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

Motivating children to reduce risk for future disease can only be effective within a framework of personal involvement and peer interaction. The 'Know Your Body' programme of disease prevention is attempting to achieve this goal by means of medical screening for risk factors, giving students their own results in a 'Health Passport', and following up with educational activities integrated into existing school curricula. Didactic teaching alone has been unsuccessful because children cannot relate information about diseases in adult life to themselves. Screening for risk factors provides the 'reality factor' which makes health education pertinent and personal, since approximately half of all students screened will already have one or more risk factors for heart disease, cancer or stroke. This high prevalence of risk factors among our children suggests that chronic-disease prevention must assume a critically important position within the health and science curricula of every school. It is as important to teach our children healthy ways of living as it is to teach reading, writing, and arithmetic.
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PMID:Motivating adolescents to reduce risk for chronic disease. 65 87

In patients with valvular heart disease the initial systolic ejection rate was determined in an attempt to characterize ventricular function in pressure and volume overload. By means of left ventricular cineangiography, the volume change during the initial third of the ejection phase was determined and the mean ejection rate of this period was calculated. A total of 40 patients were examined, 7 patients without heart disease, 15 patients with pure aortic regurgitation, 9 patient with pure aortic stenosis and 9 patients with pure mitral regurgitation. In patients with pure aortic regurgitation and high-normal values for ejection fraction and mean velocity of circumferential fiber shortening (mVcf) a significant increase in initial systolic ejection rate when compared to the group of normals was observed. The distribution of the stroke volume for each third of the ejection phase corresponded to the normal pattern. In contrast, in patients with low-normal values for ejection fraction and mVcf, a decrease in the initial systolic ejection rate below the normal value was observed, along with a pathological distribution of the stroke volume during the ejection phase. This finding was also noted in all patients with pure mitral regurgitation and pure aortic stenosis. In aortic stenosis, the decline in initial systolic ejection rate was regarded as a consequence of the outflow tract obstruction, whereas in volume overload, this was regarded as a sign of a decline in ventricular function which is not recognized with global parameters such as ejection fraction and mVcf.
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PMID:[Initial systolic ejection rate as a parameter of ventricular function in valvular heart disease (author's transl)]. 65 6

A total of 969 (73%) of 1,328 patients with cases of suspected transient ischemic attacks (TIAs) who came to six institutions during a 21-month period were followed up. Factors were identified and prospectively analyzed for risk for further TIAs, stroke, and deatn. A history of multiple carotid artery TIAs was significantly related to further TIAs. A single TIA placed the patient at greater risk for early infarction. Older age, male sex, and unreliability to take dangerous medication were risk factors for cerebral infarction. Anticoagulant therapy, older age, male sex, diabetes mellitus, heart disease, abnormal ECG, and poor surgical risk were factors for death. The increased mortality associated with anticoagulants was confined to the older age group. While white patients treated with antiplatelet-aggregating agents had a lower mortality than those treated otherwise, this was not true amont black patients.
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PMID:Cooperative study of hospital frequency and character of transient ischemic attacks. VIII. Risk factors. 67 2

In a 22-year followup of 3686 San Francisco longshoremen, the roles of physical activity, cigarette smoking habit, and systolic blood pressure level were evaluated independently in relation to risk of death from a broad range of diseases. Smoking pattern and blood pressure status were established in 1951 and job activity was assessed annually during the followup period. Lower levels of energy expenditure predicted increased risk of fatal heart attack and perhaps of stroke. Heavy cigarette smoking predicted increased risk of death from heart attack, cancer, chronic obstructive respiratory disease, and pneumonia. Higher levels of systolic blood pressure were associated with death from all cardiovascular diseases, diabetes mellitus, and cirrhosis. Tacit to these findings: sedentary living takes its toll largely through heart disease and stroke; the toxicity of cigarette smoking is associated with a broader range of diseases, including heart attack, cancer, and respiratory disease; and higher level of blood pressure related to an even broader range of cardiovascular disease than either of the other characteristics studied.
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PMID:Energy expenditure, cigarette smoking, and blood pressure level as related to death from specific diseases. 68 71

