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

In a study to determine the nature and frequency of cardiac side effects during long-term administration of tricyclic antidepressant drugs in usual dosages in the aged, 32 geriatric patients were followed for an average of 36.6 weeks. Ten of them received amitriptyline in a daily dosage of 20-75 mg for 53 weeks (average); in 2, electrocardiographic side effects developed, viz, inversion of the T waves or evidence of acute coronary insufficiency. Imipramine was administered to 21 patients in a daily dosage of 20-100 mg (average, 66 mg) over a period of 40 weeks; in 3 instances major side effects developed--intermittent left bundle-branch block, acute coronary insufficiency with node dysfunction, or T-wave inversion with sinus tachycardia; in 1 instance there was a minor side effect, viz, tachycardia only. In 1 patient, acute myocardial infarction developed after two 10-mg doses of nortriptyline. Five of the 7 patients with cardiac side effects had prior organic heart disease. It was concluded that the incidence of cardiac side effects in aged persons given tricyclic antidepressant drugs in the usual therapeutic dosages for a prolonged period is great enough to warrant frequent careful monitoring of cardiac status during therapy.
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PMID:Cardiovascular side effects of long-term therapy with tricyclic antidepressants in the aged. 42 44

Disturbances of heart rhythm, observed during 700 heart catheterizations in infants and children, are discussed. Paroxysmal supraventricular tachycardia has been observed in 25 investigations (3,6%), sinus bradycardia in 18 (2,6%), junctional rhythm in 10 (1,4%), second degree AV-block in 9 (1,3%), ventricular fibrillation in 8 (1,1%), sinus tachycardia in 7 (1%), complete block in 7 (1%), asystole and atrial flutter in 2 (0,3%) each, and ventricular tachycardia in 1 (0,15%). Supraventricular tachycardia occurred equally in all ages without preference of a special malformation. The two patients with WPW-syndrome, however, showed this disorder in each of three catheterizations. Propranolol and verapamil succeeded in terminating the attacks. Junctional rhythm and sinus tachycardia presented equal behavior and benignity. Sinus bradycardia, second and third degree AV-block, and especially ventricular fibrillation occurred mostly in neonates and infants, many of them cyanotic and suffering from complex malformations and therefore needing multiple catheter manipulations. Bradycardia was in two, asystole in one of the very sick neonates associated with subsequent death within 24 hours. Once asystole resulted in immediate death after pulmonary angiography in a child with severe pulmonary hypertension. Ventricular fibrillation could be terminated promptly by DC countershock in all patients, but three of the children died subsequently. Complete block occurred only in children with systemic right ventricular pressure, 4 of the 7 patients having pulmonary hypertension, too. In two instances the block subsided spontaneously, the rest could successfully be treated with orciprenaline (Alupent R). Life threatening arrhythmias became less frequent as a consequence of earlier investigation, if severe heart disease was suspected, and by closer control of cyanosis, acidosis and temperature before, during, and after catheterization.
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PMID:[The risks involved in the heart catheter examination. A retrospective evaluation of the complications after 700 examination. III. Irregularities of heart (author's transl)]. 53 Jul 27

The electrocardiogram was monitored in 51 patients during fiberoptic bronchoscopic procedures and was compared to recordings made before premedication. Sixteen of the patients had heart disease. During the bronchoscopic procedure, the heart rate increased by 154 "/- 5 percent (+/- SE). The frequency of atrial ectopic beats was minimally increased, by an average 0.15 +/- 0.12 beats per minute (not significant). Ventricular ectopic beats became less frequent during the bronchoscopic procedure (-0.17 +/- 0.41 beats per minute; not significant), and there was no ventricular tachycardia. Frequent ventricular ectopic beats were seen mainly during bronchoscopic procedures in patients with coronary heart disease, but even in this group, ventricular ectopic beats became less frequent than at rest (-1.13 +/- 1.46 beats per minute; not significant). The nearly uniform sinus tachycardia that was observed was well tolerated but could predispose coronary patients to ischemia; however, the fiberoptic bronchoscopic procedure per se does not enhance prior ectopy.
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PMID:Arrhythmias from fiberoptic bronchoscopy. 67 41

