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

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

Echocardiographic features consistent with the findings of false tendons (FTs) were described in five out of 1,000 consecutive cases, and they were studied in order to determine whether FT was responsible for the systolic murmurs. Three had heart diseases including aortic regurgitation, 3 degrees AV-block with aortic regurgitation, and pericarditis and mitral stenosis, and the remainder cases had no heart disease. M-mode echocardiograms showed abnormal linear echoes in the outflow tract of the left ventricle in three cases, and in the left ventricle toward the apex in another two cases. Two-dimensional echocardiograms revealed long string-like echoes stretching from the upper parts of the interventricular septum across the ventricular cavity to the lateral wall of the left ventricle in three cases in the long and short axis views or four chamber view. In another two cases, there were long slender echoes binding the lower parts of the interventricular septum and the left ventricle in the apical view. These string-like echoes seemed to represent FTs reported previously in autopsy cases. Phonocardiography with pharmacological study (amyl nitrite and methoxamine) showed no significant systolic murmur, for which Fts had been considered to be responsible, even in a dilated left ventricle. We conclude that (1) M-mode and two-dimensional echocardiograms can demonstrate the presence of FTs, (2) two-dimensional echocardiograms might be utilized in differentiating FTs from other abnormal linear echoes in the outflow tract of the left ventricle seen in M-mode echograms, and (3) FTs do not necessarily cause systolic murmur.
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PMID:[Echocardiographic features of false tendons: with special reference to phonocardiographic significance (author's transl)]. 702 2

Nifedipine is a calcium antagonistic drug which reduces elevated vascular resistances. The hemodynamic effects of 20 mg of sublingual nifedipine were studied in 10 patients with chronic pulmonary hypertension. The etiology of pulmonary hypertension was chronic lung disease in 4, congenital heart disease in 2, mitral stenosis in 1, recurrent pulmonary embolism in 2 and primary pulmonary hypertension in one case. 30' after the drug administration there was a fall both of total pulmonary vascular resistance (from 992 +/- 586 to 648 +/- 428 d s cm-5, p less than 0.02) and of systemic vascular resistance (from 1416 +/- 868 to 896 +/- 440 d s cm-5 p less than 0.02) with an increase of systemic cardiac index from 3.2 +/- 1 to 4.5 +/- 2 l/min/m'2 (p less than 0.02). No significant change in systemic arterial oxygen saturation was noted, while pulmonary arterial oxygen saturation increased from 56 +/- 16 to 62 +/- 13% (p less than 0.01). These hemodynamic changes persisted for 120' when a significant fall of mean pulmonary arterial pressure was also noted (from 59 +/- 11 to 52 +/- 9 mm Hg, p less than 0.02). These data indicate that nifedipine may be useful to reduce pulmonary resistance in pulmonary hypertension. However this effect was less pronounced in patients with chronic lung disease compared to the other cases. It is suggested that the type of pulmonary arterial changes may determine the hemodynamic response. Nifedipine may be particularly indicated when vasoconstriction (as in primary pulmonary hypertension) is the main determinant of pulmonary hypertension.
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PMID:Hemodynamic effects of nifedipine in pulmonary hypertension. 716 46

M-mode and two-dimensional echocardiography are now firmly established as routine noninvasive diagnostic procedures in cardiac patients. Echocardiography is particularly useful in elderly patients because most forms of heart disease affecting this age-group produce typical echocardiographic patterns. Notable examples include idiopathic hypertrophic subaortic stenosis, mitral stenosis, mitral anulus calcification, various forms of mitral regurgitation, and aortic valve calcification and stenosis. Echocardiography can often provide information that could previously only be obtained by cardiac catheterization; it also helps in screening elderly cardiac patients so as to select those in whom more drastic procedures and perhaps surgery are really necessary.
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PMID:Echocardiography in elderly patients. 719 11

Digitised left ventricular echocardiograms were studied in nine children with congenital mitral stenosis to assess the severity of inflow obstruction. In six children the two prime indices of mitral stenosis were abnormal, with a prolonged time from minimum dimension to 20 per cent dimension change and a reduced peak dimension change during diastole. In three, however, these values did not suggest inflow obstruction, depsite significant gradients at cardiac catheterisation. Two-dimensional echocardiography was performed in 10 children with congenital mitral stenosis to determine the mitral annular size and the morphology of the valve and subvalvular apparatus. The annular size and number of papillary muscles could be assessed along with the detection of combined mitral abnormalities. Two-dimensional studies can reliably delineate the type of mitral abnormality, and should be performed in all cases with congenital heart disease having a high incidence of associated left ventricular inflow obstruction. Digitised M-mode left ventricular echocardiography is in general unreliable in assessing congenital obstruction, though it may be of some value in individual cases.
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PMID:Congenital mitral stenosis. Anatomical and functional assessment by echocardiography. 723 58

