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

The clinical profile of 28 consecutive patients admitted with infective endocarditis (IE) between 1987 and 1988 was studied. There were 21 males and seven females with a mean age of 24 +/- 11 years. Rheumatic heart disease (RHD) was the commonest underlying disease (68%) followed by congenital heart disease (CHD). Mitral regurgitation with aortic regurgitation were the commonest valvular lesions (47%) in those with RHD while ventricular septal defect was the commonest (43%) in those with CHD. A younger age of onset, complicated course and high mortality were seen in these six patients with acute IE. Persistently positive blood cultures during life or at autopsy were obtained in 21%. Strep viridans was the commonest isolate and was often resistant to streptomycin. 2D echocardicgram revealed vegetations in 96% of patients, the aortic valve (39%) being more commonly affected than the mitral valve (11%). ESR of more than 20 mm drop 1st hour (Wintrobe) was seen in 96%. Thrombophlebitis was a common complication of therapy and cloxacillin the commonest drug implicated. A mortality of 21% as a result of refractory congestive heart failure (CHF) (50%), uncontrolled sepsis (33%) and embolic events (17%) was seen. A rising incidence of culture negative IE, combined aortic and mitral valve disease and CHF is noted.
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PMID:Changing spectrum of clinical and laboratory profile of infective endocarditis. 130 28

The issue whether a postpartum woman should take oral contraceptives can be expressed as 3 questions: has she any contraindications? would the pill affect her coagulation, lactation or psychologic state? when should she start taking the pill? The same risks and contraindication apply to postpartum women as to any others: smoker age 35, hypertension, thrombophlebitis or thromboembolism, arterial vascular disease, heart disease, liver disease, estrogen-dependent tumors, hypertriglyceridemia, and previous non-compliance. While high-dose estrogens commonly given to block lactation do increase existing hypercoagulability in the immediate postpartum period, there is no evidence that current low-dose pills further increase blood clotting. Combined pills decrease milk production, and have been prescribed in the immediate postpartum to help inhibit lactation. Progestin-only pills and injectables do not compromise lactation. It is unknown whether oral contraceptives effect postpartum mood disorders. Low-dose oral contraceptives can be started immediately postpartum if the woman has no risk of thromboembolism. It is standard practice to start 3 weeks after delivery if she does not intend to breastfeed.
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PMID:Oral contraceptives in the puerperium. 167 22

Cardiac diseases of cattle may involve valvular structures, myocardium, pericardium, or blood vessels and are manifested by the clinical signs of cardiac dysrhythmias, cardiac murmurs, generalized edema, muffled heart sounds, jugular venous distention, jugular venous pulsations, pulmonary edema, pleural effusion, or ascites. Digoxin, quinidine, and furosemide can be used effectively to control signs of CHF and cardiac arrhythmias. Combination antimicrobial therapy can be successful for cows with infective endocarditis and thrombophlebitis. Pericardial fluid drainage may temporarily improve cattle with traumatic pericarditis or lymphosarcoma so that short-term goals may be reached.
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PMID:Treatment of cardiovascular disease in cattle. 176 Jul 59

In summary, oral estrogens are often prescribed to relieve menopause symptoms. They should not be used in women who have had breast cancer, thrombophlebitis, hypertension, gallstones, or undiagnosed abnormal genital bleeding. Hormone replacement therapy has proven to be very useful in preventing osteoporosis, hot flashes, night sweats, and vaginal dryness. More information is needed before they should be recommended for the prevention of heart disease in postmenopausal women.
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PMID:Estrogen replacement therapy. 185 17

Case control studies of oral contraceptives in the literature proved an increasing risk of cardiovascular diseases ranged from 2 to 6. In the presented GDR-case-control-study 425 women with cardiovascular diseases and 1,275 controls without cardiovascular diseases have been entered. Cases and controls were examined in ten centers. We found no elevated risk for ischemic heart disease, cerebrovascular disease, and hypertonic heart disease in oral contraceptive users. The risk did not depend on age, type of oral hormonal contraceptive, and duration of use. There was only a statistical significant increase in the estimated relative risk of 2.05 in venous thrombosis and thrombophlebitis. Of course, prudent medical practice requires that a possible risk of certain cardiovascular events during hormonal contraceptive use must be taken into account when weighting the risks and benefits of each patient's contraceptive choices. Further studies are needed.
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PMID:[Hormonal contraceptives and cardiovascular risk. Results of an East German multicenter case control study]. 307 Oct 53

The complications of clinical cardiac electrophysiologic studies were prospectively evaluated in 1,000 consecutive patients studied in one laboratory with an unaltered protocol to better assess the risks of this procedure. There were 728 men and the mean age of the entire group was 58 years (range 16 to 84). Coronary artery disease was the most common type of heart disease (56%) and 200 patients had no identifiable organic heart disease. The indication for study was a ventricular tachyarrhythmia or cardiac arrest in 582 patients. Each patient underwent an initial (baseline) study and 444 patients underwent serial drug studies (2.7/patient). There was one death during these studies. Other major complications included arterial injury (0.4%), thrombophlebitis (0.6%), systemic arterial embolism (0.1%), pulmonary embolism (0.3%) and cardiac perforation (0.2%). Significant arrhythmic complications included catheter-induced permanent complete atrioventricular (AV) block in 1 patient, nonclinical atrial fibrillation that required therapy in 10 patients and severe proarrhythmic events in 12 (3%) of 397 patients undergoing drug studies for ventricular tachyarrhythmias. Cardioversion was required for termination of ventricular tachyarrhythmias in 179 baseline studies (53% of patients with inducible arrhythmia), and in an additional 35 patients, cardioversion was required at least once during follow-up studies. Although clinical cardiac electrophysiologic studies are associated with complications, the risks are small and acceptable.
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PMID:Risks and complications of clinical cardiac electrophysiologic studies: a prospective analysis of 1,000 consecutive patients. 358 18