Cardiac side effects were evaluated in 1,932 psychiatric inpatients and were found to be more common among the 48 patients with co-existing cardiac disease (18.8%) than among the remaining 1,884 patients (1.3%). Sinus tachycardia was the most common reaction and affected 19 patients, 17 of whom did not have heart disease. While there were two cases of sudden death in which drugs were suspected, in both cases a causal relationship was in some doubt. Neither of the two patients who died received tricyclic antidepressants or phenothiazines.
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PMID:Cardiac side effects and sudden death in hospitalized psychiatric patients. 83 12

Verapamil was administered intravenously to 250 patients aged between 14 and 85, suffering from tachyarrhythmia of various type. The commonest heart conditions were hypertensive cardiopathy, acquired valvular defects, and ischaemic cardiopathy. The antiarrhythmia effectiveness of the treatment is shown by the excellent results obtained in sinus tachycardia, supraventricular paroxysmal tachycardia, high frequency atrial fibrillations and even in a patient with WPW syndrome and supraventricular paroxysmal tachycardia and in one of the 5 patients with ventricular tachycardia. Generally speaking, the treatment was continued orally in a dose of 240 mg per day, and it was possible to control the clinical situation with no side effects.
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PMID:[Clinical results with verapamil in intravenous administration in the emergency therapy of cardiac arrhythmias]. 112 30

The authors examined using selected non-invasive cardiological examination methods 33 patients with neurosis. Four were eliminated on account of organic heart disease. From the group of 29 patients 12 had ECG changes (41%)--of those 5 (17%) had an incomplete right bundle branch block and 1 (3%) had a left anterior fascicular block; 2 (7%) had the syndrome of early repolarization and 4 (14%) had changes of the T wave. The polycardiogram did not reveal a statistically significant difference in the investigated indicators (PEPc, LVETc, WI, PVR) between the group of sick and healthy patients at rest. Ambulatory 24-hour monitoring of the ECG was done in 21 patients--in 2 (10%) it revealed a sinoatrial block, in 10 (50%) episodic sinus tachycardia, in 6 (30%) occasional supraventricular extrasystoles, in 5 (25%) rare ventricular extrasystoles. The echocardiographic examination confirmed the statistically significantly increased systolic function of the left ventricle (P less than 0.05) in all investigated parameters (%D, Vcf, MNSER, EF), as compared with healthy subjects. After a loading ECG test of 28 patients 2 (7%) had ST-T changes. Statistical comparison with the group of healthy subjects revealed in the patients with neurosis a significantly reduced value of systolic (P less than 0.005) and median blood pressure (P less than 0.01), as well as of the inner cardiac work at the peak of the submaximum load (P less than 0.05) and an increase of the diastolic blood pressure (P less than 0.05) during the 10th minute of recovery. The orthostatic test in 20 patients with neurosis revealed a significantly higher heart rate at rest and during the 30th and 60th second after rising (P less than 0.05) and a significantly lower orthostatic index (P less than 0.001) on statistical comparison with healthy subjects.
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PMID:[Functional cardiovascular disorders in patients with neuroses at rest and during physical loading]. 177 6

The study reported here concerns new, computerized ECG devices (R-Test 160, Heartner) which the patient can carry in his pocket and use to register cardiac episodes. Seventy-two patients experiencing sudden episodes--not of daily occurrence--marked by palpitations or irregular pulse were supplied with a device on a total of 83 occasions. The total number of attacks registered was 93. The Heartner device was used by pressing it lightly over the precordial region. The R-Test instrument, on the other hand, required attachment of two conducting arm-bands. Forty-four (61%) of the patients had no organic heart disease. During a mean observation time of 17 +/- 9 days, 28 of the patients (39%) recorded symptomatic episodes, of which 11 consisted of normocardiac sinus rhythm, 7 of sinus tachycardia and only 10 (14%) of arrhythmia. The commonest reasons for a negative test result were freedom from episodes during the observation period (22 patients) and episodes of too short a duration (6 patients). In practice, arrhythmias are not easy to detect with these "home micro-Holters". Those registered correlate poorly with the subjective symptoms, an observation already reported in a number of other Holter studies. Moreover, immediate recording of any arrhythmia occurring is not possible with the devices used in our study. The average delay in starting a recording, caused by the need to attach and switch on the device, is one minute. These ECG devices are of practical use mainly for verifying functional cardiac disorders or as an alternative method in cooperative patients with arrhythmia episodes occurring infrequently and lasting at least one minute.
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PMID:[Advantage of ECG self-recording by the patient]. 194 45

