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)

Twenty-five patients older than 60 years of age underwent cardiac transplantation using an immunosuppression protocol with cyclosporin and azathioprine, but without routine use of oral steroids. There were 24 men and 1 woman (age range 60 to 69 years, mean 63). The etiology of heart disease was coronary artery disease in 21 and idiopathic dilated cardiomyopathy in 4. Six patients had previous coronary artery bypass operations, 1 had undergone repair of an abdominal aneurysm and 1 had pulmonary embolism. Sixteen patients were in New York Heart Association class IV and 9 in class III. Donor mean age was 30 (14 to 46) years. Hospital stay after transplantation was 10 to 90 days (median 11). Four died within 30 days and none from 5 to 59 months (mean 22). The 1-year actuarial survival was 84%. The incidence of rejection was 2.16 episodes per patient. Only 1 patient (4%) had serious infection. Six patients received antihypertensive treatment, 3 had reversible impairment of renal function, 2 had gout and 1 had drop foot. No patient had convulsions, transient ischemic attack or cerebrovascular accident. None had significant psychological problems. The 21 patients currently alive are in New York Heart Association class I. Quality of life, assessed by the Nottingham Health Profile, showed marked improvement. It is concluded that the initial results of cardiac transplantation in the seventh decade of life are encouraging.
 ...
PMID:Cardiac transplantation in the seventh decade of life. 264 67

From January 1981 to June 1986 116 patients with anticoagulation-related intracranial haemorrhage were referred to hospital. Seventy six of these haemorrhages were extracerebral, 69 were in the subdural and seven in the subarachnoid space. No epidural haemorrhages were identified. Compared with non-anticoagulation-related haematomas, the risk of haemorrhage was calculated to be increased fourfold in men and thirteenfold in women. An acute subdural haematoma, mostly due to contusion, was more frequently accompanied by an additional intracerebral haematoma than a chronic subdural haematoma. Trauma was a more important factor in acute subdural haematomas than in chronic. Almost half of the patients (48%) had a history of hypertension, more than a third (35%) had heart disease and about one fifth (18%) were diabetic. Headache was the most frequent initial symptom. Later decreased level of consciousness and focal neurological signs exceeded the frequency of headache. Three patients with subarachnoid haemorrhage and nine patients with acute subdural haematomas died, while those with chronic subdural haematomas all survived and had at the most mild, non-disabling sequelae. Myocardial infarction (22%), pulmonary embolism (20%), and arterial disease (20%) were the most frequent reasons for anticoagulant treatment. Critical review based on established criteria for anticoagulation treatment suggests there was no medical reason to treat a third of these patients. The single most useful measure that could be taken to reduce the risk of anticoagulation-induced intracranial haemorrhage would be to identify patients who are being unnecessarily treated and to discontinue anticoagulants.
 ...
PMID:Anticoagulation-related intracranial extracerebral haemorrhage. 276 75

In a retrospective study of all patients who had pulmonary embolism during a 37-year span at M. D. Anderson Hospital, we identified 502 patients, 30 of whom had a primary malignancy in the head and neck region. Only five of these patients had a clinically significant pulmonary embolus during the immediate postoperative period; these patients are the subject of a more detailed review with a case study as an example. Three of these patients died. Heart disease was identified as the most common predisposing factor. We review the results of this clinical study of pulmonary thromboembolism in patients having head and neck surgery as well as the natural history, diagnosis, and current treatment of pulmonary embolism.
 ...
PMID:Pulmonary thromboembolism after head and neck surgery. 277 80

In a prospective study the complications of Heparin-Dihydroergotamine (HDHE) [2,500 units Heparin + 0.5 mg DHE] s c. twice daily as thromboembolic prophylaxis have been studied in patients undergoing a lumbar disc operation. During a two year period 616 patients were operated, 47 patients had to be excluded, 107 patients did not receive HDHE desired by the surgeon; 462 patients received HDHE as described in the protocol. Because the distribution of age, sex, duration of hospitalisation of the 107 patients without HDHE is the same as in the HDHE group, this group can be used as control group. Increased intraoperative bleeding--written down in the operation report--66 patients (14.3%) in HDHE group and 6 patients (5.6%) in the control group. There is no statistic significance between the both groups in superficial and deep wound hematomas, deep vein thromboses or pulmonary embolism. In the HDHE group two death appears. Both patients [a 37 year old, asymptomatic woman and a 65 year old man with mild ischemic symptoms 11 months prior to operation] died because of an acute myocardial infarction. The clinical course and the missing of stenosis or occlusion at autopsy let us think at the possibility of coronary arterial spasm, presumably caused by DHE, as the cause of myocardial infarction. We suggest not to apply HDHE to patients with coronary artery heart disease or with atypical thoracic pain.
 ...
PMID:[Complications of thromboembolic prophylaxis with heparin-dihydroergotamine]. 280 59

