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

The authors report 6 cases of acute respiratory failure complicating chronic bronchial and lung disease admitted to hospital with the diagnosis of: heart disease, 3 cases, pulmonary oedema, pulmonary embolism, atrial flutter; status asthmaticus : one case; neuro-psychiatric disease : 2 cases (toxic coma and agitation). The authors emphasize the frequency of chronic bronchial disease and recall the signs of acute decompensation discussing the possible difficulties in diagnosis and the therapeutic implications.
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PMID:[Deceptive and revealing clinical forms of acute respiratory insufficience in chronic bronchopneumopathies]. 19 94

The authors report 12 cases of pulmonary embolism with misleading signs and discuss the difficulty in diagnosis: 1) the frequency of incomplete forms; 2) lack of specificity of the clinical and paraclinical picture of pulmonary embolism which may simulate pulmonary or heart disease; 3) difficulties in interpretation of the signs of pulmonary embolism in cases of prior heart or pulmonary disease.
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PMID:[Misleading pulmonary emboliu]. 19 95

In 75 patients with various pulmonary disorders, ventilation and perfusion scans were obtained in multiple views with the 81mKr/99mTc technique and compared with an evaluation of regional ventilation and perfusion derived from the standard chest radiograph. In emphysema, the chest film correlated poorly with ventilation-perfusion scans, showing a trend to underestimate the functional impairment. In chronic bronchitis and asthma, large segmental defects observed on both ventilation and perfusion scans were associated with a normal chest radiograph. Typical findings in pulmonary embolism were segmental defects on perfusion scan with normal ventilation scan and clear lung fields on the chest film. In chronic left heart disease, plain films were inaccurate in predicting alteration of the base-to-apex perfusion gradient observed on the scan.
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PMID:81mKr ventilation and 99mTc perfusion scans in chest disease: comparison with standard radiographs. 41 42

Forty-one patients with significant pulmonary emboli were reviewed. The presence of heart disease and obesity was found with relatively constant frequency throughout the groups presented. Postoperative infections (wounds or abscess) were frequently associated with fatal or significant pulmonary embolism, particularly after abdominal and pelvic operations. The infection rate (65 per cent) in patients in whom significant pulmonary embolism developed after abdominal and pelvic operations is particularly striking when compared to the overall infection rate of 7 per cent for major operations in our hospital. Recent studies of prophylactic minidose heparinization reveal an increased number of complications due to the heparin [24], and thus the proper selection of cases for prophylactic minidose heparin is mandatory. The data suggest that patients at high risk for the development of postoperative complications of infection are also at high risk for the development of significant pulmonary emboli and should be considered candidates for prophylactic minidose heparinization.
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PMID:Effects of concurrent sepsis with clinically significant pulmonary embolic disease. 43 30

Although the causes of aging are still unknown, the effects of decrements in anatomic structure and physiologic function have led to wrong concepts and resulting discriminatory policies against old people. Cardiovascular changes are common among the aged but are not necessarily symptomatic; they may be the result of past illnesses or signs of diminished cardiac reserve. In many cases, a cardiac abnormality detected by our modern diagnostic hardware dose not in itself constitute the necessity for treatment. Illustrative cases are cited. A rise in blood pressure with advanced age often is a sign of adaptation to the increased rigidity of the arterial system. Certain heart murmurs mimicking mitral insufficiency may indicate slight papillary muscle dysfunction or a clinically insignificant degree of mitral valve prolapse. On the other hand, the changing clinical status in old age may involve a diminution of symptoms. Therefore, in geriatric medicine, the physician should be on the alert for aberrant manifestations, e.g., painless myocardial infarction or atypical pulmonary embolism. Psychologic evaluation is important. There is no cardiac disorder which is typical for the older age group, but also there is none from which older people are exempt.
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PMID:Cardiovascular changes in/of old age. 65 71

We compared 41 patients with angiographic proof of pulmonary embolism and clinical signs of pulmonary infarction (as evidenced by an infiltrate on x-ray study and pleuritic pain in the area of the embolus) with 24 patients with pulmonary embolism but without infarction. Only 18 of the 41 patients with pulmonary infarction had associated heart disease. Pulmonary infarction was uncommon when emboli obstructed central arteries but frequent when distal arteries were occluded. Follow-up x-ray examination showed that the infiltrates resolved in the patients with pulmonary infarction without heart disease, but persisted when heart disease was present. We suggest that obstruction of distal arteries results in pulmonary hemorrhage owing to an influx of bronchial arterial blood at systemic pressure. Hemorrhage causes symptoms and x-ray changes usually attributed to pulmonary infarction. However, hemorrhage resolves without infarction in patients without, but progresses to infarction in those with, heart disease.
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PMID:Pulmonary embolism, pulmonary hemorrhage and pulmonary infarction. 86 13

