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

Echocardiographic investigation of 65 patients with systemic scleroderma showed that the left ventricular sizes and indices of central hemodynamics were frequently lowered in them; an increase in sizes was observed mainly in the patients with stage II-III of disease. In 3/4 of the same patients pericarditis was revealed; on the whole, it was detected in 26 (40%) examinees. One patient had changes which were typical of asymmetric obstructive cardiopathy. In location of the valvular apparatus signs of mitral stenosis were found in one patient, those of mitral insufficiency in one patient and those of aortic insufficiency in one patient. Signs of mitral prolapse were noted in 7 (10.9%) patients, i.e. twice more frequently than in the entire population. Echocardiography made it possible to specify the nature of cardiac pathology and brought to light some additional features of the involvement of different heart membranes in systemic scleroderma.
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PMID:[Echocardiographic study of heart function in systemic scleroderma]. 382 23

Recurrent laryngeal nerve palsy and vocal cord paralysis due to mitral stenosis was first described in 1897 (Ortner 1897). Since then other cardiovascular causes, including hypertension, coronary heart disease, aortic aneurysm and congenital heart disease have been described. There are two recorded cases of left recurrent laryngeal nerve palsy due to pulmonary embolism (Albertini 1972; Wilmhurst et al. 1983). We describe what we believe to be the third case.
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PMID:Vocal cord paralysis in association with pulmonary emboli. 394 26

In order to investigate relations between mitral valve closure and mechanical events at the onset of left ventricular systole, simultaneous M mode echocardiograms and phonocardiograms were recorded with the apexcardiogram and its first differential (dA/dt) in 25 normal subjects and 88 patients with heart disease. The timing of mitral and aortic valve closure and the onset and peak rate of rise of the apexcardiogram with respect to the Q wave of the electrocardiogram were measured. There was considerable variation in the intervals from Q to mitral valve closure (Q-MVC) and from Q to peak dA/dt and in the isovolumic contraction time between normal subjects. There was no consistent abnormality of these intervals in patients with coronary artery or valvar disease, and no relation between the interval from Q to mitral valve closure and end diastolic pressure. When the timing of the first heart sound and peak dA/dt were considered together, however, clear abnormalities became apparent. In normal subjects, the intervals Q-MVC and Q to peak dA/dt were significantly correlated. In coronary artery disease, the expected relation between Q-MVC and Q to peak dA/dt was found only when end diastolic pressure was normal and was lost when end diastolic pressure was raised. Mitral stenosis was associated with delayed mitral closure in a few cases only, but in chronic aortic regurgitation closure was consistently early with respect to the apexcardiogram. In patients with atrial fibrillation and a normal mitral valve the timing of mitral valve closure with respect to the apexcardiogram was normal, which is inconsistent with an atrial contribution to the timing of mitral valve closure. Thus when considered in isolation the timing of mitral valve closure and the duration of isovolumic contraction time gave little information about cardiac function. Nevertheless, a predictable relation exists between mitral valve closure and the onset of left ventricular mechanical systole in normal subjects, which can be used to identify characteristic alterations in patients with heart disease.
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PMID:Relation between mitral valve closure and early systolic function of the left ventricle. 398 57

Many cardiac disorders can cause acute cerebrovascular insufficiency. The spectrum of potentially embolic cardiac conditions is wide; early recognition may determine a definite change in the management and prognosis of patients. In recent years the relevance of echocardiography in the screening of patients with cerebral ischemia has been emphasized. In order to identify potentially embolic cardiac conditions, 180 consecutive non selected patients with cerebrovascular insufficiency, underwent a clinical cardiological evaluation and an echocardiogram. The study population included 132 men and 48 women; the mean age was 51.7 years (range 19 to 72 years). A technically adequate echocardiogram was obtained in 153 patients. In 131 patients echocardiography was negative; cardiac lesions were detected in 22 patients (14.4%): mitral stenosis in 2, calcified aortic stenosis in 1, valvular endocarditis vegetations in 3, dilatative cardiomyopathy in 2, hypertrophic cardiomyopathy in 4, mitral valve prolapse in 4, regional left ventricular diskynesia in 5, mitral anulus calcification in 1. Patients were divided into 3 groups according to the results of cerebral angiography: 68 patients with normal angiography (Group I), 54 patients with atheromasic lesions on cerebral angiography (Group II), 31 patients in whom cerebral angiography was not performed (Group III). A higher incidence of cardiac diseases was found in the patients of Group I. The lack of lesions on cerebral angiography and the presence of embolic high-risk cardiac conditions strengthened a causal relationship of the cardiac disorder with cerebrovascular insufficiency in 10 of the 23 patients. In the mean follow-up period of 18 months of these 10 patients who underwent cardiac surgery or anticoagulation, no further attacks of cerebrovascular insufficiency were observed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Cardiopathy and acute cerebrovascular insufficiency. Prospective study with two-dimensional echocardiography]. 404 42

