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

Twenty-six patients under 20 years of age having cerebrovascular disease were studied from 1968 to 1972. Common risk factors such as hypertension, diabetes mellitus, hyperlipidemia and heart disease were not present. Angiographical study showed a variety of abnormalities. No consistent defect was present. There was a high incidence of pyrexia and convulsions in the early stages of stroke and it appears possible that some form of arteritis might have been important in the production of the cerebral infarction.
Stroke
PMID:Stoke in the young: a four-year study, 1968 to 1972. 115 68

This paper offers a computer-assisted analysis of the author's experience with 234 carotid endarterectomy procedures in 188 patients. The patients' ages, sex, smoking habits, symptoms, carotid bruits, arteriographic findings and associated diseases are summarized. There were 28 operations in asymptomatic patients, 170 operations in patients with transient ischemic attacks (TIA), 35-operations in patients with a completed stroke and one operation in a patient with a stroke in evolution. After surgery, transient neurologic deficits were noted in both the asymptomatic group (two instances) and the group with TIA (5 instances); permanent neurologic deficits followed 4 operations in the TIA group (2.4% incidence). Two operative deaths occurred in the TIA group (1.2% mortality), and 10 deaths occured after operation for a completed stroke (28.6% mortality). Nine of the deaths in the completed stroke group followed operations performed less than 2 weeks after a stroke. A 100% followup was obtained, and the average period of followup was 48 months. Of the patients surviving operation, all in the asymptomatic group were judged functionally normal, 94% of the TIA group were either functionally normal or improved, 76% with a completed stroke were improved, and the patient with a stroke in evolution was unchanged. There were 69 late deaths with heart disease accounting for 58% of the deaths and stroke another 17%.
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PMID:Carotid endarterectomy: an analysis of 234 operative cases. 119 Aug 78

In 167 patients with congenital and acquired heart disease (ventricular septum defect (VSD), atrial septum defect (ASD), mitral stenosis (MS), mitral insufficiency (MI), combined mitral stenosis and insufficiency (MV) aortic stenosis (AS), aortic insufficiency (AI), combined aortic stenosis and insufficiency (AV), idiopathic hypertrophic subaortic stenosis (HOK) hemodynamic measures (arterial pressure, right and left heart pressures, cardiac output, cardiac index, stroke volume, cardiac work), left ventricular volumes (endiastolic volume, endsystolic volume, ejection fraction, regurgitant flow) and diastolic pressure-volume relationships (on the basis of diastolic pressure-volume changes) were determined during routine right and left heart catheterization and left ventriculography. 1...
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PMID:[Hemodynamics, left ventricular volumes and compliance in 167 patients with congenital and acquired heart disease (author's transl)]. 120 78

Hemodynamics measures and indices of myocardial contractility were determined in 110 patients with coronary heart disease. In comparison to a normal group (n=20) right heart pressures (right ventricle, arteria pulmonalis) were increased in coronary heart disease by 48-71%. Systolic aortic pressure was increased by 20-22%. Left ventricular enddiastolic pressure was consideraibly increased by 130%, dependent on the severity degree of coronary artery disease. Cardiac output and cardiac index were decreased at comparable heart rate by 20-33%, dependent on an effective decrease of stroke volume. Isovolumic indices of myocardial contractility (dp/dtmax, t-dp/dtmax, dpmax/IP) WERE REDUCED IN CORONARY HEART DISEASE PARALLEl to the severity degree of coronary artery stenosis. All the hemodynamic chances were most pronounced in a group with left ventricular aneurysm. The results demonstrate that myocardial performance in coronary heart disease is characterized by decreases of pump function and contractility in correlation with the severity degree of coronary artery stenosis.
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PMID:[Coronary disease. I. A correlative study on hemodynamics and contactility in 110 patients]. 121 May 19