The influence of several diseases and conditions upon the prevalence of pulmonary embolism in autopsies performed over the July 1, 1964 to June 30, 1974 period at the University of Michigan Medical Center (Ann Arbor, Michigan) were analyzed. The prevalence of pulmonary was 12.3% in the 4600 necropsies in this sample. Patients with pulmonary fat emboli or tumor emboli and patients thought to have thrombosis of the pulmonary artery were not designated as having pulmonary thromboembolism. The patients were categorized with regard to heart disease on the basis of both clinical and necropsy findings. The major factors contributing to an increase in risk of development of pulmonary embolism include heart disease, certain types of cancer, obesity, acute paraplegia and accidental and operative trauma. Other risk factors which could not be assessed in this study include a prior history of venous thromboembolism, pregnancy and the puerperium, use of oral contraceptives, ulcerative colitis and Crohn's disease. Age plays a major role in the prevalence of pulmonary embolism. A portion of the effect of age is related to the age distribution of other diseases contributing to an increased risk, yet advanced age alone may have an independent influence. The risk factors defined should be used in a selective program designed to increase the rate of detection of deep venous thrombosis before pulmonary embolism occurs. Alternatively, patients at increased risk should be treated with prophylactic low dosage heparin during hospitalization.
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PMID:Risk factors in pulmonary embolism. 95 58

The hospital course of 144 consecutive patients with pulmonary embolism (PE) demonstrated by pulmonary angiography was reviewed to determine the mortality of patients with treated PE. Twelve patients (8%) died of PE, and eight died of causes other than PE; 124 (86%) survived. Pulmonary embolism was the primary cause of death in only four of the 12 patients who died of PE. Pulmonary embolism contributed to the death of eight other patients, each of whom had associated potentially lethal disease, particularly heart disease. The most important factor affecting mortality was shock due to acute right ventricular failure secondary to massive PE (mortality, 32%). Mortality was not related to magnitude of PE per se; the mortality of patients with massive PE without shock (6%) was the same as that for patients with submassive PE (5%. Patients with PE who survive long enough to have the diagnosis established and appropriate prophylactic therapy begun have an excellent prognosis, unless they have associated severe medical disease.
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PMID:Mortality in patients treated for pulmonary embolism. 98 13

In 112 patients receiving inferior vena caval, serrated, Teflon clips over a 7 year period beginning Jan. 1, 1966, the operative mortality rate was 6 percent (seven patients) and the 1 to 12 month mortality rate was 9 percent (10 patients). Patients with severe heart disease accounted for eight of these 17 deaths. The mortaligy rate was zero in patients who were free of heart disease, malignancy, sepsis, or massive pulmonary embolism. Recurrent pulmonary embolism was suspected, but not lethal, in four patients and was proved in two. Patients who had leg swelling preoperatively were more likely to have swelling postoperatively than those who were initially free of swelling. Postoperative anticoagulation was ineffective in preventing edema and carried the risk of wound hemorrhage. Twelve months after operation, 12 of the 83 patients available for follow-up had severe lower extremity symptoms and 23 had milder, easily controlled edema. Late stasis changes, therefore, appeared at an acceptably low frequency and could reasonably be expected for patients with lower extremity phlebothrombosis. There was no instance of fatal pulmonary embolism in the follow-up period extending from 1 to 6 years.
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PMID:Mortality and morbidity rates after inferior vena caval clipping. 110 11

The clinical and autopsy records of 54 cases of pulmanary embolism seen at the Lagos University Teaching Hospital over the period 1966-1972 are analysed. The incidence of pulmonary embolism during this period was 0.1 per cent of all patients admitted, and there was a 78 per cent mortality. The primary medical condition associated with pulmonary embolism is heart disease. Sex has little influence on the liability to pulmonary embolism. Age has a pronounced influence, the incidence increases steadily after the age of 40. Medical cases are more liable than surgical cases to suffer from pulmonary embolism in each age group. The view is expressed that pulmonary embolism is not rare in Africans. Our results support the opinion that the possession of the haemoglobin S predisposes although the final veridct must await the result of a larger prospective study.
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PMID:Pulmonary embolism in Africans. 113 50


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