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)

A His electrogram was registered with a Castillo tripolar catheter in seven patients with atrio-ventricular discordance and transposition of the great arteries (corrected transposition). They all had ventricular septal defect, six had pulmonary stenosis. two had atrial septal defect, and only one patient presented first degree AV block. The QRS was of normal duration, 4 had RBBB morphology in the left precordials. Two with ASD and VSD had a prolonged P/A interval. In one, the His recording was polyphasic with a prolonged H-V (55 msec) and two others showed a wide polyphasic His potential (25 and 26msec), with a prolonged H-V. These 3 cases with prolonged His had a minor degree of RBBB. The remaining 3 showed normal AV conduction. In all, the Purkinje electrogram was registered. The duration of the Pu potential and the Pu-V were normal. Corrected transposition shows a high incidence of slow AV conduction, frequently not detectable in the usual electrocardiogram in agreement with previous anatomo-pathological studies. The distal block would explain the frequency of complete AV block with low cardiac output and frequent sudden death in this type of heart disease. The distal block would compel us to take e more agressive steps in its treatment. Atrial septal defect with slowing of the intra-arial conduction is not detected in the electrocardiogram.
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PMID:[Study of the heart conduction system in atrioventricular disorders]. 93 45

Sixteen of 994 patients with arteriosclerotic heart disease and dominant right coronary arteries had isolated left circumflex obstruction. Of these, 6 patients had significant (75%) narrowing in the main circumflex, 10 in 1 or the marginal branches and 1 in the atrioventricular groove branch. Angina was mild in 5, moderate to severe in 8, and unstable in 1. Four patients had prior myocardial infarction (MI), and 1 had a recent MI complicated by posterior papillary muscle rupture. The EKG was normal in 5, showed an MI in 2, LBBB in 1, RBBB in 2, ST-T wave changes in 3, LVH in 2, and atrial fibrillation in 2. Left ventricular angiography performed in the right anterior oblique projection revealed normal contraction in 9 patients, apical hypokinesis in 4, posterobasal hypokinesis in 1, and diffuse hypokinesis in 2. The left ventribular end diastolic pressure was normal in 11 patients and elevated in 5. The cardiac index was normal in 12 patients and reduced in 2. Isolated, nondominant, left circumflex coronary disease is an uncommon entity in symptomatic patients. However, when present, it may produce significant clinical and hemodynamic impairment.
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PMID:The clinical and angiographic spectrum of isolated, nondominant, left circumflex coronary disease. 99 Dec 64

Three patients with congenital absence of the left pericardium and one patient with a partial left pericardial defect are described. Congenital absence of the left pericardium is characterized roentgenologically by levoposition of the heart, a prominent pulmonary artery segment and cardiac apex, interposition of lung between the left hemidiaphragm and the base of the heart, and unusual mobility of the heart. The electrocardiogram frequently shows right axis deviation, an incomplete right bundle branch block and leftward displacement of the transition zone in the precordial leeds. The anomaly has often been mistaken for other heart disease. As an isolated anomaly it is benign and does not require any treatment. Patients with a partial defect of the left pericardium can only be diagnosed lcinically if the left atrial appendage herniates through the defect. The herniation produces a protruding shadow along the left heart border and can be demonstrated angiographically and by fluoroscopy. In isolated cases death caused by herniation and strangulation of larger parts of the heart through a partial left pericardial defect has been described.
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PMID:[Congenital defects of the left-sided pericardium]. 100 86

The authors present a case of permanent atrial standstill with syncopal attacks, in a patient with chronic Chagas' Heart Disease. The recognition of this dysrhythmia was based upon the conventional and intracavity electrocardiographic tracings in addition to phonomecanographic and hemodynamic data. The recording of the His Bundle electrogram demonstrated the absence of atrial activity, with the His potential preceding all ventricular complexes and an advanced conduction defect distal to the bundle of His. A diffuse type of atrial involvement was suggested by the lack of response to pacemaker stimulation. An increase in ventricular rate following intravenous atropine administration, led to the diagnosis of an a-v junctional rhythm with a widened QRS complex due to an associated right bundle branch block. Following the implantation of an epicardial ventricular pacemaker, the patient became completely asymptomatic despite the persistence of electrical and mechanical atrial standstill.
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PMID:Persistent atrial standstill. 108 60

