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

Three patients with the rare anomaly of congenital absence of the ostium of the left main coronary artery are presented. In two of the patients, aged 50 and 52 respectively, the diagnosis was established during selective coronary cineangiography for a severe anginal syndrome. The third patient, a 16-year-old-girl, underwent cardiac catheterization for investigation of a congenital heart malformation, when a single right coronary artery was demonstrated with absence of the main coronary artery ostium. Two patients underwent successful aortocoronary bypass grafting. In view of the occurrence of sudden death and massive myocardial infarction in adult patients shown to have severe or complete obstruction of the left main coronary artery, it is suggested that adult patients with this condition, who require open-heart surgery for any other cardiac disorder, should undergo aortocoronary bypass grafting concurrently even prior to the development of anginal symptoms. Children shown to have this anomaly should be subjected to long-term follow-up and have an aortocoronary bypass graft performed when symptoms of coronary insufficiency develop.
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PMID:Congenital atresia of the left main coronary artery ostium. 31 42

The National Exercise and Heart Disease Project (NEHDP) was funded by the Rehabilitation Services Administration (RSA) of the Department of Health, Education and Welfare, to determine the effects of regular physical activity on the rehabilitation, morbidity and mortality of patients with healed myocardial infarctions. Planning and development lasted from June 1972 through September 1974. Since 1974, 932 subjects were referred for evaluation. At randomization, 651 subjects were assigned to exercise treatment (323) or control (328) groups. Those who qualified for randomization had to complete an initial evaluation, attend 14 of 18 consecutively scheduled, low-level physical activity sessions during a period of 6 weeks, and complete a second evaluation. This prerandomization phase was accompanied by significant alterations in work capacity, heart rate levels at rest and during three levels of physical stress, systolic blood pressure reductions during stress but not at rest, and by changes in the level of anxiety and depression. The subjects will be followed for a minimum of 2 years at regular intervals to determine if regularly performed physical activity is beneficial to the rehabilitation of myocardial infarction survivors.
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PMID:The National Exercise and Heart Disease Project. The pre-randomization exercise program. Report number 2. 35 40

Heart disease continues to be a major cause of disablement and death in Canada. Elevated serum cholesterol concentrations, hypertension and cigarette smoking are among the standard risk factors associated with ischemic heart disease. Research attention has also been directed at the role of behavioural factors in the development of atherosclerosis and myocardial infarction. Experimental findings support a conceptual approach to the interplay of psychologic stress, the type A "coronary"-prone behaviour pattern and pathophysiologic mechanisms that have been implicated in the development of coronary artery disease. It is concluded that type A behaviour and stress contribute substantially to the pathogenesis of cardiovascular disease. However, assessment of the manner in which these two variables influence the pathophysiology of ischemic heart disease requires further research, with systematic examination of physiologic and biochemical processes. Potential strategies for modifying type A behaviour are reviewed. However, unequivocal support for the preventive efficacy of behavioural approaches must await future research.
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PMID:Behavioural prevention of ischemic heart disease. 36 Nov 91

Medical treatment of heart disease has improved significantly in the past 30 years. The spectacular change in the natural history of rheumatic heart disease is apparent from a 1948 article that reported that 42% of children with rheumatic heart disease died of rheumatic infection or bacterial endocarditis. Antibiotics and cardiac surgery have improved the outcome from rheumatic heart disease. Cardiopulmonary resuscitation has had a major impact on the treatment of myocardial infarction and on the management of sudden death. The fundamental principle underlying the discovery of cardiopulmonary resuscitation is reviewed, and recent developments emphasizing the importance of intrathoracic pressure in the hemodynamics of cardiopulmonary resuscitation are highlighted. The important new drugs of the last 30 years include the oral diuretics, the antihypertensives and the antiarrhythmic agents. The development of the beta-blocking agents is cited as an example of the translation of basic physiological research to medical care. Finally, the role of epidemiologic techniques in the design of clinical trials to evaluate medical therapy and hence improve medical management is discussed.
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PMID:Research related to medical treatment of cardiovascular disease. 38 90

The topography and severity of lesions of the right branch of the bundle of His have been studied as a function of the electrocardiographie changes and the associated heart disorder in 33 cases with more than 50% of the fibres destroyed. It appears that lesions of the right branch of the bundle of His, while severe and diffuse in cases of chronic complete right branch block, were severe but localised in 5 of the 6 cases with a stable incomplete right block. Total, subtotal or partial destruction of the right branch of the bundle of His was associated with lesions of the A-V node and/or the main truck of the bundle of His in the five cases with a complete atrio-ventricular block. The lesions of the right bundle branch involved the superior, middle and inferior portions in the case of aortic valve lesions, the middle portion in mitral valve disease, and the inferior portion in those with myocardial infarction. Ventricular hypertrophy seems to play an important in deciding whether the axis of the QRS, complex is left or right.
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PMID:[Lesions of the right branch of the bundle of His. Clinical, electrocardiographic and histologic study of 33 cases]. 40 86

