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Query: UMLS:C0018799 (
heart disease
)
34,133
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
From January 1981 to June 1986 116 patients with anticoagulation-related intracranial haemorrhage were referred to hospital. Seventy six of these haemorrhages were extracerebral, 69 were in the subdural and seven in the subarachnoid space. No epidural haemorrhages were identified. Compared with non-anticoagulation-related haematomas, the risk of haemorrhage was calculated to be increased fourfold in men and thirteenfold in women. An acute subdural haematoma, mostly due to contusion, was more frequently accompanied by an additional intracerebral haematoma than a chronic subdural haematoma. Trauma was a more important factor in acute subdural haematomas than in chronic. Almost half of the patients (48%) had a history of hypertension, more than a third (35%) had
heart disease
and about one fifth (18%) were diabetic. Headache was the most frequent initial symptom. Later decreased level of consciousness and focal neurological signs exceeded the frequency of headache. Three patients with
subarachnoid haemorrhage
and nine patients with acute subdural haematomas died, while those with chronic subdural haematomas all survived and had at the most mild, non-disabling sequelae. Myocardial infarction (22%), pulmonary embolism (20%), and arterial disease (20%) were the most frequent reasons for anticoagulant treatment. Critical review based on established criteria for anticoagulation treatment suggests there was no medical reason to treat a third of these patients. The single most useful measure that could be taken to reduce the risk of anticoagulation-induced intracranial haemorrhage would be to identify patients who are being unnecessarily treated and to discontinue anticoagulants.
...
PMID:Anticoagulation-related intracranial extracerebral haemorrhage. 276 75
Although electrocardiographic (ECG) abnormalities and autopsy evidence of myocardial necrosis are associated with
subarachnoid hemorrhage
, their relation to in vivo measures of left ventricular function in this condition has not been established. Thirteen patients with
subarachnoid hemorrhage
and no prior history of
heart disease
were studied by two-dimensional echocardiography, performed initially 10 to 48 h (mean 18) after admission and serially for less than or equal to 14 days. Serum creatine kinase (total and myocardial isoenzyme) was determined 5 times over the first 48 h; ECGs were performed daily. Neurologic state was assessed with the use of a standard grading system. Four patients (Group I) exhibited left ventricular wall motion abnormalities in one to eight segments. In two of these patients there was also left ventricular apical mural thrombus that embolized in one patient, leading to further neurologic deterioration. The initial creatine kinase myocardial isoenzyme was higher in Group I than in Group II (patients without wall motion abnormalities) (10.3 versus 2.1 U/liter, p less than 0.001), initial heart rate was higher (91 versus 61 beats/min, p less than 0.01), neurologic grade was higher (2.5 to 4.5 versus 1 to 2, p less than 0.001) and inverted T waves were more common (4 of 4 versus 1 of 9). Three of the four patients in Group I died; two of the three underwent autopsy and were found to have no significant coronary artery disease. No other patients died.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:Left ventricular wall motion abnormalities in subarachnoid hemorrhage: an echocardiographic study. 340 18
The frequency and severity of cardiac arrhythmias were studied in 70 patients with spontaneous
subarachnoid hemorrhage
investigated prospectively with 24-hour Holter monitoring. Patients were less than 70 years old and without clinical and/or ECG signs of previous
heart disease
; Holter monitoring was initiated within 48 hours of
subarachnoid hemorrhage
. Arrhythmias were detected in 64 of the 70 patients (91%). Twenty-nine of the 70 patients (41%) showed serious cardiac arrhythmias; malignant ventricular arrhythmias, i.e., torsade de pointe and ventricular flutter or fibrillation, occurred in 3 cases. Serious ventricular arrhythmias were associated with QTc prolongation and hypokalemia. No correlation was found between the frequency and severity of cardiac arrhythmias and the neurologic condition, the site and extent of intracranial blood on computed tomography scan, or the location of ruptured malformation. The extremely high incidence of cardiac arrhythmias, sometimes serious, in the acute period after
subarachnoid hemorrhage
and the absence of clinical and radiologic predictors make systematic continuous ECG monitoring compulsory to improve the overall results of
subarachnoid hemorrhage
, irrespective of early or delayed surgical treatment.
...
