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

Echocardiographic findings are comparatively analyzed in 25 patients with congestive cardiopathy, combined with mitral regurgitation, a control group of healthy and 10 patients with volume loaded left ventricle with rheumatic "pure" mitral insufficiency. Some discrepancies were established in the usual echocardiographic characteristics of congestive cardiomyopathy in the patients with CCMP, combined with significant mitral insufficiency: normal, even increased amplitude of movement of the interventricular septum in the absence of systolic increase of the septal thickness. The differentiation between the rheumatic mitral insufficiency and mitral insufficiency in case of congestive myocardiopathy is difficult, due to the considerable differences in the functional Echo-C characteristics of left ventricle and morphological characteristic features in mitral echogram.
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PMID:[Echocardiographic diagnosis of congestive cardiomyopathy associated with mitral regurgitation]. 645 76

Recommendations of the Swiss Working Group for Prophylaxis of bacterial endocarditis. Despite the lack of definitive evidence for the efficacy of antibiotics in the prevention of bacterial endocarditis (BE) in man, it is accepted practice for antibiotics to be administered to patients at risk of developing BE following a diagnostic or therapeutic procedure which may cause bacteremia. The prophylactic regimens so far recommended are cumbersome and compliance is poor. An attempt is made to unify and simplify Swiss recommendations, taking into account the authors' own recent experimental results, pharmacological data, and clinical experience. It is proposed that the patients be classified into two risk groups: First, patients with congenital and acquired heart disease, previous palliative or non-definitive cardiac surgery, mitral valve prolapse with mitral insufficiency, and hypertrophic obstructive cardiomyopathy should be considered at moderate risk. For those patients a single dose of an orally administered antibiotic should be given 1 h before the procedure. The first choice antibiotic should be amoxicillin (3 g orally) for all procedures, except when S. aureus is likely to cause bacteremia (i.e. after drainage of abscesses, where flucloxacillin (2 g orally) should be used 1 h before the procedure). Amoxicillin is also recommended for patients receiving penicillin during the days prior to the procedure (for prevention of rheumatic fever, or for any other reason). Patients allergic to penicillin should be given 600 mg clindamycin orally 1 h before the procedure. Second, patients with valvular prosthesis or previous BE should be considered at high risk.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Prevention of bacterial endocarditis. Recommendations of the Swiss Work Group for the Prevention of Endocarditis]. 648 52

In view of the increased prevalence of so-called "ischemic cardiomyopathy" ( Burch ) in Japan, we attempted to clarify the clinical manifestations of this condition and to investigate the medical treatment in comparison with the surgical therapy. Eighteen patients (17 males and one female) were identified as having "ischemic cardiomyopathy" according to the following criteria: These include (i) an ejection fraction of 30% or less with asynergy on all segments of AHA classification, (ii) significant coronary stenosis (75% or more) of one or more major coronary branches, and (iii) no other coexisting lesion, such as primary valvular disease or congenital heart disease. In the history, distinct myocardial infarction or angina pectoris was observed in 10 cases (56%), and in the remaining eight cases (44%) only symptoms of cardiac failure was shown. On the ECG, all cases showed pathologic Q waves. Moreover, 10 cases (56%) of these had Q waves in five leads or more. Cardiomegaly on the chest X-ray film (CTR greater than or equal to 60%) was evident in 10 cases and that on echocardiogram ( LVDd greater than or equal to 60 mm) in 16 cases. Physical examinations demonstrated gallop sounds in 89% and a B-B' step formation on echocardiograms in 50%. The LVEDP was greater than 12 mmHg in 13 cases, and the systolic pressure of the pulmonary artery was higher than 35 mmHg in 13 cases. On the other hand, the reduced cardiac index (less than or equal to 2.21/min/M2) was observed in only one case. Selective CAG revealed multiple vessel disease in 78%. Ten of the 18 cases had mitral regurgitation demonstrated by left ventriculography.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical manifestations, therapeutic methods and prognosis of patients with ischemic cardiomyopathy]. 661 4

