Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cigarette smoking causes significant exposure to nicotine, which increases heart rate, blood pressure, and thus myocardial oxygen demand, and to carbon monoxide, which decreases the oxygen-carrying capacity of the blood because of carboxyhemoglobin formation. Cigarette smoking also predisposes the patient to coronary vasoconstriction. Smoking cessation results in the early elimination of nicotine and carbon monoxide from the system and decreases the risks of ischemia based on these mechanisms. Over the long term, smoking cessation results in elimination of the increased risk of myocardial infarction in patients without previous heart disease as early as 2 years after smoking stops. In addition, for patients with known coronary artery disease, smoking cessation results in an increase in HDL level, which may result in a retardation of atherogenesis and reduced cardiovascular morbidity and mortality. It is important for all physicians to reiterate both the short- and long-term risks of cigarette smoking as well as the good news-that smoking cessation results in a substantial, if not complete, reversal of the risk of myocardial infarction and death, particularly for patients with established coronary artery disease. In light of those established facts, efforts to develop more effective methods to help patients quit smoking must be increased so patients can realize these important health benefits.
 ...
PMID:Cardiovascular benefits of smoking cessation. 134 4

Excess fatigue is the most prevalent precursor of sudden cardiac death. This state may reflect prolonged tension or heart disease. In order to test the first explanation a prospective study was done among 3365 males, aged 45-59 years. This cohort was followed during an average period of 9.5 years. Exhaustion was assessed by the statement: 'At the end of the day I am completely exhausted mentally and physically'. Among those free of coronary heart disease at the beginning, 69 subjects died because of myocardial infarction. Data were analysed using Cox's regression analysis. The results showed a highly significant interaction between duration of follow-up and exhaustion upon the risk of cardiac death. The hazard ratios for exhaustion were 8.96, 6.33, 4.47 and 3.16 for the first 10, 20, 30 and 40 months of follow-up respectively. Thereafter the association between exhaustion and cardiac death is no more significant. It is argued that exhaustion before cardiac death does not reflect manifest heart disease but that an interaction between prolonged tension and subclinical levels of ischaemia may increase the risk of cardiac death.
 ...
PMID:Exhaustion as precursor of cardiac death. 139 66

The risk factors of ischemic cerebrovascular disorders in 77 young patients (< or = 40 years) were compared to those in 138 older patients (> 40 years). The risk factor profile of patients with juvenile stroke was considerably different from that of older patients. Migrainous headache and mitral valve prolapse occurred more frequently in the younger age group, whereas hypertension, diabetes mellitus, high levels of cholesterol and triglycerides were found more often in older patients with stroke. 65% of the women under the age of 40 took oral contraceptives which compares to the baseline community value of 28% of women in childbearing age in this country. Cardiac disorders such as atrial fibrillation, left ventricular hypertrophy, coronary heart disease including a history of myocardial infarction, as well as mitral valve disease were demonstrated more often in the group of elderly patients. 7 out of 77 younger patients (9.1%), and 59 out of 138 older patients (42.8%) were considered to belong to a group with "high cardiac risk for stroke". The results of this study indicate that electrocardiographic screening is of prime importance for detecting cardiac risk factors. However, echocardiographic examination often yields additional diagnostic information, particularly in younger patients. The conflicting opinions concerning the relevance of certain risk factors for ischemic stroke could partly be explained by the fact that these risk factors are distributed unevenly depending on age.
 ...
PMID:Different risk factor profiles in young and elderly stroke patients with special reference to cardiac disorders. 146 Apr 76

The ECG is useful in diagnosing acute myocardial infarction and unrecognized Q-wave myocardial infarction in the elderly. Unrecognized myocardial infarction and myocardial infarction associated with clinical symptoms have a similar incidence of new coronary events. Ischemic ST-segment depression on the resting ECG is associated with an increased incidence of new coronary events. The ECG is useful in the diagnosis of LV hypertrophy but is less sensitive and less specific than echocardiography in diagnosing LV hypertrophy. ECG LV hypertrophy is associated with an increased incidence of cardiovascular events in the elderly. However, echocardiographic LV hypertrophy is more sensitive in predicting new coronary events, atherothrombotic brain infarction, and congestive heart failure than is ECG LV hypertrophy. The ECG is also useful in diagnosing conduction defects and arrhythmias in the elderly. In the elderly, left bundle branch block, intraventricular conduction defect, Type II second-degree atrioventricular block, and pacer rhythm are associated with an increased incidence of new cardiac events, whereas right bundle branch block, left anterior fascicular block, and first-degree atrioventricular block are not. In the elderly, atrial fibrillation is associated with an increased incidence of thromboembolic stroke and new cardiac events. Premature atrial complexes and paroxysmal supraventricular tachycardia are not associated with an increased cardiac risk. Complex ventricular arrhythmias on the resting ECG are associated with an increased incidence of cardiac events in elderly patients with heart disease but not in elderly patients without heart disease.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Usefulness of the resting electrocardiogram in the elderly. 147 52

