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

Heart disease is the most important nonobstetric cause of maternal death; however, most young women with heart disease do well during pregnancy. If the physician is uncertain of the effects of pregnancy on a particular heart condition, needless restrictions may be imposed. The main hazards are: pulmonary edema when it occurs suddenly in mitral stenosis; pulmonary hypertension (because pulmonary vascular disease tends to be exacerbated by pregnancy); infective endocarditis (this is rare); and fulminating peripartum cardiomyopathy. The practical management of the pregnant patient with various concomitant heart conditions (congenital heart disease, pulmonary hypertension, rheumatic heart disease, anticoagulants and artificial valves, constrictive pericarditis, kyphoscoliosis, Marfan's syndrome, mitral prolapse, hypertrophic cardiomyopathy, dilated cardiomyopathy, infective endocarditis, and arrhythmias) is discussed. An absolute indication for therapeutic abortion is severe pulmonary vascular disease; discretionary indications include 'chronic thromboembolic pulmonary hypertension,' cardiomyopathies (depending on the hemodynamic disturbance), and Marfan's syndrome.
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PMID:Cardiovascular disease in pregnancy. 218 16

The specific aim of this study is to compare and contrast the biophysical and psychosocial profile of men and women undergoing cardiac surgery (coronary artery bypass graft and valve replacement) during the perioperative and home recovery period. Coronary artery disease appears to be qualitatively worse in women than men although the prevalence in women does not approach that in men until the seventh decade. Valvular disorders also reveal a different profile by sex with the greater valvular problems in women related to the fact that women have more rheumatic heart disease. A prospective, longitudinal design with a convenience sample of 117 patients undergoing cardiac surgery and their spouses (234 subjects) from five Northern California hospitals was used to tap patient response at three critical perioperative data points. Female patients were observed during the perioperative period to have significantly more shortness of breath, poorer cardiac functional status (New York Heart Association), significantly longer intensive care unit stays, and proportionately more deaths. At 1 and 3 months after discharge, however, their recoveries did not differ significantly from men's when they were compared on sexuality, recreation, or return-to-work variables. Surprisingly, female patients had significantly less mood disturbances as measured by the Profile of Mood States than their male counterparts, and they scored higher on measures of family satisfaction than did male patients. Implications of the study involve early recognition of heart disease in women, preparation of families for longer intensive care unit stays, and appreciation of different psychosocial responses to surgery.
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PMID:Differences in recovery from cardiac surgery: a profile of male and female patients. 221 Nov 55

A review of cardiac admissions to the Ethio-Swedish Children's Hospital from January 1981 to December 1988 revealed 365 cases. Patients were included in the study if they had clinical, laboratory and echocardiographic (M, 2D-Modes, doppler) proofs of the specific disease entity. One hundred and ten patients were eligible. This accounted for 0.65% of all admissions (N = 16,905). Rheumatic heart disease accounted for 54.5% (N = 60), congenital heart disease for 35.5% (N = 39), and acquired heart disease of nonrheumatic origin for 10% (N = 11) or cardiac admissions. Of patients with rheumatic heart disease, the mitral valve was involved in 41.7% (N = 25). Pure mitral stenosis was seen in 8.3% (N = 5). Ventricular septal defect was seen in 33.3% (N = 13) of patients with congenital heart disease. The mean hospital stay for patients with rheumatic heart disease was 35.4 days, and 24.7 days for patients with congenital heart. As rheumatic heart disease predominates, methods for decreasing its incidence are discussed.
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PMID:Profile of cardiac diseases in Ethiopian children. 236 44

A retrospective review for the period 1983 to 1988 was made of all sudden deaths in young Aboriginal adults from the Darwin and East Arnhem regions who had known rheumatic heart disease. A total of five cases was identified from autopsy reports. The age range was between 16 and 35 years. All were being treated for asymptomatic heart disease (grade I). The sudden, unexpected death in each of these patients resulted in their deaths all being reported to the coroner. In all cases there was no evidence at autopsy of significant coronary artery disease or bacterial endocarditis. All had evidence of rheumatic valvular heart disease affecting either one or both mitral and aortic valves to varying degrees. No other cause of death was found. This report serves to illustrate the fact that rheumatic heart disease is still a significant contributor to morbidity and mortality in Aborigines, and that while the usual picture of progressive deterioration in exercise tolerance may be the norm, sudden death without any apparent preceding symptomatology can occur.
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PMID:Sudden death in young Aboriginal adults with rheumatic heart disease. 237 20

