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)

A 54-year-old man had palpitations on swallowing without any esophageal or heart disease. Electrophysiological findings, including an A wave in the high right atrial leads appearing prior to the A wave on His bundle electrogram, revealed that the arrhythmia was paroxysmal supraventricular tachycardia originating in an ectopic focus of the atrium with intraventricular aberration. Treatment with verapamil, 120 mg/day, reduced his symptoms in spite of an insignificant decrease in the arrhythmia observed with Holter dynamic electrocardiography.
 ...
PMID:Swallowing-induced paroxysmal supraventricular tachycardia. 368 89

Nineteen young athletes with documented symptomatic tachyarrhythmia were systematically evaluated. There were 15 men and 4 women, aged 14 to 32 years (mean 22 +/- 6). Documented tachyarrhythmias were paroxysmal atrial fibrillation in five patients, paroxysmal supraventricular tachycardia in five, paroxysmal ventricular tachycardia in eight (sustained in five, nonsustained in three) and ventricular fibrillation in one patient. Abnormal substrates were demonstrated in 15 (79%) of the 19 athletes: 5 had an anomalous atrioventricular (AV) pathway and 10 had heart disease (mitral valve prolapse in 9 patients and dilated cardiomyopathy in 1 patient). In 13 (68%) of the 19 athletes, all spontaneous attacks of tachyarrhythmia had started during strenuous exercise. Tachyarrhythmia that closely resembled clinical arrhythmia was induced by programmed cardiac stimulation in 13 athletes (68%) and was reproducibly provoked by treadmill exercise in 8 athletes (42%). In four of seven athletes with ventricular tachycardia, tachycardia closely resembling clinical arrhythmia was provoked by infusion of isoproterenol. In summary: young athletes can have any of several tachyarrhythmias; abnormal substrates can be demonstrated in many athletes with symptomatic tachyarrhythmia; and tachyarrhythmias in young athletes frequently occur during exercise.
 ...
PMID:Tachyarrhythmias in young athletes. 394 Dec 11

Paroxysmal supraventricular tachycardia (PSVT) and atrial fibrillation (AF) are both supraventricular arrhythmias, but their mechanisms are completely different. This study determines the incidence of symptomatic AF in a group of patients followed closely during routine outpatient care for PSVT. Thirty-nine patients with PSVT were followed for up to 4 years using telephone transmission of the electrocardiogram to document symptomatic arrhythmias. The cumulative proportion of patients who had AF was calculated using the Kaplan-Meier life-table method. In addition, we examined the importance of clinical variables traditionally believed to influence the occurrence of AF. The cumulative proportion of patients who had AF during follow-up was 13% at 3 months, 16% at 6 months, 22% at 1 year and 29% at 2 years. In most patients the start of AF was documented during an attack of PSVT rather than de novo as another primary arrhythmia. PSVT occurred significantly earlier during an observation period without treatment in patients in whom AF developed (p = 0.03). The occurrence of AF was not related to age, number of years of PSVT, heart rate during tachycardia or coexistent heart disease.
 ...
PMID:Observations on the occurrence of atrial fibrillation in paroxysmal supraventricular tachycardia. 395 41