Risk factors for intracerebral hemorrhage (ICH) and cerebral infarction (CI), were studied by a prospective study of 7,390 men and women aged 40-69 without a history of stroke living in three rural populations in Japan. Baseline examinations were done for populations in Akita-Ikawa and Akita-Ishizawa in 1975-1979, and for Ibaraki-Kyowa in 1981-1987, and followed until 1989 for Akita-Ikawa and Ibaraki-Kyowa and 1987 Akita-Ishizawa. There were 246 stroke cases diagnosed by clinical criteria during the follow-up period in which 74 percent (n = 181) had data from computed tomography (CT) performed within three weeks of the onset. According to these CT-findings, 181 stroke were classified as 48 with ICH, 50 with CI in penetrating artery regions (penetrating artery infarction), 33 with CI in cortical artery regions (cortical artery infarction), and 31 with subarachnoid hemorrhage while there were 19 with stroke without any evident CT abnormality. Cortical artery infarction was further classified as embolic type (n = 17) and thrombotic type (n = 9) according to clinical findings of the onset and presence of possible embolic sources such as atrial fibrillation, congenital heart disease, myocardial infarction and heart valve diseases. Using a nested case-control design, risk variables at baseline examination were compared between 131 stroke cases, 48 ICH and 83 CI, with 655 controls matched for sex, age (+/- 3), and the follow-up year. Univariate analysis showed that high blood pressure was associated with all types of stroke. From conditional logistic regression analysis significant risk variables were found to be high blood pressure for ICH and penetrating artery infarction, while atrial fibrillation and ST-T abnormality in electrocardiogram (ECG) were risk variables for cortical artery infarction. Associations with hypertensive or arteriosclerotic changes in ocular fundus were stronger for penetrating artery infarction than ICH and cortical artery infarction. ST-T abnormality in ECG was associated with embolic type cortical artery infarction and high blood pressure was associated with the thrombotic type, although the number of cases were small. Compared to controls, cortical artery infarction showed a higher mean value of serum total cholesterol for thrombotic type cortical infarction, and lower mean values for embolic type and ICH, but none of them reached statistical significance. The present study also suggests that duration of hypertension varied with type of stroke. ICH may develop due to acute effects of hypertension, while penetrating artery infarction and cortical artery infarction develop by chronic effects of hypertension.
 ...
PMID:[A nested case-control study of risk factors for intracerebral hemorrhage and cerebral infarction classified by computed tomographic findings]. 150 35

Flecainide (100 mg twice daily) was used for prevention of paroxysmal atrial fibrillation (PAF) in 52 patients with frequent symptomatic attacks that were resistant or intolerant to quinidine (600-900 mg/day). Underlying heart disease was present in only 8 cases and left ventricular ejection fraction was always greater than 30%. No patient had had a myocardial infarction. Vagally induced PAF was clinically documented in 35 patients. Amiodarone, previously used and ineffective, was combined with flecainide in 33 patients. After 1-5.8 years of follow-up, complete disappearance of PAF was observed in 38 patients (73%). The success rate was slightly higher in patients with vagally induced PAF (p = 0.07). Extracardiac side effects necessitated withdrawal in only 3 cases. Permanent pacemaker was needed in 7 patients on amiodarone and flecainide because of excessive sinus bradycardia. Two patients, with previously documented atrial flutter, experienced presyncopal episodes of atrial flutter with 1:1 atrioventricular (AV) conduction and wide QRS complex. No death occurred during the follow-up. In this series, quinidine proved to be unsuccessful in 46 patients and it was withdrawn in 6. We concluded that flecainide is efficient and well tolerated for long-term prevention of PAF in patients resistant to quinidine. The possibility of 1:1 AV conduction during atrial flutter may suggest the use of verapamil or beta blockers in combination with flecainide in patients with previously documented atrial flutter.
 ...
PMID:Flecainide in quinidine-resistant atrial fibrillation. 151 1

