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)

In order to investigate the influence of cuff size and anthropometric values for the measurement of indirect blood pressure (IP) by sphygmomanometer, IP was measured simultaneously with the recording of direct aortic pressure (DP) by catheter tip micromanometer. Observations were made in 56 patients, aged 3 to 16 years. The majority had a history of Kawasaki disease and some type of congenital heart disease, but all were normotensive and none had aortic insufficiency and stenosis. As IP values, Korotokoff 1 sound, and Korotokoff 4 and 5 sounds were regarded as systolic and diastolic pressure values, respectively. IP measurement was performed in each subject using at least 6 types of cuffs with different widths and lengths. The results were as follows: (1) IP was noted to have a linear correlation to DP (p less than 0.01), but systolic IP tended to show higher values than those of DP. The same tendency was noted for the diastolic IP. (2) There was a negative correlation between IP/DP and cuff width/arm length (p less than 0.01). (3) According to cuff width/arm length, values of IP/DP were divided into 2 groups: a group less than 0.4 and another group more than 0.4. In the former group, values of IP/DP were significantly higher than those of the other group. The most important influencing factor on IP measurement was the cuff width in relation to the arm length. Use of a short width cuff may cause overestimation of the indirect blood pressure.
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PMID:Influencing factors on indirect measurement of blood pressure in children. 344 95

Two Japanese boys, 6 and 10 years old, required operation for severe Kawasaki heart disease. Both had multiple coronary arterial aneurysms and stenoses, and one had mitral regurgitation as well. The operations consisted of anastomosis between the left internal mammary artery and the left anterior descending artery and insertion of an autologous saphenous vein between the aorta and the posterior descending artery in both patients. The mitral valve was replaced in the one with mitral regurgitation. Angina pectoris has been completely relieved as confirmed by postoperative angiocardiography. Late results of coronary bypass grafting with the saphenous vein in pediatric patients with Kawasaki disease have been less than satisfactory because of the high occlusion rate of the graft. The internal mammary artery may be superior, at least theoretically, to the saphenous vein graft because it is a "living graft" with a high possibility of growing and with less susceptibility to degeneration. This is the first report of successful operation utilizing an internal mammary artery graft in coronary bypass for Kawasaki disease.
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PMID:Severe Kawasaki heart disease treated with an internal mammary artery graft in pediatric patients. A first successful report. 387 81

Non-selective opacification of the coronary arteries is often adequate for practical purposes in children, especially for studying the coronary circulation before operating congenital heart disease. However, selective coronary angiography is essential to demonstrate some abnormalities of distribution poorly visualised by the non-selective method and especially in cases of coronary anomalies or acquired coronary disease before procedures of reimplantation of revascularisation. The indications must be carefully considered and the technique particularly adapted using paediatric catheters and trained personnel skilled in retrograde arterial catheterisation in children. 51 selective coronary angiographies were carried out in 47 children 1 to 13 years old, including 12 children under 3 years of age. In 33 cases (23 Fallot's tetralogy the object was to detect coronary abnormalities not observed on non-selective opacification (3 LAD arteries arising from the right coronary, 1 single coronary artery) or to determine their anatomical relationships in complex cardiac malformations (5 cases). There were 5 cases of isolated congenital or acquired coronary disease with signs of ischaemic heart disease in 3 cases (LAD arising from the pulmonary artery and antero-septal infarction, calcified aneurysms and antero-lateral infarction in Kawasaki disease, pseudoxanthoma elastica with multiple coronary stenosis and severe angina). The investigation was indicated for complications of cardiac surgery in 2 children and in 4 cases selective coronary angiography was performed to assess the results of coronary reimplantation.
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PMID:[Selective coronary angiography in children. Technic and indications]. 392 68

Diastolic pressure and volume (P-V) curves were approximately exponential and fitted the equation, dP/dV = aP + b, where a was left ventricular volume elastic constant. Stress and strain (sigma-epsilon) curves were expressed by the equation, d sigma/d epsilon = k sigma + c, where k was wall stiffness constant. These exponential curves have been fitted over the whole diastole, but theoretically, the mid-diastole should reflect diastolic elastic properties best. In the present study, therefore, special attention was paid to the mid-diastole in each patient, and both P-V and sigma-epsilon relationships were analyzed by fitting the data to the above mentioned curves during this period of time. This analysis was made in two separate groups of patients. One was the control group consisting of 2 patients with normal hearts, 2 patients with mild pulmonary stenosis, and 25 patients with post mucocutaneous lymph node syndrome. The other group consisted of patients with postoperative congenital heart disease, that is, 8 patients with atrial septal defect and 5 patients with tetralogy of Fallot. The elastic constant (a) could not be compared if the size of the hearts differed. The results of the present study, however, demonstrated that the size of the heart was closely related to the constant, a. In the control group, the constant (a) was exponentially related to the size of the heart, and expressed as follows: a = 0.30e-0.037EDV + 0.045 (r = 0.94, p less than 0.01) In contrast, the wall stiffness constant (k) was not related to the size of the heart. After surgical repair of congenital heart disease, the stiffness constant in the left ventricle was normal in patients with postoperative atrial septal defect, while it was significantly increased in patients with postoperative tetralogy of Fallot.
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PMID:Left ventricular diastolic pressure-volume and stress-strain relationship in children. 400 27