PMID:Subarachnoid hemorrhage: frequency and severity of cardiac arrhythmias. A survey of 70 cases studied in the acute phase. 359 Feb 46
The prevalence of stroke was investigated in a Finnish population study. The results were based on cross-sectional data from a follow-up examination of a prospective study conducted in 1973-1976. The study population drawn from four regions of the country comprised 11,103 men and 11,096 women aged 20 years and over. The age-adjusted prevalence of stroke was 10.3/1000 in men and 5.8/1000 in women. The prevalence was significantly higher in non-attendants at the examination than in attendants. In 15 per cent of the prevalence cases the stroke was caused by
subarachnoid hemorrhage
, in six per cent by cerebral hemorrhage and in the remainder by cerebral infarction or the type could not be specified. Over half (57 per cent) of the survivors of stroke had no or only slight disability; eight per cent were totally disabled. Some form of organic
heart disease
and hypertension was significantly more common in the prevalence cases than in the others.
...
PMID:Prevalence of stroke in Finland. 373 52
Using 16 years of follow-up results of a prospective cohort study for 122,261 men, 95% of the census population, aged 40 years and older in 29 Health Center Districts in Japan as subjects, we compared the age-standardized mortality rates for cancer of each site and other causes of death in Japanese with life-styles similar to those of Seventh-Day Adventists (SDA), i.e., no smoking, no drinking, no meat consumption daily and eating green and yellow vegetables daily, with those of Japanese with opposite life-styles. Compared with the latter Japanese, the risks were one-fifth or less in Japanese with SDA-like life-styles for cancers of the mouth, pharynx, esophagus, and lung, and
subarachnoid hemorrhage
. Risks were less than one-half for cancers of all sites, stomach, and liver, and for peptic ulcer and
heart disease
. As a single factor, the addition of daily smoking was observed to elevate the risk most strikingly in Japanese who followed SDA life patterns. Influences of further addition of habits of daily drinking of alcohol and dietary changes were significant for cancers of the esophagus, liver, and bladder and other selected diseases. Strategies for cancer prevention by means of life-style modification, e.g., increased consumption of green and yellow vegetables, were discussed.
...
PMID:Mortality in Japanese with life-styles similar to Seventh-Day Adventists: strategy for risk reduction by life-style modification. 383 24
A 10 years old school boy, who had been known to have a small ventricular septal defect from 2 months after birth, was admitted to us with a diagnosis of
subarachnoid hemorrhage
on October 24, 1978. On admission, neurological examination revealed mild right hemiparesis and miotic pupils in semicomatose state, and thrilling, that was equivalent to Levine III, pansystolic murmur and cyanosis of nails were noticed. By CT scan, intraventricular hemorrhage originated from hemorrhage in the basal ganglia was shown and the left CAG revealed an arteriovenous malformation in the left basal ganglia. Electrocardiogram showed mild cardiac failure and chest x-ray showed pulmonary congestion. Neurological symptoms and abnormal cardiopulmonary changes made well manageable after bilateral ventricular drainage. Twenty four cases of arteriovenous malformation associated with congenital
heart disease
were reviewed in the reported literature, and 20 cases were found to combine with Galenic aneurysm with congenital
heart disease
. All of those cases had been in a little pause after the birth and the most of congenital heart diseases were of patient ductus arteriosus. The rest of cases including our present case were 4 cases, who had rather small arteriovenous malformation, and the severity of the congenital
heart disease
was attributable to the patients mortality. In all of the report at present only our case was the single survival. Embryological investigation on arteriovenous malformation of the brain and congenital
heart disease
indicated that association of both conditions could be attributable to the vascular malformation in a very limited gestational stage, and that the incidence should be much less than reported. Our case showed the intracranial hypertension was found to create serious cardio-pulmonary dysfunction when congenital
heart disease
being accompanied, and it was presumably relating to the relatively higher incidence of Galenic aneurysm associated with ductus arteriosus.
...
PMID:[Arteriovenous malformation associated with congenital heart disease, with a remark on accompanying cardiopulmonary dysfunction (author's transl)]. 724 22
Stroke is the third leading cause of death in the United States, behind only
heart disease
and cancer. With an estimated three million survivors of stroke in the United States, the cost to society, both directly in health care and indirectly in lost income, is staggering. Despite recent advances in basic and clinical neurosciences, which have the potential to improve the treatment of acute stroke, the general approach to the acute stroke patient remains one of therapeutic nihilism. Most basic science studies show that to be effective, acute intervention to reperfuse ischemic tissue must take place within the first several hours, as is the case with ischemic myocardium. In addition, most neuroprotective agents must also be administered within a short time frame to be effective at salvaging at-risk tissue. Recent studies have suggested that the outcome after intracerebral and
subarachnoid hemorrhage
is improved with early intervention. However, most stroke patients fail to present to medical attention within this short "window of opportunity." The public's knowledge about stroke is woefully inadequate. However, clinicians who deal with stroke can use the dramatic changes in the treatment of acute myocardial infarction over the last 2 decades as a guide for shaping changes in the management of acute stroke. Comprehensive educational efforts aimed at clinicians and the public at large have dramatically reduced the time from symptom onset to presentation and treatment for acute myocardial infarction, enabling treatment methods such as thrombolysis to be effective. The Decade of the Brain offers a unique opportunity to all concerned with the treatment of the patient with acute stroke to engage in a concerted effort to bring patients with a "brain attack" to specialized neurological attention within the same timeframe that the "heart attack" patient is handled. Such an effort is justified because, although at the present time there are few therapeutic interventions of "proven" value in the treatment of acute stroke, there is more than sufficient suggestive evidence that a number of approaches may be beneficial within the first few hours after the onset of the stroke.