Analysis of death certification in North Carolina for a three-year period, 1969 through 1971, showed regional differences in mortality rates from stroke in white men, with the highest rates in the Plains (tobacco growing and farming) area and the lowest rates in the Mountain region. These geographic differences in death rates were observed in all but the youngest age decade and also in the various types of stroke, i.e., hemorrhagic and occlusive cerebrovascular diseases. This regional variation in mortality, however, was not present in white women or blacks. The prevalence at death of heart disease, hypertension and diabetes also was higher in the Plains than in the Mountain region, suggesting that the observed geographic variation of stroke mortality is related to one or more of these major risk factors. It is concluded that the geographic differences in stroke mortality, which had been reported during previous decades, are real and are not due to variations in death certification, errors in diagnosis, or other explanations that might artificially produce inaccuracies in vital statistics.
Stroke
PMID:Geographic differences in mortality from stroke in North Caroline. 1. Analysis of death certificates. 125 3

To investigate the influence of atrioventricular asynchronous contraction on left and right ventricular performance, pulsed Doppler echocardiographic studies were performed in 10 patients who received permanent pacemaker (VVI mode), but without significant heart disease except for complete heart block. After setting the pacing rate at 40 per min, the performance was analyzed during the patient's own slow ventricular rate. Flow velocity patterns at the left (LVOT) and right ventricular outflow tracts (RVOT) were recorded by pulsed Doppler echocardiography, and ejection time (EjT), acceleration time (AcT), peak velocity (PV) and flow velocity integral (FVI), which is proportional to stroke volume, were measured for each outflow tract. When the patient's own atrial contraction occurred during ventricular systole, EjT, AcT, PV and FVI of flow at the LVOT and EjT, AcT and FVI of flow at the RVOT were decreased. Percent change of the FVI of flow at the RVOT (-34.6%) was significantly greater than that of flow at the LVOT (-16.2%, p < 0.01). These results indicate that the loss of right ventricular performance might play a prominent role in the genesis of the hemodynamic deterioration with atrioventricular asynchronous contraction.
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PMID:[The influence of atrioventricular asynchronous contraction on left and right ventricular performance]. 133 10

Cigarette smoking causes significant exposure to nicotine, which increases heart rate, blood pressure, and thus myocardial oxygen demand, and to carbon monoxide, which decreases the oxygen-carrying capacity of the blood because of carboxyhemoglobin formation. Cigarette smoking also predisposes the patient to coronary vasoconstriction. Smoking cessation results in the early elimination of nicotine and carbon monoxide from the system and decreases the risks of ischemia based on these mechanisms. Over the long term, smoking cessation results in elimination of the increased risk of myocardial infarction in patients without previous heart disease as early as 2 years after smoking stops. In addition, for patients with known coronary artery disease, smoking cessation results in an increase in HDL level, which may result in a retardation of atherogenesis and reduced cardiovascular morbidity and mortality. It is important for all physicians to reiterate both the short- and long-term risks of cigarette smoking as well as the good news-that smoking cessation results in a substantial, if not complete, reversal of the risk of myocardial infarction and death, particularly for patients with established coronary artery disease. In light of those established facts, efforts to develop more effective methods to help patients quit smoking must be increased so patients can realize these important health benefits.
Heart Dis Stroke
PMID:Cardiovascular benefits of smoking cessation. 134 4