Sixty-two patients diagnosed as having mitral valve prolapse, 60 to 81 years old, presented with disabling chest pain (20), symptoms of arrhythmias including palpitations and syncope (16), or mitral regurgitation (MR) with symptoms of congestive heart failure (26). The diagnosis of MVP was made on the basis of a combination of classic auscultatory, echocardiographic and angiographic findings. Thirteen of the 20 patients with chest pain had normal coronary angiograms and 7 had significant coronary artery disease (CAD). Patients with CAD could not be differentiated by clinical presentation alone. Furthermore, the incidence and types of arrhythmias, the presence of a positive stress test, and hemodynamic findings were similar in all patients in this group whether or not CAD was present. The 16 patients with palpitations had a broad spectrum of rhythm disorders, including both supraventricular and ventricular arrhythmias. Two patients had prehospital "sudden death" and 2 others had systemic emboli. Twenty-one of the 26 patients with MR had valve surgery. Intraoperatively the valves were described as enlarged, floppy and with redundant leaflets. Histologic examination showed extensive "myxomatous" changes throughout the valve leaflets. Thus, mitral valve prolapse is a cause of symptomatic heart disease in the elderly. It has a predictable pattern of clinical presentation and should be considered in the differential diagnosis of older patients with disabling chest pain and arrhythmias and as the cause of progressive or severe MR.
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PMID:Mitral valve prolapse syndrome: analysis of 62 patients aged 60 years and older. 661 75

Kawasaki disease or mucocutaneous lymph node syndrome (MCLS) is a recently recognized clinical entity in infants and young children with fever and characteristic mucocutaneous involvements accompanied by swelling of the cervical lymph nodes. It has aroused much interest because it may cause sudden death due to coronary arteritis with subsequent aneurysmal formation and thrombotic occlusion. Between January 1973 and September 1982, 611 patients with Kawasaki disease were evaluated with coronary angiography after the acute stage of illness. Of these patients, 136 (22%) were diagnosed as having coronary aneurysms, which were the most common abnormal finding at this stage. Serial two-dimensional echocardiography was useful to evaluate noninvasively the lesions of the coronary artery, and it was discovered that coronary aneurysms appeared in the eighth to 15th day of the illness, and some of them revealed an early restoration. Pericardial effusion appeared in 35% of the patients in the second to third week of the illness. Follow-up coronary angiography was performed in 72 cases who previously had coronary aneurysms five to 18 months after the acute illness. Thirty-nine cases showed completely normal findings at the second study, suggesting the regression of coronary aneurysms in this entity within one or two years after the onset of the illness. The remaining 33 patients showed abnormal findings such as stenotic or obstructed lesions, the irregular arterial wall and persistent aneurysms of coronary arteries at the follow-up study. Among the patients with abnormal angiographic findings myocardial infarction and mitral regurgitation were occasionally present. Three patients died suddenly from myocardial infarction at four months, four and six years after the onset of the illness, respectively. Early initiation of aspirin therapy (10-30 mg/kg) remains the mainstay to prevent thrombus formation and ischemic heart disease. The intracoronary thrombolysis by Urokinase was useful for prevention or treatment of acute myocardial infarction. Patients with Kawasaki disease are mostly in Japan, however, an increasing number of patients have recently been published in the foreign literatures, and this entity has become an important cause of heart disease in children. The long-term follow-up study and establishment of the effective treatment as well as elucidation of the etiology of this disease are essential.
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PMID:[Kawasaki disease: new and important problems in cardiology]. 667

The diagnosis of atrial septal defect was established in monozygotic twin females at age 63. Each patient mimicked a different acquired heart disease. One twin had congestive heart failure and atrial fibrillation and was diagnosed as having rheumatic mitral insufficiency. The other twin had atypical chest pain and systemic hypertension and was thought to have arteriosclerotic heart disease. In each case the correct diagnosis was made at cardiac catheterization. Although the same basic congenital heart lesion was present in both patients, the symptoms and findings differed. Symptomatic improvement was achieved by different therapeutic modalities. One patient had open heart surgery, while the other twin improved with medical therapy.
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PMID:Atrial septal defect in adult identical twins: a variation in theme. 668 7

