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

Six patients whose standare electrocardiograms showed multiform ventricular ectopic rhythm were studied. All patients had advanced organic heart disease and a significant intraventricular conduction defect (left bundle branch block in five and right bundle branch block plus left anterior hemiblock in one). The ventricular arrhythmia was generally resistant to antiarrhythmic therapy. Five of the six patients died after 2 to 6 months form the period of observation from terminal heart failure. None died suddenly. The ventricular arrhythmia did not seem to be directly related to mortality in any patient. Critical analysis of several long rhythm strips in each case revealed that discharge from multiple ventricular parasytolic foci shared in the multiform ventricular activity. The concurrent discharge of a minimum of three parasytolic foci and a maximum of six foci was found in the same case with a total of 24 parasystolic foci in the six patients. There was a remarkable constancy of the QRS configuration of all parasytolic foci over periods of observation of up to 16 months. However, 22 out of 24 parasystolic rhythms showed significant variation in the apparent rhythm or the administration of drugs. Fourteen parasytolic foci showed evidence of exit block, some of which were exaples of a rapid parasystole with a high degree of exit block. The study suggests that multiform ventricular ectopic rhythm may, in part, be due to the concurrent discharge of multiple parasystolic foci.
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PMID:Multiform ventricular ectopic rhythm. Evidence for multiple parasystolic activity. 4 29

Consecutive autopsy of 1,000 cases of the aged disclosed coronary sclerosis in 428 cases, myocardial infarction in 137, cardiac hypertrophy in 237, valvular heart disease in 120, conduction disturbances in 96, cor pulmonale in 41, pericarditis in 39, and congenital heart disease or anomalies in 28. There were 343 morphologically normal hearts. A total of 1,022 heart diseases were found in 657 cases, corresponding 1.6 heart diseases per one heart. Heart diseases in the aged were divided into (1) those continuing from the younger period and (2) those specifically found in the aged. The latter were non-inflammatory valvular diseases and chronic conduction disturbances. Mitral regurgitation, including mitral ring dilatation (10), mitral ring calcification (9), spontaneous rupture of the chordae tendineae (2) and calcified aortic stenosis (12) and degenerative aortic regurgitation of prolapsed cusp (35) were produced by various degeneration of the connective tissue of the valves. A total of 59 cases of conduction disturbances consisted of complete or advanced heart block (15), right bundle branch block (RBBB) (16), RBBB with left axis deviation (17), and left bundle branch block (LBBB) (11). Forty-seven cases showed main lesions in the branching portion of the AV bundle and origin of the bilateral bundle branches, which were closely related to the degeneration of the central fibrous body and fibrosis at the summit of the ventricular septum. The common field, where the valvular diseases and conduction disturbances occurred, was the fibrous trigone of the heart.
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PMID:A clinicopathological study of the heart diseases in the aged. The morphological classification of the 1,000 consecutive autopsy cases. 12 9

Two groups of young patients, one with right bundle branch block complicated by right ventricular hypertrophy due to congenital heart disease, the other with right bundle branch block and no right ventricular hypertrophy, could be separated on the basis of a few quantitative vectorcardiographic and electrocardiographic criteria. Vectorcardiographic criteria proved better than electrocardiographic criteria in detecting right ventricular hypertropy in individual patients with complete right bundle branch block. Criteria based on the configuration of the QRS loop were also specific but much less sensitive for the diagnosis of this association. In a similar population, that is, young patients with postoperative right bundle branch block, the existence of a residual right ventricular overload would be strongly suggested by the presence of any one of the following criteria: (1) a clockwise rotation of the QRS loop in the horizontal plane, (2) a ratio of the magnitude of the R wave to that of the S wave (R/S ratio) in lead X at less than 2.0, (3) a mean QRS vector in lead X more negative than--10 mv.msec, or (4) a maximal QRS vector located between 90 degrees and 270 degrees in the horizontal plane. In contrast, an R/S ratio in lead X that was equal or superior to 2.0 or an azimuth angle of the mean spatial QRS vector that was not between 90 degrees and 180 degrees would indicate that the right ventricular conduction defect is probably uncomplicated.
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PMID:Vectorcardiographic diagnosis of right ventricular hypertrophy in the presence of right bundle branch block in young subjects. 15 6