A cohort of 12,110 male workers employed 1 or more years in eight styrene-butadiene polymer (SBR) manufacturing plants in the United States and Canada has been followed for mortality over a 40-year period, 1943 to 1982. The all-cause mortality of these workers was low [standardized mortality ratio (SMR) = 0.81] compared to that of the general population. However, some specific sites of cancers had SMRs that exceeded 1.00. These sites were then examined by major work divisions. The sites of interest included leukemia and non-Hodgkin's lymphoma in whites. The SMRs for cancers of the digestive tract were higher than expected, especially esophageal cancer in whites and stomach cancer in blacks. The SMR for arteriosclerotic heart disease in black workers was significantly higher than would be expected based on general population rates. Employees were assigned to a work area based on job longest held. The SMRs for specific diseases differed by work area. Production workers showed increased SMRs for hematologic neoplasms and maintenance workers, for digestive cancers. A significant excess SMR for arteriosclerotic heart disease occurred only in black maintenance workers, although excess mortality from this disease occurred in blacks regardless of where they worked the longest. A significant excess SMR for rheumatic heart disease was associated with work in the combined, all-other work areas. For many causes of death, there were significant deficits in the SMRs.
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PMID:Mortality of a cohort of workers in the styrene-butadiene polymer manufacturing industry (1943-1982). 240 Dec 50

Between May 1982 and May 1988, 37 patients (28 males and 9 females, mean age 57.6, range 16-76 years) of approximately 600 evaluated for sustained ventricular tachycardia and/or fibrillation (VT/VF) were treated with an automatic implantable cardioverter defibrillator (AICD). Twenty-eight of the patients had coronary artery disease, 7 had nonischemic cardiomyopathy, 1 had amyloid heart disease, and 1 had rheumatic heart disease. The mean ejection fraction was 32.2 +/- 12.9% (range, 9-64%). Eleven patients have died at a mean of 16.7 months after implantation. The cumulative survival rate was 81% at 1 year, 77% at 2 years, 68% at 3 years, and 53% at 4, 5, and 6 years. Considering only sudden deaths, the survival was 97% at 1 and 2 years, 90% at 3 years, and 80% at 4, 5, and 6 years. Twenty-one of the 37 patients received spontaneous shocks. If the first shock marks the time to death in the absence of an AICD, the cumulative survival rate would have been 56% at 1 year, 42% at 2 years, 29% at 3 years, and 14% at 4, 5, and 6 years. The maximum amount of time to a first appropriate shock was 39.7 months. Thirty-nine devices have been explanted: 28 for battery depletion; 5 for infections; 3 for improper sensing; 2 for electronic failure; and 1 at the time of cardiac transplantation. The average time to failure of the 28 units removed for battery depletion was 19.8 +/- 6.9 months.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Survival of patients with the automatic implantable cardioverter defibrillator. 246 88

Among 87 pregnancies complicated by heart disease, delivered during the decade 1977-86, 70 (81%) had a congenital heart malformation, 7 (8%) an acquired heart disease and 10 (11%) arrhythmias or conduction disturbances. The incidence was 0.3%. The corresponding data from a report from Rigshospitalet during the 1950s were: 42%, 49%, and 9%, respectively, and an incidence of 0.9%. Ventricular septal defect (VSD) and atrial septal defect (ASD) were the most frequent malformations. The women were classified according to the NYHA before, during and after the pregnancy. All women except 4 re-entered their original functional class. In 51 cases, ECG showed completely normal sinus rhythm, while in 36, various degrees of arrhythmia or conduction disturbance were found as well as left or right ventricular hypertrophy and/or strains. Nine infants had congenital defects, 4 of which were a heart malformation (4.6%). One infant died. Gestational duration, weight and perinatal mortality did not differ significantly from that of the general population. Two women died, one of primary pulmonary hypertension and one with a rupture of the thoracic aorta. Rheumatic heart disease is no longer a significant factor in relation to pregnancy in Denmark, but congenital heart disease is still of great importance, because more survive and reach the age of fertility. Today most women can be brought safely through pregnancy, but obstetric, cardiologic and anesthesiologic expertise is still mandatory for a successful course and outcome of pregnancies complicated by heart disease.
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PMID:Maternal heart disease. A survey of a decade in a Danish university hospital. 258 39

