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)

Eleven patients with short P-R intervals and narrow QRS complexes had ventricular tachycardia due to organic heart disease: mitral valve prolapse with mitral insufficiency (2 patients); alcoholic (?) cardiomyopathy (2 patients); and coronary artery disease (7 patients). Intracardiac studies showed short A-H intervals during sinus rhythm in all cases. The onset of ventricular fibrillation (which, to our knowledge, has not been observed in patients having short P-R and A-H intervals coexisting with narrow QRS complexes) was documented in 4 cases. Only 1 patient (with quinidine syncope) had been premedicated. In the 3 other patients the episodes of ventricular fibrillation appeared during bouts of atrial fibrillation with rapid ventricular rates which could have been an exprerssion of the "enhanced A-V conduction" that had been manifested in sinus beats by short P-R and A-H intervals. In clinical settings and physiological conditions proven to be hemodynamically unstable (such as transient ischemia or acute myocardial infarction) these rapid ventricular rates could have led to ventricular fibrillation; directly because of the R-on-T phenomenon, and/or indirectly due to decreased coronary perfusion. Ventricular tachycardia and ventricular fibrillation due to organic heart disease probably occur more often than suggested by the few reported cases in the literature. Its significance, however, has to be clarified by further prospective studies.
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PMID:Ventricular tachycardia and ventricular fibrillation in patients with short P-R intervals and narrow QRS complexes. 9 18

132 patients with pure mono-valvular cardiopathies (mitral incompetence, aortic stenosis and aortic incompetence) were classified into two groups according to the values of the systolic work index/myocardial mass ratio (SWI/MLV). Normal values of the ejection function (EF) and mean velocity of circumferential fibre shortening (VCF) for each cardiopathy were so obtained. Only patients with aortic stenosis of group I (SWI/MLV greater than or equal to 0.75 gm . g-1) had normal EF. All the other patients had EF and VCF values below normal although this did not always imply impaired myocardial function. Therefore the myocardial mass should also be considered in the evaluation of myocardial function and it would seem desirable to take this parameter into account in the management of these patients.
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PMID:[Indices of left venticular performance and evaluation myocardial quality in mitral valve insufficiency, chronic aortic valve insufficiency and stenosis]. 10 91

Consecutive autopsy of 1,000 cases of the aged disclosed coronary sclerosis in 428 cases, myocardial infarction in 137, cardiac hypertrophy in 237, valvular heart disease in 120, conduction disturbances in 96, cor pulmonale in 41, pericarditis in 39, and congenital heart disease or anomalies in 28. There were 343 morphologically normal hearts. A total of 1,022 heart diseases were found in 657 cases, corresponding 1.6 heart diseases per one heart. Heart diseases in the aged were divided into (1) those continuing from the younger period and (2) those specifically found in the aged. The latter were non-inflammatory valvular diseases and chronic conduction disturbances. Mitral regurgitation, including mitral ring dilatation (10), mitral ring calcification (9), spontaneous rupture of the chordae tendineae (2) and calcified aortic stenosis (12) and degenerative aortic regurgitation of prolapsed cusp (35) were produced by various degeneration of the connective tissue of the valves. A total of 59 cases of conduction disturbances consisted of complete or advanced heart block (15), right bundle branch block (RBBB) (16), RBBB with left axis deviation (17), and left bundle branch block (LBBB) (11). Forty-seven cases showed main lesions in the branching portion of the AV bundle and origin of the bilateral bundle branches, which were closely related to the degeneration of the central fibrous body and fibrosis at the summit of the ventricular septum. The common field, where the valvular diseases and conduction disturbances occurred, was the fibrous trigone of the heart.
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PMID:A clinicopathological study of the heart diseases in the aged. The morphological classification of the 1,000 consecutive autopsy cases. 12 9

The ECG and Frank VCG were compared to the hemodynamic findings in 33 patients with idiopathic hypertrophic subaortic stenosis in whom cardiac catheterization had excluded concomitant valvular heart disease, congenital heart disease, or occlusive coronary artery disease. The patients were divided into two groups according to the absence (Group I) or presence (Group II) of left ventricular hypertrophy on the ECG and/or VCG. The 11 patients in Group I were found to have neither mitral insufficiency nor a resting left intraventricular gradient, and only six patients in whom mitral valve movement was visualized demonstrated systolic anterior movement of the anterior leaflet. The papillary muscles and left ventricular wall were either normal or only mildly hypertrophied in 10 of 11 Group I patients. Group II (22 patients) demonstrated either a resting left intraventricular gradient and/or mitral insufficiency in 18 patients. Twenty-one of the 22 patients showed systolic anterior movement of the anterior leaflet of the mitral valve on a cineangiogram and the papillary muscles and left ventricular wall were moderately to severely hypertrophied in 18 patients. These data suggest that specific hemodynamic and anatomic characteristics of hypertrophic subaortic stenosis may be predicted with reasonable accuracy from the ECG and VCG.
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PMID:Electrocardiographic and hemodynamic correlations in patients with idiopathic hypertrophic subaortic stenosis. 12 82

