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

One hundred and twenty-four patients treated by Fogarty balloon catheter embolectomy from 1964 through 1973 were reviewed and compared to an earlier series of 82 patients treated by direct extraction during the interval from 1948 to 1963. In patients undergoing embolectomy, the incidence of rheumatic heart disease (RHD) declined from 55 to 27 percent, and that of arteriosclerotic heart disease (ASHD) rose from 39 to 55 percent. The operative mortality rate of those with RHD was unchanged and that of patients with ASHD declined from 74 to 36 percent. This was attributed, in part, to the lesser degree of operative stress entailed by the Fogarty catheter and the local anesthesia. Limb salvage was 82 percent when ischemic symptoms were less than 24 hours in duration and 66 percent when such symptoms were more than 24 hours in duration. The amputation rate for the entire group was 22 percent. The low 2 year survival of patients with ASHD and of amputees was ascribed to the wide extent of their atherosclerotic cardiovascular disease. This was emphasized by the fact that 44 percent of late deaths were due to myocardial infarction.
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PMID:Changing clinical trends in patients with peripheral arterial emboli. 124 75

Coronary- and LV-angiography in coronary heart disease are indicated I) to clarify whether or not surgery is required (e.g. aorto-coronary-bypass operation, aneurysmectomy) in 1) drug resistent angina pectoris, 2) myocardial aneurysms (or the suspicion of), 3) VSD following myocardial infarction and/or 4) as preoperative investigations in mitral regurgitation or 5) other valve lesions. II) These investigations are furthermore indicated in the under-50-yr.-old considering their prognosis and diagnosis 1) following myocardial infarction 2) to clarify a pathological exercise test with or without angina pectoris 3) in the differential diagnosis of myocardial diseases and 4) occasionally in patients with a number of risk factors or exposed to particular occupational hazards or from families with a high incidence of early deaths from heart disease. Coronary- and LV-angiography are contraindicated in 1) generalized stenosing atherosclerosis, 2) acute myocardial infarction, 3) failure from other organ-systems (e.g. kidney), 4) drug resistent endogenous risk factors and/or relevant obesity, 5) biological age over 60-65.6) continued nicotine dependence. In many cases the specific diagnostic investigations will include the assessment of coronary flow at rest and during maximal drug induced coronary dilatation. This enables us to estimate the coronary reserve and to diagnose coronary insufficiency in patients with normal coronary angiograms.- Instructive morphological and/or functional results illustrate this presentation.
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PMID:[Indications for coronary arteriography and left ventriculography in coronary heart disease (author's transl)]. 125 Nov 19

The cardiovascular effects of prolonged administration of levodopa were studied in 54 men and women with Parkinson's disease; 23 of them were younger than 70 and 31 were 70 or older. The patients were evaluated clinically before treatment was started and at regular intervals thereafter. The average optimal dosage of levodopa for both age groups was 3.0 and 2.5 gm per day, respectively, during an average treatment period of 20.7 months. Eleven patients showed hypotension (systolic BP of 105 mm Hg or less) that was not related to dosage; in only 6 did the drug have to be permanently discontinued because of syncope; 3 of this group had an associated psychiatric disorder. Four patients had pretreatment hypertension; in 3 the BP fell to normal during therapy; in the remaining patient the hypertension persisted and was successfully treated by an antihypertensive drug. In 5 patients an occasional atrial or ventricular ectopic beat was noted both before and during levodopa therapy but no therapeutic intervention was required. Thirty of the 46 patients with adequate ECG follow-up did not show any significant changes; 5 others showed an increase, and 11 a decrease in myocardial ischemia. Thus the administration of levodopa in elderly patients with or without heart disease is a relatively safe procedure. The only exception would be patients over 70 years of age with a history of previous myocardial infarction. In this group there seems to be a higher incidence of clinically significant hypotension. In such patients, levodopa therapy should be carried out with great caution.
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PMID:Cardiovascular effects of levodopa in aged versus younger patients with Parkinson's disease. 125 82

Quantifiable 201Tl scanning of the myocardium was performed in 23 patients with coronary heart disease and 10 without heart disease. Taking into consideration normal relative minimal storage of 201Tl in different regions of the myocardium (five projections), decreased 201Tl uptake in underperfused myocardium (acute myocardial infarction, coronary artery stenoses with hypo-, dys-, and akinesia) was recognizable according to extent and localisation (iso-impulse rate scan). The lowest relative 201Tl storage was found in dyskinesia or akinesia (37.6-54.1%) in the region of the anterior wall, as well as in acute myocardial infarction (50%). In the period after myocardial infarction persistence and normalisation of underperfusion could both be demonstrated. 201Tl scan as a non-invasive test is an appropriate means for demonstrating relative regional perfusion in the myocardium, with myocardial capacity for active uptake of potassium-like thallium being determined at the same time.
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PMID:[Results of 201thallium myocardial scanning in coronary heart disease (author's transl)]. 127 50

Ray asks the question: 'If A-B does not predict heart disease, why bother with it?' (British Journal of Medical Psychology, 64 (1) 1991). Having worked for several years in prevention of heart attack recurrence, I am inclined to agree with his conclusion that the construct is a trail which should now be abandoned. Grief, hostility and social isolation, fear and work demands have each been implicated in heart disease independently of Type A.
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PMID:If A-B does not predict heart disease, why bother with it? A clinician's view. 177 80