The basic criteria for the vectorcardiographic diagnosis of right ventricular enlargement are discussed, in context with the course of myocardial activation. Right ventricular dilatation, secondary to isolated diastolic overloading (atrial septal defect) shows basically different degrees of dextrorotation. The ventricular curve starts to the left on the frontal and horizontal planes, and forward on the last one. Cases with right ventricular hypertrophy, produced by sustained systolic overload, are also evaluated. When the hypertrophy is generalized (pulmonary valvular stenosis), there is an increase in the manifestation of all the resulting vectors of activation of this ventricle: IIs, IIr, and IIIr. As a resultant of these changes, the ventricular curve presents a clockwise rotation in the three planes, and is oriented to the right and forward, with its terminal portions generally located above the E point. When the right ventricular hypertrophy is of the segmentary type, there is an increase of the manifestation of only some of the resulting vectors of the activation of this ventricle. For example, the vector IIr will be increased in cases of tetralogy of Fallot, while the IIIr will be increased in some cases of obstructive chronic pulmonary hypertensive cardiopathy. The T loop, of secondary type, generally opposes the vector IIr on the horizontal plane, and the IIIr on the frontal plane. When an important right ventricular dilatation is associated to a right bundle branch block of intermediate degree, owing to their proximity, the manifestation of the electromotive parietal forces is increased at the expense of the septal ones. This phenomenon produces a characteristic appearance of the SH loop, narrow and with a clockwise rotation.
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PMID:[Vectorcardiographic manifestations of right ventricular enlargement]. 16 77

Ebstein's disease is a frequently cyanotic form of congenital heart disease. The lesions consist of low implantation in the right ventricle of the tricuspid valves, often associated with an atrial septal defect. Our five cases (two men and 3 women) had a variable clinical presentation depending on the degree of the variable clinical presentation depending on the degree of the lesions. A fairly exceptional fact should be emphasised, which is that 3 of our patients brought to term or almost to term 3 pregnancies and gave birth to live children. Ebstein's disease should be suspected when a large heart with a rugby football shape is discovered on X ray and E.C.G., together with right atrial hypertrophy, frequent elongation of the P-R interval, low voltage and complete right bundle branch block. The diagnosis can be confirmed by angiocardiography and catheterisation. Angiocardiography shows a large right atrium and a distal right ventricle in the form of a small chamber with thin walls. Catheterisation is essential and detects the atrial septal defect in 80% of cases and a pressure gradiant intermediate between atrial and ventricular pressures, revealing ventricular morphology. Surgical treatment will be either palliative (cavo-pulmonary anastomosis) or curative: Hunter's operation (Lillehei-Hardy) implantation of the tricuspid on the atrio-ventricular ring. The prognosis is then worse.
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PMID:[Ebstein's disease. Study of 5 personal cases]. 20 42

This report presents a ten-year old child suffering from sick sinus syndrome, in the "Bradycardia-tac hycardia-asystole" variant. A long observation and an ECG made when he was 7 have never shown a sinusal rhythm. An involvement of the A-V node is also present, made clear by a block of the second degree with not very high atrial rates and by prolonged refractory periods, as well as an involvement of the intraventricular conduction, made evident by an incomplete right bundle branch block and by a long refractory period of the anterior fascicle. The clinical, laboratory and hemodynamic data excluded either a congenital or an acquired cardiopathy. The ECGs of the patient's relatives excluded a familiar type of S.S.S. It is, therefore, an idiopathic S.S.S., which is very rare in children. The nosological set in the still vague field of the idiopathic degenerations of the conduction tissue is discussed.
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PMID:[Idiopathic sick sinus syndrome with a-v and intraventricular conduction disturbances in a child. (first report in childhood) (author's transl)]. 32 8