Anticoagulant therapy has stood the test to time. Full-dose heparin and warfarin prevent recurring pulmonary embolism and deep venous thrombosis. Their use is indicated in patients who have experienced venous thromboembolism unless contraindications are compelling. Low-dose heparin is successful in preventing the initial episode of venous thrombosis in most patients at high risk for the development of thrombophlebitis. Warfarin reduces the incidence of systemic embolization in patients with heart disease and atrial fibrillation and in patients with artificial heart valves. Evidence is accumulating to suggest that warfarin may still retain an important role in the management of patients with myocardial infarction. However, bleeding remains an inevitable risk in patients receiving anticoagulant therapy. The risk, however, can be diminished when both the physician and patient understand the mechanism of action of the drugs and the factors that predispose to bleeding.
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PMID:Current status of anticoagulant therapy. 707 46

The association between white thrombus in the aorta and multiple embolic occlusions of peripheral vessels was made 22 years ago. However, mural thrombus has been neglected as a major cause of embolus because the process was attributed to paradoxical effects of heparin. Our recent experience indicates it is a more generalized problem. During the past five years, AP and lateral abdominal aortograms demonstrated the presence of large filling defects within the lumen of the aorta in 20 of 39 patients with sudden occlusion of a distal artery. Thirteen patients were not on heparin. These 3.4 X 1-2 cm defects were present anywhere from T-10 to the aortic bifurcation and were suprarenal in ten patients. The 20 patients had a total of 36 separate embolic events, with five patients experiencing seven occlusions of renal or superior mesenteric arteries. Serious medical problems coexisted, and all patients had at least two of five important "risk factors." These were heart disease, recent thrombophlebitis, heparin therapy, abdominal atherosclerosis and postoperative status. Catheter embolectomy alone was associated with recurrent embolization in four of six patients. Three patients died and two required amputation. Of 12 patients treated by embolectomy combined with open aortotomy, recurrent embolization occurred in none, death in one and amputation in two. All patients with visceral artery occlusions survived with normal function of the previously occluded structure. We urge wider application of abdominal angiography in order to treat more appropriately a sizable proportion of patients whose distal emboli originated from large chunks of white thrombus in the abdominal aorta.
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PMID:Mural thrombus of the aorta: an important, frequently neglected cause of large peripheral emboli. 730 88

To contribute for making early diagnosis and treatment of acute pulmonary embolism (APE), we investigated on clinical pictures of 225 patients with APE. Common underlying factors were heart disease, prolonged bed rest, post-surgical state, thrombophlebitis, malignant tumor and post-catheterization state in this order. Dyspnea, chest pain, tachycardia and shock were frequently seen as initial symptoms and signs. Blood screening showed leukocytosis, hypoxemia, hypocapnia and elevated serum LDH. Electrocardiographic findings highly demonstrated were ST.T abnormalities, such as T inversion with ST elevation in V1-3, ST depression in V4-6 and sinus tachycardia. Chest X-rays showed diminished pulmonary vascular marking and pulmonary artery dilation. Right ventricular dilatation were frequently seen on 2-dimensional echocardiograms. Pulmonary artery pressure were elevated up to 49/20 (30) mmHg. Twenty-five percent of the patients died, and the recurrence was seen in 4%. Thus, as soon as APE is suspected by above clinical findings, definitive diagnosis should be obtained by the lung perfusion scan and pulmonary arteriography, then oxygen and thrombolytic agents should be given immediately to prevent the fatal outcome.
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PMID:[Early diagnosis and management of acute pulmonary embolism: clinical evaluation those of 225 cases]. 835 37

In 1991, the U.S. Food and Drug Administration approved Norplant manufactured in Finland for American use. It has had over 500,000 users in almost 50 nations. It is sold as a set of 6 capsules, each containing 36 mg of levonorgestrel, which are implanted subdermally no on the medial upper arm. An American cohort of Norplant users had the following annual Pearl pregnancy rates: (a) 355 women at 1 year, 0; (b) 283 women at 2 years, 2.1; (c) 191 women at 3 years, 3.1; (d) 69 women at 4 years, 0; and (e) 25 women at 5 years, 0. The cumulative continuation rates for 396 American Norplant users were 82% at 1 year, 65% at 2 years, 50% at 3 years, and 44% at 4 years. A 2nd American cohort and groups of Norplant users in Chile, Egypt, and Thailand had higher continuation rates. Among 110 former Norplant users in San Francisco, 61% planned to use it again. The user can conceive in just 1 month after Norplant removal Many women do experience alterations in menstrual patterns, including prolonged bleeding, spotting between periods, and very light or no bleeding. The ectopic pregnancy rate has been 0.28 per 1000 woman-years of Norplant use, an incidence lower than that of ectopic pregnancies in women not using family planning. Norplant is appropriate for many women who want continuous long-term contraception. Definite contraindications to Norplant include: (a) acute liver disease, including benign or malignant tumors; (b) jaundice; (c) undiagnosed vaginal bleeding; (d) a history of thrombophlebitis, pulmonary embolism, or blood clots in the eyes; (e) a history of heart attack, chest pain as a symptom of diagnoses heart disease, or stroke (coronary artery or cerebrovascular disease); (f) possible pregnancy; (g) lactation until at least 6 weeks postpartum; (h) hemorrhagic disorder; (i) anticoagulation therapy; and (j) drugs such as rifampin, barbiturates, phenytoin, carbamazepine, phenylbutazone, and isoniazid, which may interact with the levonorgestrel in Norplant and decrease its effectiveness.
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PMID:Norplant: a welcome new contraceptive. 848 56


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