The clinical, electrocardiographic and electrophysiologic determinants and effects of antiarrhythmic agents on sustained sinus node reentrant tachycardia remain poorly defined. Of 65 consecutive men undergoing electrophysiologic studies for symptomatic paroxysmal supraventricular tachycardia over a 4 year period, 11 (16.9%), who ranged in age from 39 to 76 years, demonstrated sustained sinus node reentrant tachycardia. On the surface electrocardiogram, before electrophysiologic studies, the following diagnoses were considered in the 11 patients: sinus node reentrant tachycardia on the basis of an RP'/P'R ratio of greater than 1 and P wave configuration similar to that of sinus P waves (7 patients); atrioventricular (AV) nodal reentrant tachycardia on the basis of an RP'/P'R ratio of less than 1 (3 patients); and paroxysmal atrial tachycardia with AV block (1 patient). All 11 patients had a history of recurrent palpitation, 4 had syncope, 2 had dizzy spells and 9 had organic heart disease. Sustained sinus node reentrant tachycardia could be reproducibly induced in all 11 patients during atrial pacing or premature atrial stimulation, or both, over a wide echo zone. The tachycardia could be terminated by carotid sinus massage, atrial pacing and premature atrial stimulation. Characteristics of tachycardia included: high-low activation sequence; cycle lengths of 250 to 590 ms with wide fluctuations of 20 to 180 ms in individual patients; RP'/P'R ratio of greater than 1 in 8 (73%) of the 11 patients and a ratio of less than 1 in 3 (27%). Induction of sustained sinus node reentrant tachycardia was prevented by intravenous ouabain (0.01 mg/kg body weight) in two of two patients, by intravenous verapamil (10 mg) in two of two patients and by intravenous amiodarone (5 mg/kg body weight) in four of four patients. In contrast, intravenous propranolol (0.1 mg/kg body weight) did not affect induction of sustained sinus node reentrant tachycardia in two of two patients. It is concluded that sustained sinus node reentrant tachycardia, seen in 16.9% of the study patients with paroxysmal supraventricular tachycardia, is not as benign as previously believed; it is frequently associated with organic heart disease; it demonstrates wide variations in cycle length, unlike other forms of paroxysmal supraventricular tachycardia; it can masquerade as AV nodal reentrant tachycardia and paroxysmal atrial tachycardia with AV block on the surface electrocardiogram in 36% of patients; and it is responsive to intravenous administration of ouabain, verapamil or amiodarone.
 ...
PMID:Sustained symptomatic sinus node reentrant tachycardia: incidence, clinical significance, electrophysiologic observations and the effects of antiarrhythmic agents. 396 8

Paroxysmal supraventricular tachycardia is a common cardiac dysrhythmia which may or may not be associated with heart disease. The underlying mechanisms in the genesis of this dysrhythmia are alterations in automaticity or re-entry of the cardiac impulse. These mechanisms are reviewed in the context of the stresses of the peri-operative and operative periods. The anaesthetic management of three patients, particularly prone to paroxysmal supraventricular tachycardia, is described based on principles derived from the pathophysiology of re-entrant or ectopic atrial tachydysrhythmias.
 ...
PMID:Anaesthetic considerations in patients with paroxysmal supraventricular tachycardia. A review and report of cases. 671 78

Clinical and electrocardiographic findings for 30 patients with the pre-excitation syndrome are described together with details of treatment. Nineteen (63%) were younger than 2 years, 14 of whom were under 2 months. Sixteen infants and 7 children (77%) presented with paroxysmal supraventricular tachycardia, 14 (61%) of whom had the electrocardiographic pattern of type A Wolff-Parkinson-White (WPW) syndrome. During paroxysmal bouts the QRS complex was normal in 21 patients and wide in two. Six (20%) patients had congenital heart disease often associated with WPW syndrome type B. Seventeen patients were treated with either digoxin or verapamil intravenously to stop tachyarrhythmias. Verapamil was more effective due to the immediate response and lack of adverse effects. The tachyarrhythmias resolved in all the patients and in some of them the WPW pattern resolved later indicating maturation of the conduction tissue with loss of the accessory pathways. Verapamil provides a rapid and safe form of treatment for conversion of tachyarrhythmias since it has no effect on the accessory pathways. Oral amiodarone prevents recurrent tachyarrhythmias resistant to other treatment.
 ...
PMID:Pre-excitation syndrome in infants and children. Effect of digoxin, verapamil, and amiodarone. 683 51