The echocardiogram of the interatrial septum (IAS) was examined using the right-sided parasternal approach. The IAS can be detected in 56% of patients with heart disease and in 24% of normal subjects. In this study, we analyzed 15 normal subjects and 35 patients with right (RA) or left (LA) atrial overloading. The normal IAS shows anterior motion during ventricular systole and predominantly posterior motion in three phases during ventricular diastole. The normal IAS motion is easily correlated with events in the cardiac cycle and reflects LA volume change. In patients with pure mitral stenosis (MS), the IAS was motionless and the total amplitude of the IAS echocardiogram was decreased. In seven patients with pure mitral regurgitation (MR), the features of systolic fluttering (SF) and systolic premature anterior motion (SPAM) of the IAS movement were noted in three and six patients, respectively. The total amplitude of the IAS echocardiogram was increased. In 14 patients with MS combined with MR, SPAM was noted in six patients and three other patients presented SF of the IAS. The total amplitude of the IAS echocardiogram was normal or decreased. In two patients with tricuspid regurgitation, a reverse systolic motion of the IAS was found. These abnormal IAS motions can be explained on the basis of LA volume changes in each type of heart disease. Thus, a study of IAS motion can aid the understanding of various cardiac disease states.
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PMID:The interatrial septal echocardiogram: relationship to left atrial volume change in the normal and diseased heart. 669 96

The value of echocardiographic measurement of left ventricle volume and ejection fraction and of mitral valve area in patients with mitral stenosis has been assessed. All patients referred because of mitral stenosis have been studied by M-mode and two-dimensional echocardiography, by right and left heart catheterization, ventriculography and selective coronary angiography. Patients with other congenital or acquired heart disease or with coronary artery disease were excluded from this study. The selection lead to a series of 39 pts, all with a typical history of Rheumatic Fever: all these pts were divided in three groups according to the degree of mitral stenosis, classified as "mild", if valvular area was greater than 1.8 cm2 (8 pts), "moderate" between 1-1.8 cm2 (15 pts) and "severe" if valvular areas was less than 1 cm2 (16 pts). In all groups echocardiography underestimated left ventricular volumes as well as stroke volumes. Statistical correlation has not been excellent: the best result was again obtained in the calculation of ejection fraction (r = 0.91, P less than 0.001), confirming our previous results in a group of patients with mitral regurgitation. Cross-sectional two-dimensional echocardiography has confirmed, furthermore, as a sensitive and suitable procedure in assessing the mitral valve area (r = 0,87 P less than 0.001); at our experience echocardiography under-estimate mitral area in the cases of severe mitral stenosis.
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PMID:Echocardiographic evaluation with hemodynamic correlation of the left ventricle in mitral stenosis. 673 8

Twenty-three cases of endomyocardial disease (ED) are presented, studied in Venezuela, a tropical country in northern South America. The diagnosis was confirmed in 18 cases by means of pathological studies, and in 5 cases by angiocardiography which showed the characteristic obliterative ventricular lesions. Eosinophilia was present in 35% of the patients. The most frequent clinical feature was heart failure associated with mitral regurgitation. Systemic embolism was the first clinical feature in 5 cases. In 2 cases, ED was associated with autoimmune haemolytic anaemia or vasculitis. Necropsy revealed a predominance of the left-sided (9/16 cases) and biventricular (6/16 cases) types. The pathological lesions were characterised by fibrous thickening of the endocardium at the apex and the ventricular inflow tracts extending to the myocardium and involving the atrioventricular valves. ED is frequently misdiagnosed as rheumatic valvular cardiopathy. The two-dimensional echocardiogram is a very useful procedure for determining the spatial anatomy of ED. The echo findings were closely correlated with ventriculographic and necropsy findings. Even though ED is widely spread around the world, it is most frequently found in tropical and subtropical countries in Africa, Asia and America, such as Venezuela and Brazil. This suggests that there are aetiological factors in these latitudes, about which little is known.
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PMID:Endomyocardial disease in South America--report on 23 cases in Venezuela. 684 1

Eleven dogs with mitral regurgitation and severe cough were given hydralazine for reduction of systemic arterial pressure. The treatment was stopped and then restarted. Heart rates were measured and cough was assessed subjectively by the clients during each period. While the dogs were receiving hydralazine, heart rate and severity of cough decreased, when compared with periods either before or between treatments. Clinical improvement may have resulted from increased cardiac output or reduction in regurgitation. The improvement also may have resulted from effect on pulmonary function inasmuch as we had no evidence that the signs were a result of heart disease.
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PMID:Clinical experience with hydralazine for treatment of otherwise intractable cough in dogs with apparent left-side heart failure. 709 75


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