The experience with bundle branch block at the USAF School of Aerospace Medicine was reviewed. The clinical and follow-up status was evaluated in 394 subjects with right bundle branch block (RBBB) and 125 subjects with left bundle branch block (LBBB). The majority of subjects were asymptomatic at the time of bundle branch block diagnosis. The subjects were divided into subfroups based on electrocardiographic (EEG) findings to determine if any one subfroup was at higher risk for initial or follow-up morbidity of cardiobascular disease or follow-up mortality. At initial diagnosis and clinical evaluation, 94% of RBBB and 89% of LBBB subjects had no evidence of cardiobascular disease. In the RBBB group, 3 and 2% had cornary heart disease and hypertension, respectively; in LBBB subjects, 9 and 7% had cornary heart disease and hypertension, respectively. No one ECG subfroup in either the RBBB or LBBB group had a higher incidence of cardiobascular disease. Complete follow-up information was available in 94% of the RBBB subgroup subjects and 91% of the LBBB group. In the follow-up period, new cases of coronary heart disease and hypertension occurred in 6% of the RBBB group and 5 and 8%, respectively, in the LBBB group. Fourteen (4%) RBBB and nine (8%) LBBB subjects died during the follow-up period. No differences for follow-up groups. Progressive electrical dysfunction in the form of complete heart block occurred in one subject each absence, and degree of associated cardiobascular disease. Furthermore, within the age limits of the present aeromedical implications of bundle block are discussed.
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PMID:A clinical and follow-up study of right and left bundle branch block. 113 86

We reviewed 144 consecutive patients with symptomatic high grade atrioventricular block. Cases due to congenital heart disease, acute myocardial infarction, cardiac surgery or digitalis toxicity were excluded. Of the remaining, we chose 71 patients in whom atrioventricular conduction was observed either intermittently during complete heart block (CHB) or in electrocardiograms taken within two years prior to documentation of CHB. The mean age was 69 years, with the peak incidence in the seventh decade in 43 men and eight decade in 28 women. Bundle branch block (BBB) was present in 76% of patients as follows: 47% had right BBB (20% with normal QRS axis, 20% with left axis deviation and 7% with right axis deviation), 17% had left BBB (11% with normal QRS axis and 6% with left axis deviation) and 12% had either alternating BBB, right BBB with alternating axis deviation or atypical BBB. "Trifascicular block" patterns accounted for 21% of the total group of CHB. We also studied the prevalence of various patterns of BBB in a group of 2000 random hospital patients of comparable age and sex exclusive of those with acute myocardial infarction and heart surgery. The risk of CHB for the various patterns of BBB was calculated relative to normal intraventricular conduction. All patterns of BBB carried a considerably increased relative risk of CHB, (P smaller than .01). The relative risk was highest for RBBB with left axis deviation and lowest for LBBB with normal or left axis deviation. In the men, 74% had QRS patterns of "bifascicular" or "trifascicular" block during atrioventricular conduction. By contrast, 71% women had atrioventricular beats showing either no BBB or right BBB with normal QRS axis. QRS pattern during CHB was unchanged from that during atrioventricular conduction in 52% if cases (rabge 38%-76% with different QRS patterns) suggesting idiojunctional pacemaker. CHB in these cases was thought to be due probably to coexistent disease in the AV node or His bundle. Although the concept of uni-, bi- and trifascicular block patterns has been useful in identifying patients at greater risk of CHB, the predictability of the electrocardiogram has obvious limitations, particularly in women.
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PMID:The relative risk of spontaneous complete atrioventricular block in elderly patients with impaired intra-ventricular conduction. 115 Dec 1