These recommendations for secondary prevention of clinical coronary cardiopathy are the result of a symposium attended by 46 experts belonging to the councils on arteriosclerosis, clinical cardiology, epidemiology, and prevention and rehabilitation of the International Society and Federation of Cardiology. Secondary prevention of coronary cardiopathy refers to measures designed to prevent deterioration or death in patients with clinical manifestations of coronary cardiopathy. Such measures in addition to drugs include health actions that may improve the status of various coronary risk factors: the patient's life style should stress maintenance of proper weight, regular physical exercise, reduction of saturated fats and cholesterol in the diet, and elimination of smoking and excessive alcohol consumption. It is considered reasonable to control hypertension through the most innocuous means possible, but findings of the few existing controlled studies of effects of treatment of hypertension in coronary cardiopathy are complex. Drug treatment may be necessary for most patients, but nondrug measures should be added when possible. Various proofs including results of some controlled studies justify the recommendations for reducing elevated levels of serum cholesterol and low density lipoprotein cholesterol through dietary measures. Optimum plasma cholesterol levels are 5.2 mmol/1 or less, and the upper limit is 5.7 mmol/1. The rules for secondary prevention are the same for diabetics as for nondiabetics, but some special precautions are necessary in diabetics. Habitual and vigorous physical activity has been associated with a decline in the incidence of coronary cardiopathy in different population studies, although there has been no demonstration that exercise can alter the progression of atherosclerosis or improve collateral circulation. Stress should be recognized as a risk factor and included in secondary prevention, but the concept that stress is the key risk factor in coronary events is in conflict with a large body of scientific evidence. Oral contraceptives (OCs) tend to increase boood pressure and weight as well as serum triglyceride levels, and to reduce glucose tolerance and high density lipoprotein cholesterol in some formulations. OCs also affect the integrity of the vascular endothelium and alter blood coagulation, fibrinolysis, and platelet function. These thrombogenic changes are intensified with age, especially after 35, and with smoking. OCs are innocuous in women under 35 with no history of venous or arterial disease or pulmonary embolism and who have normal blood pressure and serum cholesterol levels. Patients using OCs should control their blood pressure and weight and be alert to any symptoms of thrombotic episodes. The risk/benefit ratio of longterm estrogen treatment in meno- and postmenopausal women with coronary cardiopathy has not yet been established. Apart from 1 study in primates, there is no evidence that vasectomy should be considered either indicated or contraindicated for coronary patients. Beta blockers, platelet function inhibitors, anticoagulants, and other drugs are under active study for secondary prevention of coronary cardiopathy.
 ...
PMID:[Recommendations for secondary prevention of the clinical coronary cardiopathy]. 285 11

The incidence of pulmonary embolism and the number of clinically missed diagnoses of it in necropsies carried out between 1960 and 1984 at this department were investigated. Pulmonary embolism primarily affects elderly people with serious underlying disease; in this study it was found more often in women. The incidence of pulmonary embolism (9% of all necropsies) was unchanged during the period studied. In contrast, pulmonary embolism as the "sole" cause of death increased (p less than 0.0005). Although most pulmonary emboli were the immediate cause of death, the clinical diagnosis was often missed (in 84% of all cases). Furthermore, such clinically missed diagnoses increased over the years (p less than 0.005), especially in patients with heart disease and cancer. Without necropsy there will be considerable underdiagnosis of pulmonary embolism, therefore providing a misleading figure in the death statistics for this often fatal disease.
 ...
PMID:Comparison of clinical and postmortem diagnosis of pulmonary embolism. 292 54

