Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Of the right aortic arch anomalies, a right arch with isolation of the left subclavian artery is the least common. Herein we describe a 52-year-old woman in whom this anomaly was discovered during cerebral angiography for evaluation of a giant symptomatic intracavernous carotid aneurysm. Isolation of the left subclavian artery may be suggested in a patient with a right arch in whom the blood pressure or pulse in the left upper extremity is diminished. Although the isolated left subclavian artery produces the hemodynamic alterations of a subclavian steal, review of the 39 cases reported in the literature revealed only 5 patients with symptoms suggestive of vertebrobasilar insufficiency and 5 patients with weakness of the left upper extremity. Although the patient we describe had no known heart disease, congenital heart disease was present in 23 of the 39 reported cases (59%), tetralogy of Fallot occurring most frequently.
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PMID:Right aortic arch with isolation of the left subclavian artery: case report and review of the literature. 217 46

The management of patients with cerebral transient ischemic attacks and carotid artery stenosis remains controversial. Noninvasive techniques help to determine which patients require surgical intervention without exposing the majority of patients to the risk and discomfort of invasive procedures. Measurement of ophthalmic artery pressure by ophthalmodynamometry or oculoplethysmography gives a representation of perfusion pressure in the internal carotid artery circulation. Doppler ultrasound studies can define the extent of obstruction to flow at the carotid artery bifurcation and assess collateral flow from the external carotid artery. Real time B-mode ultrasonography can detect nonobstructive ulcerated plaque in the carotid artery bifurcation. Employing these examinations in a test battery can identify hemodynamically significant lesions, which are more likely to precipitate a stroke. The information obtained from these studies can be utilized in patients with episodes of cerebral transient ischemic attacks, asymptomatic carotid artery bruits and vertebrobasilar insufficiency. Noninvasive carotid artery testing is also useful in screening patients with nonspecific symptoms, such as dizziness or light-headedness, which may be related to decreased flow in the carotid circulation. Noninvasive carotid artery testing can provide valuable anatomic and physiologic information required in the appropriate management of patients with cerebrovascular disease. It is of particular value in managing patients with heart disease who are at high risk for complications from invasive procedures.
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PMID:Clinical applications of noninvasive carotid artery testing. 388 May 66

Patients who have undergone a Blalock-Taussig anastomosis for treatment of congenital heart disease may have the vascular anatomy of the subclavian steal syndrome. Cerebral ischemia has been reported in such patients, but not when total surgical correction has eliminated other predisposing factors. We report a patient who developed vertebrobasilar insufficiency 31 years after Blalock-Taussig anastomosis and 4 years after total intracardiac repair of tetralogy of Fallot. He had angiographically proven subclavian steal and no other known predisposing factor for cerebral ischemia. This case suggests that symptomatic subclavian steal may be a late risk of surgical treatment of congenital heart disease that leaves the vascular anatomy of subclavian steal intact. Vascular reconstructive surgery can be effective treatment for these patients and may be indicated prophylactically at the time of intracardiac repair if subclavian steal syndrome becomes a more frequently recognized sequela of prior Blalock-Taussig anastomosis.
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PMID:Vertebrobasilar ischemia after total repair of tetralogy of Fallot: significance of subclavian steal created by Blalock-Taussig anastomosis. Vertebrobasilar ischemia after correction of tetralogy of Fallot. 670 43