Intraventricular conduction defects are common following repair of various forms of congenital heart disease. Such defects may affect adversely the long-term prognosis of patients in whom cardiac hemodynamics were adequately restored. Review of previously published studies suggests that the site of the conduction defect may be the reason for the different prognoses reported for patients from different institutions. The so-called "trifascicular block" pattern which sometimes occurs following open heart surgery is probably due to a more extensive lesion to the branching and penetrating parts of the His bundle rather than additional injury to the posterior left bundle branch fibers. Transient complete heart block in the immediate postoperative period seems to be a predictor for late development of complete heart block or sudden death at least as powerful as right bundle branch block and left anterior hemiblock.
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PMID:Prognosis for patients with congenital heart disease and postoperative intraventricular conduction defects. 34 55

In this study, we describe the findings in 18 young patients (age range 4 days to 24 years, mean 16.6 years) who had ventricular tachycardia and/or ventricular fibrillation and were followed for 4--70 months (mean 22.4 months). Patients had a variety of problems associated with their arrhythmia, including mitral valve prolapse, cardiomyopathy, myocarditis, prolonged QT syndrome and hypokalemia. Six patients had no clinically recognizable cardiac abnormality. The ventricular tachycardia showed a left bundle branch block contour in 10 of 17 patients, right bundle branch block in four, was multiform in two and had an indeterminate contour in one. Sustained ventricular tachycardia was initiated and terminated reproducibly by atrial and ventricular stimulation in three of seven patients who did not have spontaneous episodes of ventricular tachycardia during the electrophysiologic study. In one other patient, short bursts of ventricular tachycardia were induced. Patients who had ventricular fibrillation, those who died, and those who are still symptomatic with poorly controlled ventricular arrhythmias had significant heart disease. In one patient, a ventricular tachyarrhythmia that had required more than 100 electrical cardioversions spontaneously disappeared after requiring 1 year of antiarrhythmic therapy.
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PMID:Ventricular tachycardia and ventricular fibrillation in a young population. 48 57

The time interval between tricuspid valve closure and pulmonary valve opening, termed the isovolumic contraction time of the right ventricle, was evaluated echographically in 38 normal children and within 24 hours of cardiac catheterization in 53 children with congenital heart disease and normal conduction as assessed with the electrocardiogram. In the 53 patients with congenital heart disease, isovolumic contraction time was strongly influenced by right ventricular afterload, as defined by pulmonary arterial end-diastolic pressure (r = 0.87). It was possible to utilize isovolumic contraction time to separate patients with normal or elevated values for pulmonary arterial end-diastolic pressure. Similar correlations were demonstrated between isovolumic contraction time and mean pulmonary arterial pressure and calculated pulmonary vascular resistance. Evaluation of 15 children with complete right bundle branch block revealed values for isovolumic contraction time that did not significantly differ from those of patients with similar pulmonary arterial end-diastolic pressure but no conduction abnormalities. These findings indicate that serial echographic evaluation of the interval from tricuspid valve closure to pulmonary valve opening can give an accurate reproducible assessment of right ventricular afterload in many children with congenital heart disease and complete right bundle branch block
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PMID:Echocardiographic assessment of pulmonary arterial pressure in children with complete right bundle branch block. 66 33

Cardiac catheterization was used to evaluate 298 asymptomatic, apparently healthy aircrewmen with electrocardiographic abnormalities. These men were identified from annual electrocardiograms and exercise tests used to screen for latent heart disease. Data from 27 additional symptomatic aircrewmen who underwent cardiac catheterization because of mild probable angina pectoris are also included. The men were grouped according to major reason for cardiac catheterization. The order of groups by increasing prevalence of coronary artery disease was as follows: abnormal treadmill test (labile lead only), supraventricular tachycardia, right bundle branch block, left bundle branch block, abnormal treadmill test, ventricular irritability, probable infarct and angina. Approximately 60 percent of the men were completely free of angiographic coronary artery disease. Risk factors and other possible causes for the electrocardiographic abnormalities are discussed. The electrocardiographic abnormalities studied have a poorer predictive value for coronary artery disease in asymptomatic apparently healthy men than in a hospital or clinic population.
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PMID:Angiographic findings in asymptomatic aircrewmen with electrocardiographic abnormalities. 83 26


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