We assessed the use of echocardiography in the evaluation of stroke by recording M-mode and two-dimensional (2D) echocardiograms in 100 consecutive hospitalized patients. Of the 95 persons satisfactorily imaged with 2D echocardiography, 47 lacked clinical and routine laboratory evidence of heart disease; no potential embolic source or other finding that altered therapy was diagnosed by echocardiography. In the remaining 48 patients with clinical or routine laboratory evidence of heart disease, two with left ventricular thrombus as a potential embolic source were identified by 2D echocardiography. M-mode echocardiograms failed to detect the thrombus in either patient. No patients with left atrial thrombi, mitral stenosis, cardiac tumor, or vegetations suggesting endocarditis were identified. One patient had possible mitral valve prolapse. Echocardiograms in patients lacking other available evidence of heart disease are unlikely to yield findings that alter the clinical approach to patients with stroke; echocardiography in stroke patients with clinically evident heart disease may have greater clinical utility; additional study of the role of echocardiography in selected subgroups of stroke patients is indicated.
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PMID:Echocardiography in diagnostic assessment of stroke. 724 27

Left ventricular diastolic pressure was evaluated in 15 patients with mitral stenosis and 16 patients with no significant heart disease to determine if a stenotic mitral valve can cause the left ventricle to produce a negative diastolic pressure, indicative of ventricular diastolic suction. The minimal level of diastolic pressure in patients with mitral stenosis ranged between 6 and -7 mm Hg; in normal subjects it did not fall below 0. The average value of minimal diastolic pressure in patients with mitral stenosis (-2 +/- 1 mm Hg [mean +/- standard error of the mean]) was significantly lower than in patients without significant heart disease (5 +/- 1 mm Hg) (p less than 0.001). These observations indicate that the human left ventricle, in the presence of mitral stenosis, can generate a negative diastolic pressure. The presence of a negative diastolic pressure in patients with mitral stenosis suggests that the dynamics of the ventricle during diastole may contribute to the filling process.
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PMID:Negative intraventricular diastolic pressure in patients with mitral stenosis: evidence of left ventricular diastolic suction. 735 53

Several forms of congenital heart disease that cause left ventricular inflow obstruction have similar M-mode findings, and frequently the exact anatomic diagnosis cannot be made by M-mode echocardiography alone. We examined five children with various forms of left ventricular inflow obstruction using two-dimensional echocardiography. The diagnosis was confirmed by cardiac catheterization and surgery in all five patients. In one patient with congenital mitral valve stenosis, a thick mitral valve with two papillary muscles was imaged. This patient was easily distinguished from a second child with parachute deformity of the mitral valve in whom a single papillary muscle arising from the left ventricular apex was seen. These two patients with mitral valve stenosis were easily differentiated from the three patients in whom the left ventricular inflow obstruction was caused by a membrane within the left atrium. The membrane could be seen in several spatial planes; however, we could not distinguish by two-dimensional echocardiography one child who had cor triatriatum from the other two patients who had a supravalvar mitral ring. Because of its spatial anatomic display, the two-dimensional echocardiogram provides information for a more detailed anatomic diagnosis in children with congenital left ventricular inflow obstruction.
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PMID:Congenital left ventricular inflow obstruction evaluated by two-dimensional echocardiography. 735 25

Motion of the posterior aortic root on echocardiography is related to left atrial volume changes. Early diastolic posterior motion of the aortic root reflects both LA emptying and filling and has been measured as the atrial emptying index. To study late diastolic motion of the aortic root, we measured the slope of posterior motion of the aortic root after left atrial systole (following the P wave of the ECG) in 25 subjects without heart disease (Group 1), in 15 patients with left ventricular hypertrophy due to pressure overload (Group 3) with mitral stenosis. The aortic root slope measured (mean +/- SEM) 58.0 +/- 1.9 mm./sec. in Group 1, 50.6 +/- 4.5 mm./sec. in Group 2 (NS vs 1) and 28.8 +/- 4.5 mm./sec. in Group 3, (p < 0.01 vs 1 or 2). In 16 patients (four in Group 1 and 12 in Group 2) studied at catheterization, an inverse correlation ( r = -0.74, p < 0.01) was found between the aortic root slope (over a range of 30 to 73 mm./sec.) and left ventricular late diastolic chamber stiffness measured with simultaneous left ventricular echo and high-fidelity pressure recordings. No correlation was found between this slope and either left atrial size, total aortic root excursion, left ventricular pressure pre "A" wave, height of the A wave, end-diastolic pressure, or the atrial contribution to left ventricular filling. Therefore, the aortic root slope in late diastole is decreased in mitral stenosis and in the absence of mitral stenosis, it appears to be related to late diastolic properties of the left ventricle.
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PMID:Hemodynamic correlates of late diastolic posterior motion of the aortic root. 741 30

The atrial myocardium has been barely visible with thallium-201 myocardial scintigraphy. This is probably related to the difference in size, distance from anterior chest wall, and small coronary blood flow of the atrium, compared with the ventricle. We have encountered eight cases of visualization of the right atrial appendix (RAA). All had disease involving the right side of the heart, such as mitral stenosis (four cases), congenital heart disease (two), cor pulmonale (one), and primary myocardial disease (one). The RAA was identified from multiple projections in all cases and sometimes confirmed by radionuclide angiocardiography. The RAA was seen at the right upper aspect of the ventricles and was distinguishable from them. Evidence derived from ECG, chest radiographs, and cardiac catheterization, indicated that the most important factor in the visualization might be the displacement of the RAA to a more anterior position.
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PMID:Visualization of right atrial appendix by thallium-201 myocardial scintigraphy: concise communication. 742 Jan 90


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