of postoperative low cardiac output syndrome (LCOS) with pulmonary hypertension (PHT). The occurrence of early LCOS with PHT significantly increased both early and late mortality (78% early mortality, 100% overall mortality). This syndrome occurred in 9 patients (29%) and was attributed to primary graft failure in 2, increased pulmonary vascular resistances in 6 and multiple factors in 1. Although not significant, two factors may increase early survival: young age (less than or equal to 1 year) at operation and improved technique of graft preservation.
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PMID:Heart transplantation in children: risk factors of early and late mortality. 205 50

A 3-year-old castrated male domestic shorthair cat had renal lymphoma and infiltrative cardiomyopathy, both of which responded to combination chemotherapy. Diagnosis was made on the basis of results of renal biopsy and echocardiography. Cardiac lesions included hypertrophy of the left ventricular free wall and interventricular septum, ventricular hypokinesis, and diminishment of the left ventricular chamber. Cytologic evaluation of pericardial fluid did not contribute to a diagnosis. Combination chemotherapy resulted in rapid improvement of renomegaly and cardiac structure and function. Although it might be assumed that the myocardial infiltration was attributable to metastatic lymphoma, histologic diagnosis of the heart disease was not established.
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PMID:Infiltrative cardiomyopathy responsive to combination chemotherapy in a cat with lymphoma. 280 2

The clinical introduction of cyclosporine has resulted in increased enthusiasm for cardiac transplantation. Since July, 1983, 61 patients (50 male and 11 female) have undergone orthotopic cardiac transplantation for cardiomyopathy (48 patients), ischemic heart disease (11), or congenital heart disease (2). Mean age was 39 years (range, 1.5 to 57 years). Median hospital stay was 26 days (range, 4 to 60 days). Maintenance immunosuppression consisted primarily of prednisone and cyclosporine; it was modified in 9 patients because of a pre-existing clinical condition. The incidence of rejection was 0.44 episode/patient-month within 3 months of cardiac transplantation and 0.10 episode/patient-month subsequently. The incidence of infection was 0.05 episode/patient-month. Major side effects of cyclosporine included renal dysfunction (63%) and hypertension (61%). No recipient required dialysis for renal dysfunction. Ten patients died (rejection, 4; infection, 3; carcinoma, 1; lymphoma, 1; and pulmonary hemorrhage, 1); actuarial survival at 1 and 2 years was 84 +/- 6% and 76 +/- 8%, respectively. Patient follow-up (cumulative, 719 patient-months) revealed that 96% of recipients were rehabilitated and 50% had returned to work. With increasing understanding of cyclosporine immunosuppression, recipients can continue to look forward to an extended life with nearly complete rehabilitation.
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PMID:Present expectations in cardiac transplantation. 329 75

A case of malignant lymphoma with cardiovascular manifestations is reported. It is a febrile form with compression of the aortic ring provoking a murmur simulating aortic valve disease with an Osler's graft. An analysis of the various complications due to lymphomas reported in the published literature emphasizes the iatrogenic nature of some of them: cardiac toxicity of chemotherapy, post-radiotherapy pericarditis, and increased incidence of coronaritis after both cobalt and radiotherapy. The diagnosis of lymphomas in the cardiac area is difficult but should be evoked in case of febrile and chronic cardiopathy, no other etiology being detectable.
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PMID:[Cardiac localizations of lymphomas. A case report and review of the literature (author's transl)]. 625 94

Infections of the central nervous system in patients at risk are relatively uncommon when compared with pneumonia, bacteremia, and soft tissue infection. However, they carry serious morbidity and are frequently fatal. Each of the diverse conditions that can place a patient at risk for central nervous system infection is associated with a fairly predictable spectrum of etiologic organisms. Various forms of trauma (including blunt and penetrating injuries and neurosurgery, especially when a cerebrospinal fluid shunt is implanted) predispose to infection with common pathogenic bacteria. Defects of cellular immunity including congenital immune deficiencies, immunosuppressive drug therapy, leukemia, lymphoma, and the acquired immune deficiency syndrome are more likely to give rise to infection with a distinctive spectrum of opportunistic viruses, fungi, and protozoa. Other underlying conditions include sinus, ear, and mastoid infections, congenital heart disease, intrathoracic suppuration, endocarditis, and bacteremia, hypogammaglobulinemia, and complement deficiencies. Some preventive measures including vaccines, antibiotics, and surgical procedures are available. However, for many of these central nervous system infections, preventive measures are lacking or less effective than those for infections in other organs. In the future, opportunistic central nervous system infections will increase in frequency as the number of patients at risk continues to grow.
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PMID:Prevention of central nervous system infections in patients at risk. 637 75