The effects of thoracic epidural analgesia (TEA) on the circulation at rest, during, and after physical exercise were investigated in 10 volunteers. At rest, TEA did not affect oxygen consumption (VO2) or cardiac output (Q), but heart rate (HR) was, increased by 7 beats/min, and stroke volume decreased correspondingly by 13 ml. Systolic arterial blood pressure was slightly reduced, but no other changes in systemic or pulmonary circulatory parameters were produced. TEA did not change VO2 during exercise, a 2.11/min reduction of Q being accompanied by a 4.2% increase of oxygen utilization coefficient. HR showed a relative reduction of about 10%. At moderate work loads during TEA, systemic arterial blood pressures were significantly lower than during control exercise. The resulting rate pressure product (RPP) was markedly reduced, while total peripheral resistance (TPR) remained unchanged. During recovery after the termination of exercise during TEA, VO2, Q, HR, RPP and TPR fell more rapidly towards values obtained at rest. From a clinical point of view the results support the safeness of TEA and also support its use in surgical patients with heart disease.
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PMID:The influence of thoracic epidural analgesia on the circulation at rest and during physical exercise in man. 69 17

In 30 patients with congenital or acquired heart disease the haemodynamic effects of diazepam (Valium) 0.3 mg/kg were investigated during surgical procedures under neuroleptanalgesia. The following parameters were measured or calculated: Heart rate (HR), arterial pressure (-Part, Psyst, Pdiast), pulmonary artery pressure (-PAP), right (-PRA) and left atrial pressure (-PLA), left ventricular pressure (PLV), left ventricular enddiastolic pressure (PLVED), left ventricular peak dp/dt (dp/dtmax), cardiac output (CO), cardiac index (CI), stroke volume (SV), stroke index (SI), total systemic resistance (TSR), total pulmonary resistance (TPR), work index of the right (RVWI) and left ventricle (LVWI). In comparison with a control group (n = 36) diazepam caused a decrease in arterial pressure cardiac index, stroke index, right and left atrial pressure and dp/dtmax. This, however, was mainly attributable to vasodilatation and not to a negative inotropic effect, which is of only minor importance with diazepam. These haemodynamic changes resulted in a reduction in myocardial oxygen consumption. Diazepam is a valuable drug in neuroleptanalgesia, when an increase in blood pressure can not be controlled by fentanyl or droperidol.
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PMID:[Diazepam (valium). Changes in haemodynamics, myocardial oxygen consumption and vascular tone (author's transl)]. 69 81

In 44 patients with congenital or acquired heart disease, functional class II--IV NYHAC, the effects of calcium gluconate (10 ml 10%) and calcium chloride (10 ml 5.5%) on hemodynamics, inotropy and myocardial oxygen consumption were investigated during and immediately after cardiosurgical procedures. There was a significant increase in blood pressure, left ventricular pressure, total systemic resistance, cardiac index, stroke index, peak dp/dt and myocardial oxygen consumption as well as in arterial perfusion pressure during extracorporeal circulation due to i.v.-injection of either one of the drugs. The positive inotropic effects were more pronounced after application of calcium chloride. In emergency situations during anaesthesia or resuscitation, therefore, calcium chloride seems to be of more advantage than calcium gluconate.
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PMID:[Effects of calcium gluconate and calcium chloride on cardiocirculatory parameters in man (author's transl)]. 72 23

