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

During the last two years, reports have appeared linking cocaine use to virtually every type of heart disease. Ischemic events have been reported regularly, and there appears to be a strong relationship between cocaine use, contraction bands, and sudden arrhythmic death. The evidence concerning cocaine-induced myocarditis, cardiomyopathy, and valvular heart disease is less clear. In this article, we review the currently known morphological changes induced by cocaine and discuss the possible mechanisms of action leading to these changes.
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PMID:The pathology and etiology of cocaine-induced heart disease. 327 99

Patients under evaluation for cardiac transplant surgery were seen for routine psychiatric diagnosis and treatment. Of 35 patients with idiopathic cardiomyopathy, 83% (N = 29) had definite or probable panic disorder. Of 25 patients with postinfarction cardiac failure, rheumatic heart disease, or congenital heart disease, only 16% (N = 4) had definite or probable panic disorder. The authors suggest that autonomic mechanisms may underlie the association of cardiomyopathy and panic disorder and that increased cardiac sympathetic tone or circulating catecholamines may cause myocarditis and cardiomyopathy.
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PMID:Idiopathic cardiomyopathy and panic disorder: clinical association in cardiac transplant candidates. 331 Jun 71

The diagnosis of active lymphocytic myocarditis by the use of the endomyocardial bioptome is at present a hotly debated topic. However, the question of whether lymphocytes reside in the myocardium of individuals without systemic or cardiac disease has rarely been addressed, but is obviously of critical importance in helping to resolve this issue. Therefore, we examined endomyocardial biopsies obtained from 86 young heart disease-free cardiac transplant donors at the time of transplantation. Foci of inflammatory cells were found in eight (9.3%) cases and by definition contained greater than five inflammatory cells per focus. The inflammatory infiltrates were predominantly lymphocytic. Based on these results and those of others, it is becoming evident that there is a normal myocardial lymphocyte population which must be reckoned with when considering the diagnosis of myocarditis, realizing the potential therapeutic implications of this diagnosis.
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PMID:Myocardial lymphocytes. Fact, fancy, or myocarditis? 333 50

The ratio between maximal and minimal R-R intervals measured during the Valsalva maneuver is an adequate means of studying the functional state of the cardiac parasympathetic nervous system. We studied the changes in heart rate evoked during the Valsalva maneuver in 49 asymptomatic Chagasic patients with different degrees of myocardial involvement. The Chagasic patients were divided in three groups. Twelve patients had no evidence of heart disease except for an abnormal myocardial biopsy. Sixteen patients had a normal electrocardiogram but revealed evidence of localized myocardial damage as shown by left ventricular cineangiography. Twenty-one patients had abnormal electrocardiograms and revealed multiple areas of abnormal left ventricular wall motion. The Valsalva ratio (mean +/- standard error) was 1.62 +/- 0.12 for controls, 1.52 +/- 0.10 for those with an abnormal biopsy, 1.48 +/- 0.06 for those with localized myocardial damage, and 1.31 +/- 0.04 for those with an abnormal electrocardiogram. There were no statistically significant differences between the control group (normal sero-negative subjects) and those patients with normal electrocardiograms. Results in those with an abnormal electrocardiogram, however, were statistically different (P less than 0.05) from the other groups. These results are in discordance with the commonly accepted hypothesis that cardiac parasympathetic denervation causes a dilated myocardiopathy in patients with chronic Chagasic myocarditis.
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PMID:Valsalva maneuver: a test of the functional state of cardiac innervation in Chagasic myocarditis. 336 May 20

Methods have been developed for measuring several biochemical parameters (isoenzymes of LDH and ASAT, glycogen phosphorylase, lipid peroxides) in extremely small tissue samples (0.2-1.8 mg) taken using a left ventricular biopsy technique. Endomyocardial biopsies from patients with dilative and hypertrophic cardiomyopathy (CMP) and with myocarditis were investigated and compared with a reference group without actual functional and morphological evidence of chronic heart disease. Patients with myocarditis showed the highest activities of LDH and its isoenzymes, ASAT, ASATm and glycogen phosphorylase and the highest concentration of lipid peroxides. In patients with hypertrophic CMP increased activities of glycogen phosphorylase and decreased activities of ASAT and ASATm have been found. In patients with dilative CMP slightly elevated ASAT and ASATm activities have been observed. The results obtained in this study suggest that the parameters investigated could be useful in differentiating between cardiomyopathies and myocarditis.
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PMID:Enzyme pattern and lipid peroxides in endomyocardial biopsies from patients with cardiomyopathy and myocarditis. 337 58