The authors analyze in a retrospective investigation the clinical picture of 15 adult patients (12 men and 3 women) with an abnormal origin of the coronary arteries, diagnosed from a total of 5500 coronarographic examinations made in the Institute for Clinical and Experimental Medicine. In four patients the anomaly was isolated and in 11 patients it was associated: in six with coronary disease, in three with rheumatic heart disease and in two with an atrial septal detect. The authors evaluate the long-term clinical course by check-up ambulatory examinations after time intervals of 64.6 +/- 45.7 months following the coronarographic examination. The long-term course was favourable in the four patients with the isolated anomalous origin of the coronary arteries. In patients with an associated anomalous origin of the coronary arteries and other heart disease the long-term course was not favourable. Two patients died, two suffered a myocardial infarction, one suffered from angina and one from cardiac dysrhythmia. The authors assume that the complications developed mainly due to the associated heart disease, congenital or acquired. The objective physical finding, ECG and X-ray finding of the heart and lungs did not change significantly in the meantime. It appears thus that an isolated anomalous origin of the coronary arteries may be a relatively benign disease. The prognosis of the patients depends above all on associated heart disease or other diseases.
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PMID:[Long-term clinical course in the anomalous origin of coronary arteries]. 259 50

Thirty cases of infective endocarditis identified in the autopsy service of the University Hospital over a 10-year period are reviewed. The mean age of the patients was 30.6 years, and 70% were below the age of 40 years. Sixty per cent of the cases had previous heart disease of which rheumatic heart disease was the most common. Degenerative heart disease and floppy mitral valve contributed one case each. The mitral valve was most commonly affected, and there were only 2 cases of right-sided endocarditis. Evidence of systemic embolization was present in 83% of the patients. The results of this study are compared with others from both developed and under-developed countries.
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PMID:Infective endocarditis at the University Hospital of the West Indies. A postmortem evaluation. 262 45

We report clinical and laboratory findings of 15 children with bacterial endocarditis, admitted to the Department of Child Health, University of Indonesia/Cipto Mangunkusumo Hospital from February, 1987 to June, 1989. There were 8 boys and 7 girls with bacterial endocarditis, ranging in age from 10 weeks to 16 years. The diagnosis was suspected because of prolonged fever, with or without other manifestations, i.e. congestive heart failure, refractory anemia, or paroxysmal atrial tachycardia. The underlying heart disease was congenital in 12 cases and rheumatic heart disease in 3 cases. The clinical, electrocardiographic, and radiologic manifestations were generally predominated by the pre-existing heart disease. No 'characteristic' findings of bacterial endocarditis, i.e. Osler's nodes, Janeway lesions or splinter haemorrhages were detected. Positive bacterial culture was obtained in 12 cases; the most frequent bacteria isolated was Pseudomonas aeruginosa (4 cases). Streptococcus viridans was isolated in 2 cases only. Vegetation was visualized echocardiographically in 12 cases; 9 with clear cut evidence of large vegetation, and in the other 3 the vegetation was equivocal. On follow-up they disappeared gradually with clinical improvement. Large vegetation might need 2 full months to disappear echocardiographically. It is concluded that bacterial endocarditis is not a rare complication of structural heart disease in our hospital, with a high mortality rate. The availability of good resolution echocardiography has been very helpful in establishing the diagnosis as well as in following-up patients with bacterial endocarditis.
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PMID:Bacterial endocarditis in children: clinical and laboratory findings, and the role of echocardiography in its diagnosis and management. 263 Oct 25


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