...
PMID:"Brain attack": the rationale for treating stroke as a medical emergency. 812 51
The reports relating emotional stress to sudden death are largely anecdotal. In addition to experimental and electrophysiological studies, an opportunity for a better understanding of possible stress-related sudden death (SSD) may be provided by medicolegal autopsies. The goal of our autopsy study was to analyze cardiovascular pathologic findings in cases of SSD and if possible identify mechanisms by which the stressful event (SE) could be the cause. Forty three cases were studied (29 males and 14 females). In all cases, the SE and the death were witnessed. The age range was 22 to 90 years in males (mean, 52) and 30 to 92 years in females (mean, 64). Death occurred in all cases without premonitory symptoms. In 20 cases, death occurred during the SE and in the other 23 cases occurred within 2 h of the event. SE included fear, 15 cases; altercation, 21 cases; sexual activity, 3 cases; police questioning or arrest, 4 cases. According to police reports, in 40 cases (90%), the victims had no previous clinical history of cardiovascular disease. At autopsy, the heart weight in males ranged from 255 to 1000 g with a mean of 517 g and in females the range was 250-700 g with a mean of 417 g. In only 3 cases, gross and microscopic examination of the heart was normal. In 2 of the remaining 40 cases the subjects died of
subarachnoid hemorrhage
. In 38 cases, a cardiac cause of death was found as follows: coronary heart disease, 27 cases; cardiomyopathy, 6 cases; aortic valvular stenosis, 2 cases and right ventricular dysplasia, 3 cases. A coronary artery thrombosis was found in 8 cases of sudden coronary death. Post myocardial infarction fibrosis was present in 25 cases (92%) of sudden coronary death. In conclusion, it appears from our autopsy study that SSD occurs primarily in those individuals with severe
heart disease
, especially coronary heart disease.
...
PMID:Stressful events as a trigger of sudden death: a study of 43 medico-legal autopsy cases. 906 8
A stroke registry was established in the Eastern Province of Saudi Arabia with an estimated population of 750,000 inhabitants of whom 545,000 are Saudi citizens. The register started in July 1989 and ended in July 1993. The Gulf war led to its interruption from August 1990 to August 1991. Four hundred eighty-eight cases (314 males, 174 females) of first-ever strokes affecting Saudi nationals were registered over the 3-year period. The crude incidence rate for first-ever strokes was 29.8/100,000/year (95% CI: 25.2-34.3/100,000 year). When standardized to the 1976 US population, it rose up to 125.8/100,000/year. Ischemic strokes (69%) predominated as in other studies but
subarachnoid hemorrhage
(
SAH
) was extremely rare (1.4%). The important risk factors were: systemic hypertension (38%), diabetes mellitus (37%),
heart disease
(27%), smoking (19%) and family history of stroke (14%). Previous transient ischemic attacks (3%) and carotid bruits (1%) were uncommon. The 30-day case fatality rate was 15%. The study showed that the age-adjusted stroke incidence rate for Saudis in this region is lower than the rates reported in developed countries but within the range reported worldwide. The pattern of stroke in Saudi Arabia is not different from that reported in other communities with the exception of the low incidence of
SAH
. The risk factors are similar to findings in other studies except for the high frequency of diabetes mellitus in our cases. The lower mortality rate was probably due to the younger age of the population and the availability of free medical services for management of cases.
...
PMID:Stroke register: experience from the eastern province of Saudi Arabia. 954 5
Cardiac arrhythmia and sudden death are most frequently caused by preexisting
heart disease
. Rarely, cardiac arrhythmia is a first symptom of an acute neurological event. We describe a patient with asystole and other cardiac arrhythmias, as initial symptoms of acute aneurysmal
subarachnoid hemorrhage
. Several aspects of cardiac arrhythmias and acute aneurysmal
subarachnoid hemorrhage
are discussed.
...
PMID:Cardiac arrhythmia as initial presentation of aneurysmal subarachnoid hemorrhage. 1059 35
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