Clinical and experimental heart irradiation can cause a variety of sequelae. A single dose of greater than or equal to 15 Gy leads to a reversible exudative pericarditis, occurring in dogs, rabbits or rats at around 100 days. Its time-course is very similar in all species investigated, but there are considerable species and strain differences in severity and incidence. After longer, dose-dependent latency times chronic congestive myocardial failure develops. At histological examination myocardial degeneration and necrosis is observed, which in some species is accompanied by a variable degree of interstitial fibrosis. In rabbits and rats, myocardial degeneration becomes apparent at around 70 days after 20 Gy and is preceded by a marked reduction in capillary density as well as ultrastructural endothelial cell degeneration. Simultaneously to structural capillary damage, a focal loss of the endothelial marker enzyme alkaline phosphatase was observed in rats in areas with subsequent myocardial degeneration. Cell kinetic studies in rabbits and rats revealed a radiation-induced wave of increased endothelial cell proliferation at 30-100 days postirradiation. In the rat it is exclusively seen in conjunction with alteration of endothelial cell marker enzymes. The temporal and spatial pattern of proliferative response exludes endothelial cell death in mitosis as the sole pathogenetic mechanism causing capillary loss and myocardial degeneration. Parallel to development of morphological damage, haemodynamic studies in various rats strains revealed a drop in cardiac output and left ventricular ejection fraction to about 64% of normal values after 20 Gy. In vivo, this slightly reduced cardiac function was then maintained in a steady state for many weeks, probably due to a compensatory up-regulation of cardiac beta-adrenergic receptors. In denervated working heart preparations in vitro, however, these compensatory mechanisms are not effective and stroke volume as well as cardiac contractility show a rapid and steady deterioration. In many respects radiation-induced heart disease conforms to radiobiological concepts of late-responding tissues, showing a chronic progressive time-course and a very pronounced fractionation effect. However, pathogenesis cannot be understood in terms of target cell depletion alone, and experimental evidence indicates the importance of alterations of regulatory mechanisms.
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PMID:Radiation-induced heart disease: review of experimental data on dose response and pathogenesis. 135 1

Proposed guidelines for the diagnosis of transient ischaemic attack (TIA) involve interpretation of symptoms, so it can be very difficult to distinguish a TIA from other disorders, such as migraine, epilepsy, syncope, or neurosis. Atypical cerebral and visual events may be classified as TIA. To see whether TIA or stroke patients with atypical cerebral or visual symptoms are at high or low risk of cardiac complications, we prospectively followed 572 patients (entered into the Dutch multicentre TIA trial) with a diagnosis of TIA or minor ischaemic stroke, but whose symptoms did not fully accord with internationally accepted criteria. We compared their outcome with that of 2555 other TIA or stroke patients in the trial, who had unequivocal symptoms; all patients were treated with aspirin. During mean follow-up of 2.6 years the risk of a major vascular event did not differ between the groups (14.5% in patients with atypical symptoms vs 15.1% of patients with typical attacks). Patients with atypical attacks had a lower risk of stroke (5.6% vs 9.4%, hazard ratio 0.6, 95% confidence interval 0.4-0.9) and a higher risk of a major cardiac event (8.4% vs 5.9%, 1.4, 1.0-2.0) than did patients with typical attacks. These differences could not be explained by differences in cardiac risk factors, and were independent of minor discrepancies in baseline characteristics between the groups. A heavy or tired feeling in one or two limbs was the only atypical symptom associated with cerebral rather than cardiac events (ratio cardiac/cerebral events 0.8). For all other atypical symptoms cardiac events were about twice as common as cerebral events (range 1.3-2.5). Our findings suggest that TIA or minor stroke patients with atypical symptoms may have symptomatic heart disease, especially cardiac arrhythmia.
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PMID:Risk of cardiac events in atypical transient ischaemic attack or minor stroke. The Dutch TIA Study Group. 135 13

Twenty-four patients presenting an acute stroke with watershed cerebral infarct on CT scan or MRI were included in this retrospective study. Age was 63 +/- 14 years (mean +/- SD), and sex ratio was 2 men for 1 woman. Main clinical features were: in anterior location, lower limb weakness and frontal syndrome with transcortical motor aphasia in left lesions or spatial dyscalculia in right ones; in posterior location, brachiofacial weakness with constant quadranopsia and hypoesthesia, and Gerstmann syndrome in left lesion. There was no distinctive feature for subcortical and multiple infarcts. In bilateral infarcts, there were one pseudobulbar syndrome, and 2 pseudo brainstem syndromes with neuropsychological signs. Aetiologies were severe carotid artery disease in 14 cases, severe cardiopathy in 6, isolated cerebral angiitis in 1, essential thrombocythemia in 1, protein C deficiency with sickle cell disease in 1, and cholesterol emboli in 1 anatomical case. CBF performed in carotid artery occlusions or tight stenoses showed evidence of haemodynamic changes. Microembolic process can be proposed in the case with cholesterol emboli. Preventive treatment is discussed.
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PMID:Watershed cerebral infarcts: retrospective study of 24 cases. 135


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