Coronary lesions of periarteritis nodosa are detected in a newborn suffering from a Fallot's tetrad. The authors remind us of the present concept of infantile P.A.N. similar to adults' and of the notion of Kawasaki's syndrom that is almost the same as the infant's serious P.A.N. The reported case, original in many a detail, seems to represent the later expression monosymptomatic of Kawasaki's syndrom as if this one had been amputated at that stage of the greater part of its elements and then, casually developed in utero upon a congenital cardiopathy.
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PMID:[Tetralogy of Fallot, congenital coronary aneurysms with the histology of periarteritis nodosa: nosologic problems]. 610 36

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

Recently, Kawasaki disease has been attracting more attention as a new acquired heart disease in pediatrics, but the etiology of this disease has still not been established. In this study, the authors performed throat cultures not only on the patients themselves but also on their parents in order to investigate its etiology. No abnormal and specific bacterium was found in the present study. However, there have been many reports which may suggest bacterial or viral involvement at the onset of this disease. Therefore, it may be necessary to continue bacteriological analysis more systematically.
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PMID:The throat culture in Kawasaki disease. 713 10

Problems of arrhythmogenic sudden death (ASD) in athletes have been re-assessed on the clinicopathological plane, encompassing the emerging, unsolved, question of so-called idiopathic ventricular tachycardia, and its debated diagnostics versus arrhythmogenic right ventricular dysplasia-cardiopathy. Ischemic-infarction ASD from coronary artery pathology in young athletes has been seen to present with atherosclerotic "soft" subintimal plaques, rich in newly formed smooth myocytes, often attended by adventitial mast cell, as suspect microscopic markers of spasm, relevant to reperfusion; these features can be found also in precociously intramural arteries, responsible for ASD. Rare congenital abnormalities of the coronary ostia occasionally underlie ASD, together with the acquired aneurysmic coronaritis of chronic Kawasaki disease. Ischemic ASD can also be due to coronary arteriolopathy attending hypertrophic cardiomyopathy, a not uncommon disease in athletes, to be carefully discriminated from training heart hypertrophy. Young South-American sportsmen with Chagas' chronic cardiopathy seem to be at particular risk of ASD. Minor, but specific arrhythmogenic cardiac malformations such as accessory AV pathways have been detected in athletes succumbing to otherwise unexplained ASD, undergone careful post-mortem investigation. The need of more attentive and extended histopathologic control emerges from the hitherto ignored cardiac neuropathological substrates of reflexogenic ASD, which is cogent to problems of ASD in competing athletes. The thorough examination of the cardiac vascular centers in the brain stem, and of the peripheral cardiac innervation, at either abutments of the arc of dive- and/or Bezold-Jarisch cardioinhibitory-vasodepressor reflex, made it possible to suggest novel clinicopathological explanations in controversial cases of athletes' ASD, safeguarding from grave leval misjudgements due to sport's forensic medical mistakes.
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PMID:Structural and non-structural disease underlying high-risk cardiac arrhythmias relevant to sports medicine. 750 Jun 31

This article is an up-to-date review of issues surrounding Kawasaki disease, with particular emphasis on the immunologic aspects. Kawasaki disease is now the leading cause of acquired heart disease in children in most developed countries.
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PMID:Kawasaki disease. 756 92

Kawasaki syndrome (KS) is an acute multisystem vasculitis of infancy and early childhood associated with the development of myocarditis and coronary artery abnormalities. Despite the widely held belief that KS is caused by an infectious agent, there remains considerable controversy over its etiology. Recent immunologic and microbiologic studies suggest a potential role for staphylococcal and streptococcal toxins (superantigens) in the pathogenesis of KS. Confirmation of these findings could result in more effective diagnostic and therapeutic approaches to this common cause of acquired heart disease in children.
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PMID:Superantigens in Kawasaki syndrome. 758 18


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