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)

The epidemiology, natural history, diagnostic evaluation and therapy of patients with valvular heart disease have changed during the last 25 years in developed countries. The incidence of rheumatic heart disease has declined, while degenerative forms of valvular heart disease have become more common; arteriosclerotic heart disease commonly complicates valvular disease. A variety of non-invasive techniques demonstrate with considerable accuracy the presence and severity of valvular lesions. Both medical and surgical therapy for valvular heart disease have improved; the prognosis for these patients is far better today than it was 25 years ago.
 ...
PMID:Changing concepts in the diagnosis and management of patients with valvular heart disease: a clinician's view. 332 14

A clinical evaluation of the surface-averaged ECG (SAE) to record His-Purkinje activity (HPA) was made on 70 patients who underwent His bundle electrograms (HBE). The recorded signals first judged as HPA in 43 patients by the noninvasive method alone were later verified in 37 patients by HBE; the accuracy of the HPA recordings (predictive value) was 86.0%. The HPA-V interval measured noninvasively had a high correlation with the HV interval by HBE (r = 0.89, p less than 0.01). The verified detection rate in all 70 patients was 52.9%: HPA was detected in 12 of 18 patients (66.7%) with sclerotic and hypertensive heart disease (Group I), five of 19 patients (26.3%) with rheumatic heart disease (Group II), 11 of 17 patients (64.7%) with congenital heart disease (Group III), and nine of 16 patients (56.2%) with miscellaneous conditions (Group IV). The detection rate was markedly lower in Group II than in other groups (Group II vs Group I or III, p less than 0.025). The PR segment was significantly longer in the patients in whom HPA was detected than in those in whom it was not detected (71.5 +/- 22.3 msec vs 43.9 +/- 19.5 msec, p less than 0.001). His-Purkinje activity (HPA) was detected in 32 of 52 recordings (61.5%) with sinus rhythm and seven of 20 recordings (35.0%) with atrial fibrillation, including two recordings in each of two cardioverted patients (p less than 0.05). We conclude that the surface-averaged ECG (SAE) has clinically acceptable sensitivity and accuracy except in patients with rheumatic heart disease, short PR segments or atrial fibrillations.
 ...
PMID:Sensitivity and accuracy in recording His-Purkinje activity by surface-averaged electrocardiography. 335 11

A simple and inexpensive assessment of cardiac murmurs and school health problems was conducted in an isolated island in the kingdom of Tonga. The prevalence of rheumatic and congenital heart disease in the population of 'Eua was 0.5% and 0.15%, respectively. The incidence of rheumatic heart disease for 1985 was 0.8 per 1000 population. The screening of 1106 students, who were aged five to 12 years, showed skin disease to be the most important problem. All identified cases were treated and referred for follow-up. The total cost of this study was US $281.48. This exercise demonstrated an alternative approach to maximizing the use of health resources as well as maintaining the skill and morale of health workers in isolated areas.
 ...
PMID:Rheumatic heart disease and school screening: initiatives at an isolated hospital in Tonga. 337 26

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

Infective endocarditis is an uncommon manifestation of group B streptococcal disease. Seven cases of group B streptococcal endocarditis are reported herein. Another fifty-five cases published in the literature since 1962 are reviewed: the male to female ratio was 1.4:1. The average age was 53.8 years, and 45% of patients were 60 years of age or older. Two cases of nonsocomial endocarditis and two cases of polymicrobial endocarditis were identified. There were five cases of prosthetic valve endocarditis. Mitral and aortic valvular involvement were present in 48% and 29% of cases, respectively. Underlying heart disease was found in more than half of the cases. Rheumatic heart disease was the commonest underlying cardiac condition. Noncardiac underlying conditions included diabetes mellitus, alcoholism, pregnancy, intravenous drug abuse, and genitourinary disease. Onset was varied as was initial presentation of the disease. Large arterial thrombi were common. Overall mortality was 43.5%. Penicillin is the treatment of choice for group B streptococcal endocarditis. However, based on in vitro and in vivo studies as well as case reports, some authors feel that the combination of penicillin and an aminoglycoside is a superior regimen. Cephalothin or vancomycin are alternatives for patients who are allergic to penicillin.
 ...
PMID:Group B streptococcal endocarditis: report of seven cases and review of the literature, 1962-1985. 351 20

The spectrum of recognized cardiac lesions underlying infective endocarditis has been changing as a result of the decline in incidence of rheumatic heart disease, the recognition of the entity of mitral valve prolapse, and the improvement in cardiac diagnostic techniques. Sixty-three cases of native valve endocarditis diagnosed in Memphis hospitals between 1980 and 1984 were reviewed. All diagnoses of underlying cardiac lesions were confirmed by two-dimensional echocardiography, cardiac catheterization, and/or histopathologic examination of valve tissues. Major categories of underlying lesions were as follows: mitral valve prolapse, 29 percent; no underlying disease, 27 percent; degenerative lesions of the aortic or mitral valve, 21 percent; congenital heart disease, 13 percent; rheumatic heart disease, 6 percent. Thus, mitral valve prolapse and, in the elderly, degenerative lesions have displaced rheumatic and congenital heart diseases as the major conditions underlying endocarditis. Redundancy of the mitral valve leaflets was noted in 17 of 18 patients in whom endocarditis was superimposed upon mitral valve prolapse. The risk of infective endocarditis appears to be substantially increased in the subset of patients with mitral valve prolapse who exhibit valvular redundancy.
 ...
PMID:Underlying cardiac lesions in adults with infective endocarditis. The changing spectrum. 356 26