Factors influencing the effect on employment status were investigated in 250 patients (males: females 224:26) who underwent coronary artery bypass surgery between March 1983 and November 1985. The median age at operation was 57.9 (range 36.6-69.4) years and the median follow-up time 32 (19-52) months. Preoperatively 149 patients (59.6%) were receiving sick pay or disability pension because of their heart disease. Only 64 (25.6%) were gainfully employed, in contrast to 97 (38.8%) at follow-up. Of those who were working at the time of operation, all but eight returned to work postoperatively. At follow-up 183 (80.3%) were free from symptoms or much improved, with degree of improvement somewhat greater in those who were working postoperatively. The period of sick leave and the preoperative waiting time were significantly shorter for patients who were working postoperatively than for those who were awarded disability pension. Age, previous myocardial infarction, duration of preoperative angina and type of work were also found to influence postoperative employment status.
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PMID:Factors influencing return to work after aortocoronary bypass surgery. 128 32

A controlled study was carried out on 160 patients of both sexes (age between 39 and 86 years) discharged from the Cardiology Department of the Santa Chiara Hospital, Pisa, with a diagnosis of recent myocardial infarction. L-carnitine was randomly administered to 81 patients at an oral dose of g 4/die for 12 months, in addition to the pharmacological treatment generally used. For the whole period of 12 months, these patients showed, in comparison with the controls, an improvement in heart rate (p < 0.005), systolic arterial pressure (p < 0.005) and diastolic arterial pressure (NS); a decrease of anginal attacks (p < 0.005), of rhythm disorders (NS) and of clinical signs of impaired myocardial contractility (NS), and a clear improvement in the lipid pattern (p < 0.005). The above changes were accompanied by a lower mortality in the treated group (1.2%, p < 0.005), while in the control group there was a mortality of 12.5%. Furthermore, in the control group there was a definite prevalence of deaths caused by reinfarction and sudden death. On the basis of these results, it is concluded that L-carnitine represents an effective treatment in post-infarction ischaemic cardiopathy, since it can improve the clinical evolution of this pathological condition as well as the patient's quality of life and life expectancy.
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PMID:Controlled study on L-carnitine therapeutic efficacy in post-infarction. 129 18

A total of 166 patients who had one or more attacks of myocardial infarction and those with angina pectoris, forty-five relative of 18 hyperlipidemic survivors of ischaemic heart disease, and 330 healthy persons (controls) were investigated for serum lipid profiles. Fifty-six of the 166 patients were hyperlipidemic. The commonest abnormalities in lipoproteins were Types IIa, IIb and IV. 75.5% of the 45 relatives investigated were hyperlipidemic. The familial studies showed that hyperlipidemias occurred in the family members of persons with ischaemic heart disease suggesting that hyperlipidemia could play an important role in predisposing familial clustering of coronary heart disease. A family history of heart disease may be a useful marker for identifying persons who are more likely to have high levels of blood lipids for possible treatment.
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PMID:An assessment of serum lipid and lipoprotein levels in patients with ischaemic heart disease. 129 16

Nearly 15 years ago, it has been shown that myocardial infarction is accompanied by left ventricular dilatation. In the following years more details were obtained on morphological changes consecutive to myocardial infarction, now grouped together under the term left ventricular remodelling. These changes enable the patients to survive despite reduction of the contractile ventricular mass, but they expose the ventricles to constraints resulting in excessive work load. It has been shown that these changes can be reduced by early myocardial reperfusion and by administration of angiotensin-converting enzyme (ACE) inhibitors. These findings were established first in animals, then in man. Administering ACE inhibitors to patients with symptomatic heart failure consecutive to advanced ischaemic cardiopathy prolongs the patients' survival. When ACE inhibitors are given to patients with severe asymptomatic left ventricular dysfunction which started soon or long after a myocardial infarction, they reduce the frequency of ischaemic events, passage to symptomatic heart failure and, at least in one study, mortality. ACE inhibitors have also been shown to reduce the size of myocardial necrosis when administered in the acute phase of experimental myocardial infarction. Preliminary data have demonstrated that ACE inhibitors given in the acute phase of myocardial infarction reduce the left ventricular dilatation which follows infarction. However, a study of ACE inhibitors administered to a large number of patients in the acute phase of myocardial infarction had to be interrupted because of the over-mortality in the treated group. These facts are reviewed in this article, and attempts have been made at deducing from them the current indications of ACE inhibitors in patients with coronary heart disease.
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PMID:[Converting enzyme inhibitors and coronary failure]. 129 42

A case of recurrent ventricular tachycardia in the setting of chronic chagasic heart disease refractory to conventional antiarrhythmic agents as well as high doses of amiodarone (600 mg/day) is reported. Left ventriculography disclosed an apical aneurysm and a filling defect image suggestive of a thrombus. Sustained monomorphic ventricular tachycardia with the same QRS configuration as "clinical" tachycardia could be induced by means of right ventricular programmed electrical stimulation. The risk of systemic embolization precluded endocardial activation mapping of ventricular tachycardia. Intracoronary cold saline injections were done during induced ventricular tachycardia looking for a coronary artery branch related to the arrhythmogenic substrate. Cold saline mapping results pointed to an apical site of origin. Next step was intracoronary injection of ethyl alcohol in the distal part of the left anterior descending artery leading to a small and uncomplicated myocardial infarction. Control programmed stimulation was unable to reinduce ventricular tachycardia. Clinical outcome was uneventful and there was no recurrence of clinical arrhythmia in 6 months of follow-up.
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PMID:[Transcoronary chemical ablation of ventricular tachycardia in a patient with chronic chagas cardiomyopathy]. 134 Jul 1


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