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

The case files of 4,456 medical admissions in 1975--1976 at Ahmadu Bello University Teaching Hospital, Kaduna, Nigeria, included 354 cardiovascular patients. The most common causes were hypertension (45.5%), cardiomyopathy (20.6%) and chronic rheumatic heart disease (14.4%). The mean age of hypertensive and cardiovascular patients was lower than in Europe. The majority of hypertensive patients suffer from essential hypertension. Congestive cardiac failure is the commonest complication of hypertension and cardiomyopathy. Rheumatic valvular disease with mitral incompetence is frequent and sometimes severe in young people. Other cardiovascular diseases included pericardial disease, bacterial endocarditis, cor pulmonale, anaemic heart failure, congenital and syphilitic heart disease. Coronary heart disease was only encountered in non-Africans. Cardiovascular mortality in hospital was high (20%).
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PMID:Cardiovascular disease in Northern Nigeria. 31 94

Mitral valve replacement is considered when there is severe mitral stenosis, severe mitral insufficiency or a combination of the two. Ordinarily, surgical replacement is considered only for patients who are in functional classes III or IV and do not respond to medical management. Patients with symptomatic mitral stenosis should be treated with mitral commissurotomy whenever possible. Patients selected for commissurotomy should have a pliable valve, no other major valve dysfunction, sinus rhythm, no systemic embolism and good left ventricular function. Early operation is not ordinarily required. Mitral insufficiency may require mitral valve replacement in six rather common settings: rheumatic disease, rupture of mitral chordae tendineae, postinfarction rupture of a papillary muscle, intractable infective endocarditis, floppy mitral valve and malfunction of a prosthetic valve. Rupture of mitral chordae tendineae can usually be recognized from the history, physical examination, echocardiogram and angiocardiogram. Severe left ventricular papillary muscle dysfunction is usually due to cardiac infarction, and occurs within the first 9 days of infarction. When only a papillary muscle tip is ruptured the patient may survive long enough for a mitral valve replacement. In infective endocarditis, operation is more often needed because of congestive heart failure than because of refractory infection. Evidence of mitral stenosis or insufficiency in a patient with a previously implanted prosthetic valve usually indicates an urgent need for study and early operation. Uncommon causes of mitral incompetence that may require valve replacement are endocardial fibroelastosis, Marfan's syndrome, calcified mitral anulus, osteogenesis imperfecta, methysergide-induced heart disease and carcinoid heart disease.
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PMID:Indications for surgical replacement of the mitral valve. With particular reference to common and uncommon causes of mitral regurgitation. 37 33

1) In "left-sided" cardiac diseases, the effects of nitroglycerin on arterial pressure and heart rate were noted to be modest and disappeared within 15 minutes whereas the effect upon venous pressure, measured on the median cubital vein, lasted for approximately 30 minutes. 2) At 30 minutes after a dose of nitroglycerin there occured a significant depression of venous pressure elevation on exertion in patients with such "left-sided" cardiac diseases as ischemic heart disease, arteriosclerotic heart disease and hypertensive cardiovascular disorder. In patients with mitral insufficiency and aortic stenosis, on the other hand, the exertional venous pressure elevation was significantly suppressed 7 minutes after nitroglycerin although the suppression did not longer exist 30 minutes after administration. 3) The arterial pressure, heart rate, resting venous pressure and venous pressure elevation on exertion were virtually not affected by the administration of nitroglycerin in "right- or both-sided" cardiac disorders. 4) There was no significant change in cardiac output 30 minutes after a sublingual dose of nitroglycerin. The data obtained seem to stress importance of the effect of dilating capacitance vessels in the mechanism of antianginal action of nitroglycerin.
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PMID:[Effect of nitroglycerin on peripheral venous pressure at rest and during exercise in patients with heart diseases (author's transl)]. 40 92

To evaluate myocardial function in patients with documented mitral valve prolapse (MVP) 14 patients (six men and eight women with a mean age of 28 +/- 6.3 years) were examined noninvasively. Systolic time intervals were recorded at rest (in the supine and upright position) and after bicycle ergometry (upright position) and were compared with 10 healthy control subjects of similar age. Tracings were coded with random numbers and were evaluated by two blinded investigators. Contractility indices such as pre-ejection period index (PEPc) and ratio pre-ejection period/left ventricular ejection time (PEP/LVET) revealed no significant differences between patients and controls both at rest and after exercise. We conclude that young patients with MVP have no evidence for impaired myocardial function, provided there is no significant mitral incompetence or associated heart disease.
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PMID:Noninvasive assessment of myocardial function in young patients with mitral valve prolapse. 42 76

A case of pulmonary arteriovenous fistula associated with rheumatic mitral heart disease is presented. We have reviewed the literature and no published case with such association has been described. The loud mitral insufficiency murmur hide the continuous murmur of the fistula. The angiographic study demonstrated the A-V fistula. Retrospectively the diagnosis should have been suspected due to cyanosis, slight clubbing, the radiologic findings and the important Qs/Qt shunt. The associated pulmonary embolic phenomena made more difficult the diagnosis.
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PMID:[Arteriovenous fistula and rheumatic cardiopathy]. 47 2


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