To examine the effects of theophylline toxicity on cardiac rhythm, patients underwent continuous ambulatory ECG recording during acute theophylline toxicity and recovery. The patients, who were recruited form inpatient wards, intensive care units, and emergency departments of a University Medical Center and a Veterans Administration Medical Center, had serum theophylline concentrations (STC) greater than 30 mg/L. There were 14 men and two women with a mean age of 66 years. Fourteen patients had COPD and developed toxicity following long-term theophylline overmedication. Two patients had asthma and ingested an intentional overdose. The STC at the onset of ECG recording ranged from 23 to 67 mg/L. The principal rhythm was sinus in 15 patients; one patient had atrial fibrillation. Sinus tachycardia (heart rate greater than 100/min) was common, and heart rate fell in proportion to STC as toxicity resolved. Supraventricular ectopic beats (SVEs) were noted in seven patients with multiple runs of SVE being present in four. One patient developed multifocal atrial tachycardia (MAT) during toxicity that resolved spontaneously. During the 11 +/- 8 hours of recording during toxicity (STC greater than 20 mg/L), 80 percent of patients had ventricular premature beats (VPBs), 44 percent had paired VPBs, and 25 percent had ventricular runs. One elderly patient with heart disease developed sustained ventricular tachycardia (VT) when STC = 66 mg/L. No other patient had ventricular ectopy that required intervention. During the 10 +/- 6 hours of recording during the "recovery phase" (STC less than 20 mg/L), all patients with VPBs continued to have ectopy; however, the number of VPBs declined significantly. A follow-up 24-hour ECG recording obtained one week after recovery from toxicity in the patient with sustained VT demonstrated marked reduction in the frequency and complexity of VPBs. Patients with frequent (greater than 10/h) or repetitive VPBs were older (p less than 0.05) than those without complex ectopy. There was a trend (p = 0.07) suggesting patients with underlying heart disease were at risk for having complex ventricular ectopy. We conclude that sinus tachycardia, SVE, and VPBs are common among patients with theophylline toxicity; however, sustained ventricular or supraventricular tachyarrhythmias that require antiarrhythmic therapy are uncommon.
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PMID:Cardiac arrhythmias during theophylline toxicity. A prospective continuous electrocardiographic study. 188 98

Of 400 patients with acute, chronic or chronic relapsing pancreatitis surveyed in the present study, only 54 had had ECG in their files. Among these, 80% showed ECG alterations, mostly sinus tachycardia and diffuse disturbances of ventricular repolarization. The causes of these alterations are, as yet controversial. Some explanations for these alterations are hypovolemia, sepsis and acute inflammatory state. Other important findings in the patients were bundle branch block, not encountered either before the pancreatic crisis or after its resolution, nor was dielectric effect and lesion current observed in either the acute and chronic forms. The possibility of the presence of previous cardiopathy in patients with high alcoholic intake, Chagas' disease, high blood pressure or diabetes, which are quite likely in these patients, should be recalled as important factors: marked electrolytes disorders were not frequent and did not correlate with ECG findings. The aim of this study is to highlight the importance of ECG during systematic search in the follow-up of patients with pancreatitis, in order to better understand associated cardiac disorders and to improve diagnosis, prevention and treatment.
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PMID:[Electrocardiographic changes in pancreatitis]. 260 72

The study of the tapes of ambulatory patients who died while wearing Holter devices allows us to know the terminal electrical events of death in these cases and which are the electrical triggering mechanisms leading to the terminal event. From the evaluation of seven published series with 10 or more cases, we can see that the most frequent causes of sudden death are ventricular tachyarrhythmias (84% of cases) and bradyarrhythmias (16%). VF was the most frequent ventricular tachyarrhythmia, usually secondary to VT. The rest were due to torsades de pointes in patients often without heart disease but who were taking antiarrhythmic drugs. The VT leading to VF was often preceded by sinus tachycardia or new atrial tachyarrhythmia. Only a small percentage of patients presented ischemic ST changes. In patients who died due to bradyarrhythmias, this was more often due to sinus depression than to atrioventricular block.
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PMID:Ambulatory sudden cardiac death: mechanisms of production of fatal arrhythmia on the basis of data from 157 cases. 291 68


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