This investigation was undertaken to study the prevalence of amoxycillin-resistant oral streptococci in normal healthy patients and patients with a cardiac condition, susceptible to infective endocarditis. Samples of supragingival dental plaque were collected from two test groups, children with congenital heart disease and adults with a history of rheumatic fever, and two control groups comprising normal healthy children and normal healthy adults. Bacteria from these samples were grown on a medium selective for oral streptococci, as well as on the same medium containing known concentrations of amoxycillin. The results indicate that a high percentage of rheumatic heart patients and children with congenital heart disease harboured amoxycillin-resistant oral streptococci. The level of amoxycillin resistance in the plaque of adults with rheumatic heart disease was significantly greater than in that of normal adults. In view of the high percentage of patients at risk harbouring amoxycillin-resistant streptococci, it is important that the individual clinical situation be monitored. Perhaps antibiotic sensitivity tests should be performed to select an appropriate antibiotic for prophylaxis of infective endocarditis.
 ...
PMID:Amoxycillin-resistant streptococci in dental plaque. 363 61

During a 12-month period 115 patients defaulted from a rheumatic fever clinic, so a study was undertaken to identify factors related to non-compliance by comparing defaulters with a group of 50 regular attenders. Those defaulting were significantly more likely to be coloured, male, and over 12 years old. They lived 10-99 km from the hospital, were on several drugs and despite more frequent appointments, usually had a record of poor attendance. The severity of the underlying heart disease and use of parenteral penicillin did not affect compliance. Since the use of regular penicillin prophylaxis for the secondary prevention of rheumatic fever is an essential step in reducing the prevalence of rheumatic heart disease, rheumatic fever clinics should be structured to address the needs of adolescents. Furthermore, the use of neighbourhood clinics for routine therapy between visits to a rheumatic fever clinic is essential to improve compliance.
 ...
PMID:The problem of compliance in rheumatic fever. 368 81

This study has been carried out with the aim of assessing the incidence and other features of Infective Endocarditis in the region Veneto (Italy) in the years 1975-84, with particular regard to the patients admitted to the hospitals in Verona. Of the 692 patients admitted in hospitals of Veneto, 629 were resident in the region (an incidence equal to 1.6/100,000 inhabitants per year). The age range was from 8 to 72 (55 +/- 9). All social classes were affected, although retired, disabled and unemployed subjects were in the majority. The average stay in hospitals was 27.6 days. In 7.6% of the cases surgical therapy was required; the over-all mortality rate was 10%. Of the 80 patients admitted to the hospitals in Verona, 79% were suffering from pre-existing cardiopathy (40% rheumatic heart disease, 25% valvular prosthesis, 7.5% congenital heart disease, 5% prolapsing mitral valve, 1.2% obstructive hypertrophic cardiomyopathy); 54% of the cases had been exposed to bacteriological infections in the preceding months: bronchopulmonary, oropharyngeal, genitourinary or gall bladder infections processes or oral surgery or heart surgery or drug addiction. Only in 19% of these cases a correct antibiotic prophylaxis had been carried out. The responsible germ was identified in 50 patients (67% of the cases in which blood cultures had been performed): Streptococcus in 22%, Staphylococcus in 20%, Gram-negative in 12%, Corynebacterium in 4%, polymicrobial associations in 9% of the cases. These data stress the need for an improvement in antibiotic drug regimen (both in prophylaxis and treatment) and the diffusion of norms of hygiene aimed to the reduction of skin and mucous sources of bacteremia and interpersonal transmission of infections disease.
 ...
PMID:[Clinico-epidemiological aspects of infectious endocarditis in a present-day Italian population]. 371 44

In children with congenital heart disease serial noninvasive assessment of the pulmonary vascular bed is desirable in order to determine the appropriate timing of cardiac catheterization and corrective surgery. To assess the value of pulmonary Doppler echocardiography for the estimation of pulmonary arterial pressure we correlated the rightsided systolic time intervals (preejection period, acceleration period, ejection period) derived from pulmonary artery Doppler traces with catheterization data (systolic, mean and diastolic pulmonary arterial pressure, total and vascular pulmonary resistances). 62 children aged from 1 month to 15 years suffering from congenital heart disease (n = 52), from rheumatic heart disease (n = 4), from cardiomyopathy (n = 5) or from primary pulmonary hypertension (n = 1) were investigated. The major finding was a highly significant correlation between the acceleration period and the systolic pulmonary arterial pressure (r = 0.79; p less than or equal to 0.0001). However the acceleration period could not be used for prediction of pulmonary arterial pressure in children with poor myocardial contractility.
 ...
PMID:[Doppler echocardiographic evaluation of pressure in the pulmonary artery in children with congenital heart defects]. 381 67


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