To determine the need for prophylactic temporary pacing in bifascicular block during surgical and other procedures, a retrospective analysis was carrried out in 38 patients who underwent a total of 74 procedures. The male:female sex ratio was 3.2:1 and mean age was 74 (range 48-96) years. Known organic heart disease was absent in 45 percent of the total group. Patients were divided into four groups on the basis of their preoperative electrocardiograms. Of the 74 procedures, 19 were carried out under general, 22 under spinal and 29 under regional anesthesia; four endoscopic procedures were done without anesthesia. There was only one complication relating to deterioration of AV conduction. It is concluded that asymptomatic patients with right bundle branch block and left anterior hemiblock do not require prophylactic preoperative pacemaker insertion. Though experience is limited, the same may be true of patients with the additional finding of prolongation of PR interval.
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PMID:Indications for prophylactic preoperative insertion of pacemakers in patients with right bundle branch block and left anterior hemiblock. 117 7

Electrophysiological and histopathological examinations were carried out in 2 patients with persistent atrial standstill. Intracardiac studies revealed that atrial standstill was due to atrial inexcitability. It was demonstrated in both patients that prolongation of the H-V interval and the duration of H deflection was associated with complete right bundle branch block and that the escape rhythm was an A-V junctional origin. Histologically, marked fibrosis of the right atrium and fibrous strands in the right ventricle were demonstrated in a 69-year-old man with idiopathic cardiomyopathy. In another female patient with peripartum heart disease aged 40 years, there was moderate degeneration of the myocardium in the right ventricle. The results of electron microscopic observations are also presented. The importance of the examination of His bundle electrography in persistent atrial standstill and the diagnostic criteria and treatment of this lesion are discussed.
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PMID:Persistent atrial standstill due to atrial inexcitability. An electrophysiological and histological study. 118 87

Electrocardiograms obtained in two groups of patients with inversion of the ventricles and transposition of the great arteries, were analyzed: group I corresponding in situs solitus and group II to situs inversus. This series comprises 36 cases (29 of group I and 7 of Group II), in which the diagnosis of the main congenital heart disease --ventricular inversion-- and of the associated defects was established by angiocardiography. In 7 cases of group I and in one of group II, the angiocardiographic diagnosis was proved at least in part during open heart surgery. Direct anatomic study was possible in 5 more cases of group I and in 2 more of group II. Each group comprises two subgroups: A, without RBBB, and B, with RBBB of different degrees. Group I consists of 11 cases of subgroup A and 18 of subgroup B. In group II there were 2 cases of subgroup A and 5 of subgroup B. Vectorcardiograms were obtained following Grishman's method in 17 cases of group I (8 of subgroup A and 9 of subgroup B) and in 3 cases of group II (1 of subgroup A and 2 of subgroup B). In 7 cases of group I (5 of subgroup A and 2 of subgroup B), it was possible to record also the vectorcardiographic curves following Frank's method. Electro and vectorcardiographic findings were correlated with hemodynamic data and, in some cases, also with anatomic ones.
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PMID:[Electro-ventorcardiographic manifestations of ventricular inversion with transposition of great arteries]. 119 Sep 3

This phonocardiographic-echocardiographic study was based on measurement of the interval between the aortic component of the second sound (IIA) and the peak of the E wave of the mitral echogram. The study was performed in 20 cases of left bundle branch block (LBBB), 10 cases of right bundle branch block (RBBB), 10 cases of old myocardial infarct (MI), and 10 cases of systemic hypertension (HY). All patients were above 60 years of age, and their data were compared with those of old persons without evidence of heart disease serving as controls. The IIA-E interval was found markedly prolonged in LBBB, less prolonged in MI and RBBB, and was shortened in HY. A dynamic analysis revealed that this interval results from the isovolumic relaxation period (IRP) of the left ventricle plus the "opening time" of the mitral valve. The changes observed were explained as resulting from a modification of the IRP that should be correlated with a similar modification of the isovolumic contraction time. Myocardial fibrosis would cause prolongation of IRP through structural lesions while hypertension would cause abbreviation of IRP through hormonal effects modifying both contraction and relaxation.
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PMID:Ventricular relaxation and mitral opening time in various ventricular conditions of old age. 121 36


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