The paper deals with the need for institutional change and behaviour change in the medical care and social security system of the Federal Republic of Germany. The data reported are from the Oldenburg Longitudinal Study (OLS), in which a thousand males suffering from a first myocardial infarction have been surveyed with mailed questionnaires five times in five years. In this study, special emphasis has been given to the influence of social support from the spouse, the medical care system, and workmates on the coping process. Special emphasis has been given as well to institutional factors and organizational problems in the rehabilitation system of general practitioners, rehabilitation clinics and the social security system. The paper concludes that there is a clear need for comprehensive services and other measures that promote self-reliance and self-help activities among patients and their relatives. In the literature on heart disease, "health promotion" is mostly defined as behavioural change on the part of the individual--i.e. patients or members of what is conventionally called a "higher risk group". In this paper, however, I shall concentrate on another aspect which is no less important: the need for institutional change and behavioural change in the medical care and social security systems. This change, I argue, is needed in order to promote the health of patients who survived a first myocardial infarction.
 ...
PMID:Effecting institutional change. 151 13

Prerequisite of a rational antiarrhythmic therapy is the correct diagnosis of the given cardiac rhythm disorder. The majority of intermittent and latent cardiac arrhythmias can be reliably induced and analyzed during the electrophysiologic study (EPS). In case of bradyarrhythmias, the method is indicated in patients with suspected sinus node disease or high-grade AV conduction disturbances, as far as the cause of clinical symptoms cannot be settled by Holter recordings. Since patients with paroxysmal supraventricular tachycardias (WPW syndrome and AV nodal reentrant tachycardia) can be cured by transvenous ablation techniques, EPS is indicating in this setting in all symptomatic patients for the diagnosis and the treatment of the given arrhythmia. In patients with recurrent ventricular tachyarrhythmias, EPS should be performed to establish the diagnosis and to control medical treatment; in addition, EPS is a prerequisite for nonpharmacologic treatment modalities such as defibrillator therapy and transvenous or surgical ablation techniques. In survivors of cardiac arrest without new Q-wave myocardial infarction, persistent ventricular tachyarrhythmias can be induced in some 50% of the patients. Patients should be evaluated by EPS in case the reasons for significant clinical symptoms cannot be determined otherwise, given the likelihood, that brady- or tachyarrhythmias are the cause of the clinical symptoms; this includes patients with organic heart disease and with unexplained syncopes.
 ...
PMID:[Who should be referred for electrophysiologic studies?]. 151 85

This paper describes the motivations of individuals (N = 101) assisting in the delivery of a program of information and support for heart attack and heart surgery patients and their partners. The majority of those surveyed were recruited through association with charitable foundations or through a professional colleague and are motivated by the personal satisfaction derived from providing education and support to those recovering from heart disease.
 ...
PMID:Motivations of professionals for involvement in the delivery of a heart disease education and support program. 152 54

The usefulness and limitations of antiarrhythmic drugs in ventricular tachycardias (VT) associated with congestive heart failure remain uncertain. The purpose of this study is to evaluate the proarrhythmic effects of antiarrhythmic drugs in patients with refractory VT associated with left ventricular dysfunction using electrophysiologic study (EPS). Twenty-four patients with left ventricular dysfunction, defined by left ventricular ejection fraction (LVEF) lower than 40% using left ventriculography, were studied. The average LVEF was 29.5%. As for underlying heart disease, 14 had old myocardial infarction, 8 cases had dilated cardiomyopathy and 2 had aortic regurgitation. As a control to this group, 23 cases with underlying heart disease and LVEF higher than 40%, and 27 cases with no obvious heart disease were studied. We considered a drug to have proarrhythmic effects if 1) it decreased by one the number of stimuli needed to induce VT, 2) induced non-sustained VT in the control study which changed to induced sustained VT, 3) the sustained VT or ventricular fibrillation was newly induced, or 4) the induced sustained VT which was stopped by pacing in the control study changed to induced VT which could not be terminated by pacing and required DC shock. Proarrhythmic effects were recognized in 17 of 24 cases with left ventricular dysfunction. Of the 67 drug trials, proarrythmic effects were seen in 26. Proarrhythmias were observed in 9 of 23 cases (39.1%) with organic heart disease associated with LVEF higher than 40%. In 12 of 69 drug trials (17.4%) proarrhythmias were observed. Of 27 cases with no obvious heart disease 10 cases (37%) had proarrhythmias. In 14 of 130 drug trials (10.8%), proarrhythmias were recognized.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Evaluation of proarrhythmic effect of antiarrhythmic drugs on ventricular tachycardia associated with congestive heart failure. 153 78


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>