By correlating the functional classification of mitral stenosis proposed by A.N. Bakulev and E.A. Damir with the myocardial changes detected on the ECG in 282 patients operated on for mitral stenosis, it has been established that the hypertrophic process in the right ventricle at Stage IV of heart disease corresponds to the stage of wearing off and progressive cardiosclerosis. Heart disease of Stage III is associated with morphological alterations in the left atrium and the right ventricle of various severity. In developing a surgical classification of heart disease it is necessary to consider electrographically evident morphological changes in the heart.
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PMID:[Functiono-morphological principles of classification of mitral valve stenosis]. 623 17

Accurate assessment of ventricular muscle contractile function in patients with heart disease is impaired by alterations in afterload, preload and wall thickness which often accompany the disease. The relationship between pressure and volume at end systole is considered to provide a contractile index which is independent of preload and which accounts for afterload. Use of the index prerequisites determinations of the left ventricular end systolic pressure, wall thickness as well as the dimensions or volumes, respectively, which may be assessed with either invasive or noninvasive methods. In patients with aortic stenosis and congestive heart failure, there was a significantly reduced slope (0.9 +/- 0.5) of the end systolic stress-volume relationship as compared with healthy subjects (5.8 +/- 1.3) or patients with aortic stenosis without congestive heart failure (3.9 +/- 1.3), while the ejection fraction showed no significant differences. In patients with mitral regurgitation with no or only minimal symptoms postoperatively, preoperatively the end systolic index (ESS/ESVI) was higher (3.3 +/- 0.4) than in patients with marked symptoms postoperatively or those who died perioperatively (2.2 +/- 0.2) and the values of both patient groups were lower than those of normals. In contrast, the values for ejection fraction among the normals and both groups of patients showed substantial overlap. In patients with aortic insufficiency and congestive heart failure, as opposed to patients with aortic insufficiency and only slight symptoms, there was a significantly compromised ejection fraction as well as diminished end systolic index (ESS/ESVI). Patients with hypertension accompanied by congestive heart failure had a significantly diminished slope of the relationship between end systolic left ventricular stress and volume while the values for hypertensive patients without congestive heart failure were within normal limits; in both groups of patients, the ejection fraction was normal. In patients with mitral stenosis, the end systolic index at 5.28 +/- 0.53 did not differ significantly from that of healthy subjects at 4.87 +/- 0.53, while the velocity of circumferential fiber shortening was diminished. Patients with large atrial septal defects and symptoms of congestive heart failure did not differ with respect to end systolic index or ejection fraction as compared with atrial septum defect patients without symptoms. In children with aortic stenosis and high pressure gradients, there was an increased ejection fraction together with a normal end systolic index.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Assessment of systolic ventricular muscle function in man: the end systolic index. 623 85

Forty-nine cases of Wolff-Parkinson-White syndrome (WPW) were diagnosed out of 10 750 patients with cardiac disease (0.45 p. 100), 24 cases out of 3 761 congenital malformations and 25 cases in the 6 989 patients with acquired heart disease. Right ventricular pre-excitation was recorded in 31 cases; 13 in the lateral zone, 12 in the posterior paraseptal zone and 6 in the anterior paraseptal zone. Left ventricular pre-excitation was recorded in 18 cases: 8 in the lateral zone, 5 in the anterior paraseptal and 5 in the posterior paraseptal zones. WPW and congenital heart disease: Out of 20 cases of Ebstein's anomaly, 5 cases of WPW were observed: 4 right posterior and 1 right lateral pre-excitations. Out of 218 cases of hypertrophic obstructive cardiomyopathy, 7 cases of WPW were observed, 4 of which were congenital. Three cases of WPW were recorded in 699 patients with ventricular septal defects. Out of 1 348 cases of atrial septal defect, 5 cases of pre-excitation were recorded, including 3 right posterior pre-excitations associated with an ostium primum defect. Pre-excitation was also observed in isolated cases of corrected transposition of the great arteries, supravalvular aortic stenosis, aortic incompetence and patent ductus arteriosus. Pre-excitation and acquired heart disease: Five cases of pre-excitation were recorded out of 305 cases of dilated cardiomyopathy (1.62 p. 100). Eleven cases of pre-excitation were recorded in a total of 3 471 cases of valvular heart disease (0.31 p. 100): 9 in rheumatic valve disease and 2 in mitral valve prolapse. Nine cases of pre-excitation were observed in 2 850 cases of coronary artery disease. Intermittent Wolff-Parkinson-White syndrome: Ventricular pre-excitation masks the ECG changes of complete right bundle branch block in Ebstein's anomaly, complete left bundle branch block in aortic incompetence and dilated cardiomyopathy, and the in-complete right bundle branch block often seen in mitral valve prolapse. The characteristic appearances of WPW depend on the zone of pre-excitation. Right ventricular hypertrophy observed in ventricular septal defect with pulmonary stenosis and mitral stenosis may be masked by right lateral pre-excitation. Changes of inferior wall myocardial infarction may be masked by left anterior wall pre-excitation. On the other hand, the effects of WPW on left ventricular hypertrophy are variable, high amplitudes of the resultant forces seeming to depend on late and isolated activation of one of the left ventricular walls.
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PMID:[Wolff-Parkinson-White syndrome and cardiopathies]. 624 Feb 36

