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

Clinical data from 186 patients (133 males and 53 females) with 190 episodes of infective endocarditis (IE) occurring between January 1981 and July 1991 were studied retrospectively at a large referral hospital in Northern India with the intention of highlighting certain essential differences from those reported in the West. The mean age was much lower (25 +/- SD 12 years, range 2 to 75 years). Rheumatic heart disease was the most frequent underlying heart lesion accounting for 79 patients (42%). This was followed by congenital heart disease in 62 (33%) and normal valve endocarditis in 17 (9%). Twenty-four patients had either aortic regurgitation (n = 15) or mitral regurgitation (n = 9) of uncertain etiology. Prosthetic valve infection and mitral valve prolapse were present in only 2 patients each. A definite predisposing factor could be identified in only 28 patients (15%). Postabortal sepsis and sepsis related to childbirth accounted for 6 and 5 cases, respectively. Only 1 patient had history of intravenous drug abuse. Two-dimensional echocardiography showed vegetations in 121 patients (64%). Blood cultures were positive in only 87 (47%), with a total of 90 microbial isolates. Commonest infecting organisms were staphylococci (37 cases) and streptococci (34 cases). Except for a significantly higher number of patients with neurologic complications in the culture-negative group, there were no differences between patients with culture-positive and culture-negative IE. Of the 190 episodes of IE, the patients had received antibiotics before admission in 110 (58%) instances. A significantly greater number of culture-negative patients had received antibiotics than did culture-positive patients (87 vs 23, p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Active infective endocarditis observed in an Indian hospital 1981-1991. 144 18

Recommendations for the prophylaxis of infective endocarditis have been published by working groups in several countries. We performed an enquiry amongst 276 dentists in Geneva to evaluate how the Swiss recommendations were applied. Of the 183 dentists who answered, the majority knew that extraction (85%) or scaling (76%) required prophylaxis. They correctly prescribed antibiotics to patients with valve prostheses (84%), to those with rheumatic heart disease (80%), a previous history of endocarditis (73%) or congenital heart disease (49%). Not conforming to the recommendations, many dentists considered that coronary bypass surgery (40%), mitral valve prolapse without mitral regurgitation (30%) or previous myocardial infarction (22%) also required antibiotic prophylaxis. Only 34% of dentists used the recommended 3 g of amoxicillina, the others preferring a lower dose of another antibiotic. About one third started prophylaxis 1 to 3 days too early and less than 20% used the suggested single dose of antibiotics. These results showed that dentists caring for cardiac patients should be better informed of the risks of endocarditis and its prevention. We make a few suggestions to improve antibiotic prophylaxis.
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PMID:[Do dentists enforce correctly the recommendations for prophylaxis of bacterial endocarditis?]. 156 27

A total of 99 cases of viridans streptococcal endocarditis encountered during the period of 1973 and 1990 at the Veterans General Hospital-Taipei were reviewed to evaluate its prognostic factors. Applying strict clinical and laboratory criteria, 24 cases were categorized as definite, 44 probable, 23 possible and 8 likely. The symptoms were frequently subtle and atypical but initial laboratory tests gave useful indications: 69.1% with leukocytosis, 78% with anemia, 58.5% with elevation of LDH level, 88.9% with elevation of ESR value and 100% with elevation of CRP level. Furthermore, 32.4% of the cases demonstrated proteinuria and 67.4% microscopic hematuria. Seventy-three of the subjects had a history of underlying heart disease, predominantly rheumatic heart disease. Histological examination and echocardiography revealed that 51 patients suffered from vegetative endocarditis, 7 (13.7%) of whom were found to have anatomically confirmed vegetations without initial echocardiographic evidence, Vascular events were seen in 61 cases (61.6%): peripheral stigmata (32 cases), cerebral vascular accidents (17 cases), pulmonary embolism (10 cases) and others (2 cases). The overall mortality rate was 18.2%. Congestive heart failure with embolization was the most common cause of death in this group. The presence of vegetation was not well correlated with embolic events. There was no statistically significant association between the mortality and the following characteristics: age, sex, underlying heart disease, evidence of echocardiographically detected vegetations, major surgical intervention and recurrent cases except for embolic events (p less than 0.01). In conclusion, viridans streptococcal endocarditis complicated embolic events usually presented with a fulminant course and a grave outcome.
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PMID:Overview of viridans streptococcal endocarditis: clinical analysis of 99 cases. 165 35