In a clinical demonstration, case reports on 3 patients are presented: 1. In a 27-year-old male who developed severe multicentric atypical pneumonia, CNS, liver and renal involvement and signs of rhabdomyolyses suggested infection with Legionella pneumophila. Diagnosis was confirmed by the presence of Dieterle-stain positive organisms and positive culture of lung biopsy tissue. Antibiotic treatment, especially erythromycin, and prolonged mechanical respiration produced complete recovery. 2. The presence of chylomycrons Rin ascitic and pleural fluid in a patient with epimembranous glomerulonephritis and nephrotic syndrome was the first sign of malignant non-Hodgkin lymphoma. Chemotherapy with cyclophosphamid, oncovin and prednisone induced remission of tumor and nephrotic syndrome, which promptly recurred parallel to later reactivation of the malignancy. Paraneoplastically induced nephrotic syndrome, especially due to lymphoma, may precede the malignancy by months. 3. In a 52-year-old male with terminal renal failure due to primary oxalosis a cadaver renal transplant functioned for only 14 months because of oxalate deposits in the transplant. Hemodialysis before and after transplantation modified the clinical course. In place of uremia, the clinical picture was dominated by oxalate-induced gangrenous arteriopathy, arthritis, and heart disease.
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PMID:[Clinical demonstrations. Legionnaires' disease. Tumor-associated nephrotic syndrome. Primary oxalosis]. 703 33

A 39-year-old patient with Hodgkin's disease, treated with radiation and chemotherapy, developed an undetected severe cardiopathy that was responsible for a sudden death. Possible causes of this cardiac damage are discussed. The therapeutic success on lymphoma, confirmed by postmortem examination is emphasized.
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PMID:Severe heart disease induced by radiation and chemotherapy for Hodgkin's disease. 731 63

The mortality experience of firefighters has been an active topic of investigation. Collateral toxicological evidence suggests that certain causes of death are likely to be associated with firefighting: lung cancer, heart disease, and obstructive pulmonary disease. To date there has not been a clear and consistent demonstration of excess risk due to occupational exposure for these outcomes, but certain other cancers, including genitourinary, colon and rectum, and leukemias, lymphomas, and myeloma, appear to be consistently elevated. A major unproven hypothesis is that risk increased following the introduction, in the 1950s of combustible plastic furnishing and building materials known to generate toxic combustion products. Mortality by cause of death was examined for two cohorts totalling 3,328 firefighters active from 1927 to 1987 in Edmonton and Calgary, the two major urban centers in the province of Alberta, Canada, examining associations with cohort (before and after the 1950s) and years of service weighted by exposure opportunity. The study attained 96% follow-up of vital status and over 64,983 person-years of observation, yielding 370 deaths. Mortality from all causes was close to the expected standardized mortality ratio (96; 95% confidence limits (CL) 87, 107) as was that for heart disease (110; 95% CL 92, 131), and neither was statistically significant at the p < 0.05 level (N.S.). Excesses were observed for all malignant neoplasms (127; 95% CL 102, 155, p < 0.05) and for cancer of lung (142; 95% CL 91, 211, N.S.), bladder (315; 95% CL 86, 808, N.S.), kidney and ureter (414; 95% CL 166, 853, p < 0.05), colon and rectum (161; 95% CL 88, 271, N.S.), pancreas (155; 95% CL 50, 362, N.S.) and leukemia, lymphoma, and myeloma (127; 95% CL 61, 233, N.S.); obstructive pulmonary diseases (157; 95% CL 79, 281, N.S.). Fire-related causes showed a marked excess (486; 95% CL 233, 895, p < 0.01), but external causes overall showed a significant deficit (66; 95% CL 49, 87, p < 0.05). The lung cancer excess was confined to Edmonton; there was no consistent association with duration of employment, exposure opportunity, or cohort of entry (before or after the 1950s) except that the highest risk was observed among Edmonton firefighters with over 35 weighted years. The excess of cancers of the urinary tract was observed mostly among firefighters entering service after 1950, appeared to increase with length of service and exposure opportunity, and was observed in both cities. An occupational association with heart disease and chronic pulmonary disease is not supported in this study on this population.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Mortality of urban firefighters in Alberta, 1927-1987. 832 77

It is well known from autopsy series that metastatic tumors of the heart can be found in 1.5% to 21% of patients with malignancies and the incidence of cardiac metastases is showing a gradual increase in recent years. The most common cause of metastatic heart disease is bronchial carcinoma followed by carcinoma of the breast, pleural mesothelioma, malignant melanoma, leukemia and lymphoma, in decreasing order of frequency. However metastatic cancer to the heart is not commonly diagnosed prior to death. Atrial extension has been reported as a common route of local spread in patients with bronchial carcinoma, but cardiac conduction system invasion is infrequent. The purpose of this report is to describe an unusual case of pulmonary adenocarcinoma that presented with cardiac manifestations mimicking atrioventricular (AV) block. This AV block was corrected by pacemaker. Chest radiography and bidimensional echocardiography didn't visualize important lesions. The cardiac findings at autopsy were remarkable not only for the severity of epicardial, myocardial and endocardial involvement, but for the metastatic implants into the His bundle and for the elective and wide infiltration of bifurcating His bundle. On addition histological examination revealed neoplastic emboli in the myocardial lymphatics. No valvular involvement was noted. Technical annotation: histological examination of the conduction system of the heart has been carried out on serial sections with the technique devised by one of the present authors. Bichromic (hematoxylin-eosin) and trichromic (Heidenhain-azan) stainings have been routinely employed.
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PMID:[Cardiac block caused by metastasis of lung adenocarcinoma to the bundle of His]. 849 66


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