Fifty-four spontaneous episodes of paroxysmal supraventricular tachycardia (PSVT) in 23 patients, varying in age from one day to fourteen years, were treated with intravenous verapamil according to a specific protocol. Stable sinus rhythm was obtained promptly with no side effects in 76% of episodes. There was no response in 9%; an unstable rhythm in 7.5%; and severe side effects (hypotension, sinus bradycardia and cardio-respiratory arrest) in 7.5%. All severe side effects were associated with larger than recommended doses of verapamil. Intravenous verapamil reverted 100% of all episodes of idiopathic PSVT in eight patients; 83% of episodes in five patients with congenital heart disease; and only 57% of episodes in nine patients with Wolff-Parkinson-White syndrome. It was ineffective in one neonate who had had intra-uterine SVT.
 ...
PMID:Intravenous verapamil in the treatment of paroxysmal supraventricular tachycardia in children. 687 Jul

Twenty-five patients with the preexcitation syndrome underwent operation for ablation of an accessory pathway. The patients were young (mean age 28.1 years) and 20% had congenital heart disease. In 24, markedly symptomatic refractory supraventricular tachycardia had been present for a mean of 12.6 years. The accessory pathway was right or left ventricular free wall in 22 patients and septal in 3 patients. Operation resulted in persistent ablation of the pathway in 80% of the patients. There was no perioperative mortality and no persistent complete heart block. During a mean follow-up of 15.6 months, 83.3% of patients with a preoperative history of supraventricular tachycardia had no recurrence of the arrhythmia. Two patients (8.3%) had macro-reentry paroxysmal supraventricular tachycardia related to a persistently functioning bypass tract. The remaining two patients had supraventricular tachycardia unrelated to a functioning accessory pathway. We conclude that the surgical treatment of patients with preexcitation syndrome (Wolff-Parkinson-White) is safe and effective. It should be considered (1) in patients who are markedly symptomatic with refractory supraventricular tachycardia, (2) in those who have the potential for sudden cardiac death, (3) in younger patients with symptomatic tachycardia in whom there is concern about the long-term effects of antidysrhythmic treatment, and (4) in patients with tachycardia who are undergoing cardiac surgery for repair of associated conditions.
 ...
PMID:The Wolff-Parkinson-White syndrome: a surgical approach. 707 68

The effectiveness and lack of undesirable side-effects has made Verapamil the drug of choice in the treatment of paroxysmal supraventricular tachycardia in infants without underlying heart disease. The case described demonstrates the occasional severe negative inotropic effect of the drug, independent of its influence on heart rate and conduction. Severe heart failure and shock ensued after a therapeutic dose of i.v. Verapamil in a newborn suffering from atrial flutter with no associated heart disease. Although the arrhythmia was promptly converted to sinus rhythm, the baby required two hours of cardiopulmonary resuscitation and inotropic support. Follow-up during the first year of life revealed a normal healthy baby. Attention to the hemodynamic status in addition to continuous ECG monitoring is mandatory during i.v. Verapamil administration also in patients without underlying heart disease.
 ...
PMID:A hemodynamic complication of verapamil therapy in a neonate. 730 34

The technique, indications and results of surgical division of accessory atrioventricular connections in 10 infants and children with drug-resistant supraventricular tachycardia are described. The patients ranged in age from 6 months to 15 years. Four patients had associated congenital heart disease. Division of accessory connections were performed on free wall pathways in nine patients (seven right atrial, two left atrial) and on a septal pathway in one patient. Four patients had both anterograde and retrograde conduction over the accessory connection (manifest Wolff-Parkinson-White conduction) whereas six had only retrograde conduction (concealed Wolff-Parkinson-White conduction). The manifst Wolff-Parkinson-White conduction was abolished by surgical division in all four patients. In 8 of the 10 patients the procedure stopped the attacks of paroxysmal supraventricular tachycardia for follow-up periods ranging from 9 months to 3 1/2 years; no patient receives medication to date.
 ...
PMID:Surgical treatment of supraventricular tachycardia in infants and children. 740 42


<< Previous 1 2 3 4 5 6 Next >>