In a series of 683 consecutive carotid endarterectomies, there were 16 postoperative myocardial infarctions which resulted in five deaths. Of 399 operations on patients with no previous history of heart disease, there were only two myocardial infarctions (0.5%). Two hundred and eighty-four operations were performed on patients with heart disease, and vasopressors were administered in 135 of these procedures. For these patients the risk of myocardial infarction increased from 2.0% to 8.1% with the use of vasopressors (P less than 0.001). The management of the patient with stable heart disease undergoing carotid endarterectomy is discussed.
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PMID:Myocardial infarction following carotid endarterectomy: a review of 683 operations. 42 94

1496 women age 55 to 74 were studied in an effort to determine heart disease risk factor differences attributed to postmenopausal estrogen (PME) use. 39% of the females reported using estrogen at the time of the study, with peak hormone use in the 55 to 59 year age group. Analysis of the following possible confounding variables, social class, current cigarette smoking, family history of heart attack or diabetes and obesity found that only obesity was statistically significant ( P .001) and thus further analysis of PME use was adjusted for obesity. Results showed average cholesterol level was 9.4 to 20.4 mg/dL lower among PME users compared to nonusers. Although triglyceride level was higher in PME users at all ages it was only statistically significant for women aged 60-69 years. Mean systolic and diastolic blood pressures were 2 to 4 mm Hg lower in PME users and the average fasting plasma glucose level was significantly lower in young PME users only. Multivariate Hotellings T statistic was used to test for independence. While the study examined the net cumulative effect of PME use of putative heart disease, it did not examine specific estrogens, dosage or duration of use differences. The authors concluded that further studies are needed before final conclusions can be made regarding the use of PME as a risk factor reducer in heart disease.
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PMID:Heart disease risk factors and hormone use in postmenopausal women. 43 Aug 17

Because the advantage that women have over men in a lower heart attack rate is gradually lost after menopause, it has been suggested that estrogen may exert a protective effect against heart disease. The situation is complex, and the available data are open to various interpretations. Available data show a gradual, predictable increase in the death rate from heart disease among women with advancing age, despite the apparent increase in cardiovascular events around the time of menopause. This suggests that men may be particularly susceptible to heart disease, rather than that women have an immunity to the disease. The theory that estrogen exerts a protective effect against heart disease was examined when men who had had heart attacks were treated with estrogen in the Coronary Drug Project. The practice was discontinued when it was found that men receiving estrogen had an elevated incidence of myocardial infarction, a finding that suggests that estrogen may promote heart disease. Additional evidence that estrogen may have a harmful effect on the cardiovascular system comes from a recent study by Gerald B. Phillips who found that men who had suffered heart attacks before age 43 had higher levels of estradiol in their blood than men who had not had heart attacks. A noteworthy finding from th e Framingham study was the fact that the relative risk of cardiovascular events in postmenopausal compared with premenopausal women seemed to decrease with age. Hans Selye identifies stress as "the final, decisive eliciting factor" in precipitating heart attack. Broda O. Barnes also maintains that stress is a major cause of heart attack, but adds that most stress-prone individuals suffer from thyroid deficiency, which is the underlying cause of their increased susceptibility to heart attacks.
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PMID:Hormones and heart disease. 44 79

Accelerated idioventricular rhythm (AIVR) has been reported in patients with acute myocardial infarction, digitalis excess, and subarachnoid hemorrhage, and in patients with rheumatic, primary myocardial, and hypertensive heart disease. Discovery of AIVR in 2 patients without heart disease led us to review reports from 700 Holter monitor studies. Seven patients without recent myocardial infarction were studied retrospectively. Three of the 7 had no evidence of heart disease; 5 of the 7 had abnormalities of the central nervous system. Examples of AIVR show approximation of the sinus rate and ectopic rate; onset and offset occur abruptly or with sinus rate slowing and fusion beats. One patient remained in AIVR for up to 10 minutes accompanied by retrograde atrial capture. The rhythm's acceleration with exercise suggests that it is under autonomic influence, a phenomenon also seen in CNS stimulation studies in dogs. AIVR occurs infrequently in patients without demonstrable heart disease. Our experience suggests a good prognosis, but further study is needed onthe natural history of AIVR in asymptomatic patients and on the necessity of treatment.
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PMID:Accelerated idioventricular rhythm in patients without acute myocardial infarction. 50 62

The direct body Bcg has been shown to reflect various expressions of the known physiological principles of cardiac dynamics. Emphasis has been placed on the identification and characteristics of the individual segment rather than on gross pattern variability for proper Bcg pattern evaluation. Its sensitivity in the detection of early myocardial infarction with particular attention to its initial HI forces has been described. The significance of the simple Master two-step test (double) in eliciting the amplification or deterioration of these forces as a measure of myocardial integrity has also been emphasized. With this proposed definitive direction, there is call for widely organized attempts to clarify its potential as an important adjuvant in the study of clinical heart disease.
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PMID:Direct body ballistocardiography: a 25 year survey. Landmarks in its representation of cardiac dynamics. 50 59


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