Thirty-two children with 33 episodes of infective endocarditis were admitted into the paediatric unit of Ahmadu Bello University Teaching Hospital, Zaria during an 8-year period (January 1982-December 1989). Thirty (94%) had underlying heart disease. Rheumatic heart disease was the pre-existing anomaly in 21 (66%) while congenital cardiac anomalies were detected in nine (28%). Cardiac failure, changing murmur or persisting fever drew attention to the disease. Bacterial isolation was achieved in 19 patients (58%), staphylococci in 11, and salmonella was found in three children. Others included Acinetobacter spp. in two patients, one of whom had a mixed infection involving alpha haemolytic streptococcus whereas three children had Klebsiella, pseudomonas or alpha haemolytic Streptococcus, respectively. Only six patients (18%) recovered. Abscondment rates were high (28%) and overall hospital mortality was 47%. Intractable cardiac failure and neurological complications were the most important events heralding death. There is a need for increased awareness and improved facilities for prompt and effective treatment.
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PMID:Infective endocarditis in children in the Guinea savannah of Nigeria. 171 22

The study of Histocompatibility Locus Antigen (HLA) frequencies in 48 cases with congenital heart disease (CHD) in children in Cairo showed high incidence of A10. Cases with atrial septal defect have shown a significant association with A3 besides A10. There is also a significant association between B12-45 and right loop anomalies (Fallot's and pulmonary stenosis) together with A10. On the other hand, children with rheumatic heart disease have shown strong positive association with HLA group B8 and negative association with A28.
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PMID:HLA antigen frequencies in children with cardiac disease in Cairo. 178 55

The author, in the light of 14 cardiovascular pathology cases among patients affected by sickle cell disease, itemizes the following data: Cardiovascular pathology in sickle cell disease can be a preoccupation not only among homozygotes but also among heterozygotes. The clinical polymorphism of this pathology concern not only the common anemia heart disease and the type of sickle cell heart disease what looks like a rheumatic heart disease, but also includes cases of cor pulmonale among young patients, sickle cell cardiomyopathy, and myocardial infarction among young. The sickle cell disease area, which outstrips the borders of the traditional african "sickle cell belt" requires that all practitioners be widely informed of the sometimes disconcerting polymorphism of this cardiovascular pathology which has a fairly particular etiology.
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PMID:[Cardiovascular pathology in sickle cell anemia]. 180 79

A series of 31 patients referred for evaluation of paediatric cardiac disease in rural Kenya is reported. The prevalence of symptomatic rheumatic heart disease is unchanged from previous data in the literature which is well over a decade old. We can conclude that recent improvements in medical care in Kenya have not yet reached certain rural areas as far as rheumatic fever is concerned. In addition, a significant number of children presumed to have had no discernible heart disease at this evaluation, suggesting the need for critical re-evaluation of this population at intervals. Finally, cyanotic disease seems under-represented in the series, suggesting that infants with certain cyanotic lesions may have been selected out and hence not referred to us.
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PMID:Prevalence of paediatric cardiac disease in rural Kenya. 181 99

Archibald Garrod was apparently the first to document congenital heart disease as a component of Down syndrome. This arose from his interest in fetal endocarditis, a theoretical cause of cardiac malformations, in vogue roughly from 1840-1940, that drew its strength from analogies with rheumatic heart disease in adults. Garrod's discovery sheds light not only on nineteenth century ideas about teratology, but also on his methodology, genius, and approaches that, in many ways, foreshadowed the techniques that guided his later work on inborn errors.
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PMID:Sir A. E. Garrod, congenital heart disease in Down syndrome, and the doctrine of fetal endocarditis. 183 62

Cardiovascular status was studied in 500 natives living at high to extreme altitudes (3000m to 5500m) of the Himalayas. No case of congenital heart disease, rheumatic heart disease, coronary artery disease, primary myocardial disease or hypertension was found. A significant rise, however, was noted in both the systolic and diastolic systemic arterial pressure with age. Serum lipid and lipoprotein profile estimation in 148 subjects showed that with increasing altitude, the HDL cholesterol increased, while the LDL cholesterol, total cholesterol/HDL cholesterol ratio and the LDL cholesterol/HDL cholesterol ratio decreased. Electrocardiograms of 160 subjects (120 males and 40 females) above the age of 25 years showed right ventricular hypertrophy in 8 (5%), 6 of whom (17.6%) lived above the altitude of 4800m. Echocardiographic examination showed normal left ventricular function in all, while 27 per cent of the natives at an altitude of 4500m-5000m had evidence of pulmonary hypertension and rise of normalised right ventricular preejection period.
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PMID:Clinical, biochemical, electrocardiographic and noninvasive hemodynamic assessment of cardiovascular status in natives at high to extreme altitudes (3000m-5500m) of the Himalayan region. 208 44

Pregnant patients with heart disease seen between 1980 and 1985 were studied. The incidence of heart disease in pregnancy was 1.3%. Rheumatic heart disease was the commonest lesion (78%), followed by congenital heart disease (18.7%). In the rheumatic heart disease group, mitral stenosis was the commonest lesion (71.54%), and patients who had been or were operated on for their heart disease had less severe dyspnoea and fewer complications. The mode of delivery and the foetal and maternal mortality did not differ significantly in operated and non operated patients.
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PMID:Pregnancy with heart disease. Experience at Postgraduate Institute of Medical Education and Research, Chandigarh. 209 24


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