From 1969 to 1973, 68 patients were admitted to the 4th Division of Medicine of the Brescia Civil Hospital with the diagnosis of viral myocarditis. The patients were divided into two groups according to the results of the Coxsackie virus complement fixing antibodies test: Group 1 (42 patients) with a fourfold or greater rising antibody titre; Group 2 (26 patients) with a negative serum test. Both groups were examined after a follow-up period of 15 years. Ten patients from Group 1 died. The diagnoses were chronic myocarditis (three cases); chronic cardiomyopathy-pulmonary embolism (one case); chronic cardiomyopathy-liver cirrhosis (one case); dilated cardiomyopathy-sudden death (two cases); congestive cardiomyopathy (three cases). No Group 2 patients died. The 15-year mortality rate of Group 1 was significantly higher than that of Group 2 (Fisher Test: p less than 0.005). In conclusion, the natural history of Coxsackie virus heart disease is characterized by two possibilities: a complete recovery from a clinical point of view, in some cases with only minor T wave abnormalities, or evolution into a chronic disease (dilated cardiomyopathy) having a high mortality rate within 10 years of the onset of the acute disease.
 ...
PMID:Coxsackie virus heart disease: 15 years after. 322 24

Heart disease is a major cause of death in thal patients after the first decade of life. This study was carried out on autopsy material from 76 patients, six with beta-thal major, 58 with beta-thal/Hb E, and 12 with Hb H disease. Of the 58 patients with beta-thal/Hb E, which form the main group, all but one had cardiac hypertrophy, accompanied by dilatation in 17, five of ten patients with right ventricular and 14 of 25 patients with biventricular hypertrophy had chronic pulmonary thromboembolism. Iron deposition, while present in 18 patients, was very slight. Four patients had fibrinous pericarditis, two with diagnostic rheumatic heart disease; 15 patients had chronic pericarditis, with extensive fibrosis in half the cases. In comparison, the six patients with beta-thal major showed more severe cardiac changes, including more iron deposition. Of the 12 Hb H patients, two died of rheumatic heart disease, one had frank bilateral pulmonary embolism and striking right ventricular hypertrophy, while the remaining nine showed little cardiac pathology.
 ...
PMID:Cardiac pathology in 76 thalassemic patients. 339 May 39

Pulmonary emboli, even small, cause irreparable lung damage. Recurrent pulmonary emboli further increase the amount of non functional lung tissue and may result in incapacitating respiratory disease or death. It is therefore mandatory that the disease be correctly diagnosed and adequately treated. As prevention is better than cure, every patient presenting with clinical signs of deep venous thrombosis (DVT) should be correctly explored. The site and size of thrombosis must be visualized preferably with contrast venography with imaging of the veins of the limbs, iliac veins and vena cava. Risk factors such as obesity, immobilization etc. must be taken into account. Underlying disease such as heart disease and venous insufficiency must be treated. Malignancy must be looked for as in a recent series of patients with primary DVT which were studied, 15% presented with an up till then unknown malignant disease. In patients presenting with recurrent DVT this percentage rose to 20%. When a patient presents with DVT of the femoro-iliac vena cava axis, aggressive treatment must be adopted. Fibrinolysis or if this is contra-indicated, thrombectomy will be used. A vena cava filter may be necessary and longterm anticoagulation is mandatory. The same rationale is applicable in cases of pulmonary embolus whether it is a primary event or a recurrence.
 ...
PMID:Recurrent pulmonary embolism: importance, diagnosis, management and prevention. 352 Nov 67

The complications of clinical cardiac electrophysiologic studies were prospectively evaluated in 1,000 consecutive patients studied in one laboratory with an unaltered protocol to better assess the risks of this procedure. There were 728 men and the mean age of the entire group was 58 years (range 16 to 84). Coronary artery disease was the most common type of heart disease (56%) and 200 patients had no identifiable organic heart disease. The indication for study was a ventricular tachyarrhythmia or cardiac arrest in 582 patients. Each patient underwent an initial (baseline) study and 444 patients underwent serial drug studies (2.7/patient). There was one death during these studies. Other major complications included arterial injury (0.4%), thrombophlebitis (0.6%), systemic arterial embolism (0.1%), pulmonary embolism (0.3%) and cardiac perforation (0.2%). Significant arrhythmic complications included catheter-induced permanent complete atrioventricular (AV) block in 1 patient, nonclinical atrial fibrillation that required therapy in 10 patients and severe proarrhythmic events in 12 (3%) of 397 patients undergoing drug studies for ventricular tachyarrhythmias. Cardioversion was required for termination of ventricular tachyarrhythmias in 179 baseline studies (53% of patients with inducible arrhythmia), and in an additional 35 patients, cardioversion was required at least once during follow-up studies. Although clinical cardiac electrophysiologic studies are associated with complications, the risks are small and acceptable.
 ...
PMID:Risks and complications of clinical cardiac electrophysiologic studies: a prospective analysis of 1,000 consecutive patients. 358 18


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