Although long-term effects have been studied, the immediate effect of surgery for acquired heart disease on left ventricular function is not well defined. Accordingly, 44 adults with acquired heart disease underwent intraoperative two-dimensional echocardiography with a gas-sterilized transducer before and immediately after cardiopulmonary bypass. Ejection fraction was measured by short-axis area change at the maximum left ventricular cross section (SAAC-EF) and also by a method using multiple sections. Correction of both mitral and aortic regurgitation produced a significant intraoperative decrease in ejection fraction from 0.49 +/- 19 (SD) to 0.32 +/- 0.16 (p less than .02) and from 0.41 +/- 0.13 to 0.30 +/- 0.17 (p less than .0005), respectively. Relief of aortic stenosis and mitral stenosis resulted in an intraoperative increase in ejection fraction from 0.45 +/- 0.10 to 0.55 +/- 0.09 (p less than .02) and from 0.41 +/- 0.05 to 0.50 +/- 0.07 (p less than .05), respectively. Ejection fraction after coronary artery bypass grafting was unchanged. Preload (end-diastolic area) was significantly decreased after correction of aortic regurgitation (p less than .02) but unchanged in other lesions. We conclude that (1) correction of pure mitral and aortic valvular lesions produces characteristic alterations in ejection fraction in the immediate postoperative period; (2) with the possible exception of patients with aortic regurgitation, the observed change in ejection fraction does not appear to reflect changes in preload; (3) noninvasive assessment of left ventricular function by two-dimensional echocardiography during cardiac surgery appears feasible and could provide data important for clinical decision making in the early postoperative period.
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PMID:Left ventricular ejection fraction during cardiac surgery: a two-dimensional echocardiographic study. 660 9

Between 1974 and 1982, 16 patients (four men, twelve women, mean age 50.5 years) underwent surgery for left atrial myxoma at the Hannover Medical School. Clinical features encompassed cardiac murmurs (100%) and findings compatible with mitral stenosis (87%), chest pain (37%), arrhythmias (37%), syncope (18%) and malaise (37%). Arterial tumor embolism (to the right leg) occurred in one case. The sedimentation rate was consistently elevated. Sinus rhythm was present in 14 and atrial flutter in two patients. In all but one case, the diagnosis was documented through cardiac catheterization. In recent years, however, noninvasive methods such as echocardiography and computer tomography have proved to be accurate and reliable diagnostic methods such that cardiac catheterization would now appear indicated primarily for patients with additional heart disease and for those over the age of 40 years to rule out the presence of asymptomatic coronary artery disease. Surgery was performed with cardiopulmonary bypass and all patients survived the procedure. In 13 cases the tumor was removed through a right atrial approach with septal incision, in two through the left atrium and in one case both approaches were used. Complete removal of the tumor was achieved in all patients. The tumors were found to arise from the atrial septum in 15 and from the inferior wall of the left atrium in one patient. The size of the tumors ranged from 30 mm in diameter up to 100 mm X 60 mm X 40 mm with weights between 4.8 and 125 grams. Although no residual tumors have been seen during an average observation period of 29.2 months (range nine to 56 months), long-term follow-up, readily accomplished with noninvasive methods, is warranted for such patients.
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PMID:Surgical experience with left atrial myxomas. 661 18

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


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