Serum catecholamines (epinephrine, dopamine and norepinephrine) were measured two, four and six hours after open heart surgery. The ratios of stroke index (SI) and cardiac index (CI) to catecholamines (CA) were determined. Patients studied consisted of 27 with congenital and 14 with acquired heart disease. Extracorporeal circulation (ECC) time was longer than 90 minutes in 17 and shorter in 24 patients. SI and CI diminished in elder patients with congenital disease (Group Cg-ad), patients with acquired disease (Group Ac) and patients with a longer ECC time (Group L). Therefore, elder age and/or longer ECC time seems to be responsible to the lower indices. However, the ratios of the indices to CA showed that the lower indices indicated the poor response of the myocardium to CA in Group Ac and Group L. The response was larger in Group Cg-ad and the lower indices were related to lower serum CA level. It was concluded, therefore, that the indices of stroke volume and cardiac output had inverse correlation to ECC time, but not to age, namely, prolonged ECC compromised more severely the myocardium and resulted in the poor response of the myocardium to CA. Subsequently, to compensate for the poor response, serum CA levels were elevated probably to maintain due SI and CI in patients with prolonged ECC.
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PMID:Relation of stroke and cardiac indices to serum catecholamines following open heart surgery. 73 52

Disorders of the peripheral vascular system often are associated with heart disease which may increase operative risk. The purpose of this study was to investigate the clinical usefulness of radionuclide angiocardiography for evaluation of cardiac function in patients with vascular disorders. This simple procedure provides measurements of cardiac output, pulmonary blood volume, and left ventricular end-diastolic volume, stroke volume, and ejection fraction with no significant risk or discomfort to the patient. A total of 22 patients with vascular disorders were studied by this technique. Five patients had systemic arteriovenous malformations. The cardiac output, end-diastolic volume, and stroke volume were documented to be greater than normal in these patients before operation. In three patients studied following closure of the arteriovenous fistula, the cardiac output, left ventricular end-diastolic volume, and stroke volume decreased. Postoperative changes in left ventricular ejection fraction were variable. A group of 17 patients with atherosclerotic vascular disease underwent cardiac evaluation. In nine patients with no history of cardiac disease, the lowest ejection fraction of 0.45 occurred in a patient with a saccular thoracic aneurysm, the only patient of the 22 who died after operation. A wide variation in ejection fraction was observed in patients with a history of cardiac disease which ranged from 0.32 to 0.86. Objective documentation of cardiac function by radionuclide angiocardiography would appear to enhance the management of patients with peripheral vascular disorders.
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PMID:Noninvasive radionuclide assessment of cardiac function in patients with peripheral vascular disease. 75 15

The role of surgery in the treatment of extracranial cerebrovascular disease is essentially a prophylactic one but it should be borne in mind that apart from preventing stroke, such procedures will or should eliminate symptoms. The authors believe that every patient suffering from cerebrovascular insufficiency should be thoroughly evaluated for extracranial cerebrovascular occlusive disease and that arteriograms should be performed on all patients who could be expected to be candidates for surgery. The various indications for surgery have been discussed. The authors believe that people who have severe bilateral disease and who are of an advanced age are probably in a higher risk group. They also believe that surgery should not be offered to people who have a complete stroke and who are in semi-coma or coma, no matter how rapidly they may be transferred to the operating theatre. The authors firmly believe that intra-operative E.E.G. monitoring is an important adjunct to the safe surgical treatment of lesions of the carotid bifurcation, not only to indicate when shunting is necessary but also to indicate how well that shunt is functioning. In spite of the frequent presence of associated heart disease, hypertension and other vascular lesions, operation can be offered with confidence to suitable candidates. Elimination of symptoms can be expected in over 90% of cases. Only one patient has suffered a stroke since leaving hospital and this occurred because of occlusion in his internal carotid artery which was not operated on. Apart from patient selection, the factors which have contributed to the authors' low morbidity and mortality have been the use of intra-operative E.E.G. monitoring, intra-operative heparinisation and the availability of excellent angiographic studies.
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PMID:The surgical management of extracranial cerebrovascular occlusive disease: a review of 200 consecutive surgical cases. 76 4


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