A 48 year-old-man, with fulminant hepatitis complicated with myocarditis was treated. Despite intensive care, he died of fulminant hepatitis associated with hepatitis B virus infection. Electrocardiography (ECG) showed myocardial infarction-like changes when he went into a deep coma. Microscopically, scattered foci of myocardial cell damage and cell death associated with clusters of inflammatory cells were present in the heart at autopsy. However, there were no findings related to myocardial infarction and staining for hepatitis B surface antigen and core antigen were nil. The concentration of plasma catecholamine was elevated concomitantly with high level of ECG changes. We consider that abnormal ECGs may reflect a hypersecretion of catecholamine and suggest that our patient had a catecholamine cardiopathy.
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PMID:Electrocardiographic changes related to hypersecretion of catecholamine in a patient with fulminant hepatitis. 341 84

Unusual lesions caused by Streptococcus suis involved the heart of 48 pigs necropsied over a four-year period. Lesions included fibrinopurulent pericarditis (six pigs), hemorrhagic, necrotizing myocarditis resembling mulberry heart disease (21 pigs), and vegetative valvular endocarditis (21 pigs). Histologically, the myocarditis was characterized by focally extensive and diffuse hemorrhages and necrosis, with infiltrations of neutrophils and mononuclear cells, and thrombosis of small and large myocardial vessels. The 21 pigs with vegetative valvular endocarditis generally were over ten weeks old and had died suddenly. The left atrioventricular valve was affected in 18 hearts. Most of an affected valve was replaced by a layer of granulation tissue covered by a mixture of fibrin, inflammatory cells, necrotic debris and large numbers of coccoid bacteria.
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PMID:Gross and histopathological findings in unusual lesions caused by Streptococcus suis in pigs. I. Cardiac lesions. 345 68

Endomyocardial biopsy is a safe, reliable, and reproducible technique to confirm or establish the diagnosis of the pathology that affects cardiac function in conditions previously classified as cardiomyopathies of unknown cause. The first 64 consecutive patients to undergo endomyocardial biopsy were reviewed to determine its utility in various clinical settings. Furthermore a review of literature relating to endomyocardial biopsy is presented. On the basis of these findings, we conclude that endomyocardial biopsy is indicated in the clinical setting of dilated cardiomyopathy, for evaluating underlying myocarditis. In patients with dysrhythmias or clinical myocarditis, endomyocardial biopsy may disclose myocarditis or changes consistent with congestive cardiomyopathy. In patients with systemic disease endomyocardial biopsy is instructive to prove or to exclude myocardial involvement. In patients with angina-like chest pain but with normal coronary angiograms or exercise tests, endomyocardial biopsy may prove underlying heart disease.
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PMID:Right ventricular endomyocardial biopsy: clinicopathologic correlates in 64 consecutive patients. 349 65

Cardiovascular diseases responsible for sudden unexpected death in highly conditioned athletes are largely related to the age of the patient. In most young competitive athletes (less than 35 years of age) sudden death is due to congenital cardiovascular disease. Hypertrophic cardiomyopathy appears to be the most common cause of such deaths, accounting for about half of the sudden deaths in young athletes. Other cardiovascular abnormalities that appear to be less frequent but important causes of sudden death in young athletes include congenital coronary artery anomalies, ruptured aorta (due to cystic medial necrosis), idiopathic left ventricular hypertrophy and coronary artery atherosclerosis. Diseases that appear to be very uncommon causes of sudden death include myocarditis, mitral valve prolapse, aortic valve stenosis and sarcoidosis. Cardiovascular disease in young athletes is usually unsuspected during life, and most athletes who die suddenly have experienced no cardiac symptoms. In only about 25% of those competitive athletes who die suddenly is underlying cardiovascular disease detected or suspected before participation and rarely is the correct clinical diagnosis made. In contrast, in older athletes (greater than or equal to 35 years of age) sudden death is usually due to coronary artery disease, and rarely results from congenital heart disease.
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PMID:Causes of sudden death in competitive athletes. 351 Feb 33

Young rabbits (1-2 months of age) inoculated with trypomastigote forms of the Colombia strain of Trypanosoma cruzi have been shown to develop cardiac pathological changes (together with parasitological and immunological alterations) which are very similar to those observed in the acute and chronic phases of Chagas' disease in man. The cardiac alterations in the acute phase are characterized grossly by slight cardiomegaly with dilatation of the right-sided chambers. Microscopically they are characterized by mild focal myocarditis. The chronic phase is characterized by moderate to marked cardiomegaly with hypertrophy and dilatation of both ventricular chambers. There is thinning of the apical region (apical aneurysm), particularly of the left ventricle. Focal myocarditis is seen microscopically with areas of myocytolytic necrosis, atrophic and hypertrophic myofibers, an inflammatory response predominantly composed of mononuclear cells and interstitial fibrosis. Cineventriculography in the left ventricle of rabbits during the chronic phase disclosed regional myocardial dysfunction, with typical apical systolic bulging. The pathogenesis of Chagasic cardiomyopathy is briefly discussed in the light of these findings. Our investigation has further shown that this animal model is particularly suitable for studies on on the mechanisms, pathology and treatment of Chagas' heart disease.
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PMID:The evolution of experimental Trypanosoma cruzi cardiomyopathy in rabbits: further parasitological, morphological and functional studies. 351 79


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