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)

The histories of 117 patients with left axis deviation and complete right bundle branch block (rbbb) on the electrocardiogram were reviewed for evidence of clinical cardiac disease, hypertension or emphysema. One hundred fifty-four patients with complete right bundle branch block alone served as controls. The incidence of coronary artery disease (myocardial infarction or angina) was significantly greater in the group with pronounced left axis deviation; the other factors evaluated showed no significant difference between the two groups. Pronounced left axis deviation of the mean qrs axis is associated with a high prevalence of clinical coronary artery disease. The presence of complete right bundle branch block does not alter their relationship. Some patients with complete rbbb, or with rbbb and pronounced left axis deviation, have no clinical evidence of heart disease.
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PMID:The significance of pronounced left axis deviation in the presence of right bundle branch block. 577 97

Identification of individuals at increased risk of sudden cardiac death is an important but difficult problem, especially in persons without clinically apparent heart disease. The ability of the electrocardiogram (ECG) to predict sudden death was determined in a study of 3983 men who were 30.8 years of age (mean) at entry and who had been followed with regular examinations, including ECGs. During the 30-year observation period, 70 cases of sudden death occurred in men without previous clinical manifestations of heart disease. Electrocardiographic abnormalities were detected before sudden death in 71.4% of cases. The abnormalities were, in decreasing order of frequency, ST segment and T-wave abnormalities, ventricular extrasystoles, left ventricular hypertrophy, complete left bundle branch block, and pronounced left axis deviation. When these electrocardiographic findings in men without clinical manifestations of heart disease were related prospectively to the incidence of sudden death, ST segment and T-wave abnormalities, ventricular extra-systoles, left ventricular hypertrophy and complete left bundle branch block were significant predictors of sudden death, while left axis deviation and right bundle branch block were not significant predictors of sudden death. Increased severity of primary T-wave abnormalities and the association of ST segment and T-wave abnormalities with increased QRS voltage further increased the sudden death risk. The combination of ventricular extrasystoles with either ST-T abnormalities or left ventricular hypertrophy considerably increased the risk of sudden death. Thus, these data indicate that electrocardiographic abnormalities detected on routine examination in men without clinical evidence of heart disease identify men at an increased risk of sudden death.
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PMID:Electrocardiographic abnormalities in apparently healthy men and the risk of sudden death. 620 83

We describe five young patients with recurrent ventricular tachycardia in the absence of organic heart disease. In all patients tachycardia could be terminated or prevented with verapamil. Tachycardia in four patients was very similar, with a QRS pattern of right bundle branch block and left axis deviation. Electrophysiology studies in two patients showed that VT was inducible in one patient (rapid atrial or ventricular pacing, ventricular extrastimuli) but not in the other. The clinical and electrocardiographic similarities in these patients suggest that their ventricular tachycardias may share a common pathophysiology and may be dependent on slow channel activity.
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PMID:Recurrent ventricular tachycardia responsive to verapamil. 620 31

Probable causes of ECG abnormalities in Ebstein's anomaly were investigated by comparing tracings from 18 young patients with the disease (group I) and 20 age-matched patients with a morphologically similar cardiopathy: right ventricular endomyocardial fibrosis (group II). Tall p waves (greater than or equal to 2.5 mm) occurred in about a third of the patients in each group and were attributable to right atriomegaly. 8 patients, 4 from each group, had prolonged P-R intervals (greater than or equal to 17 s) resulting from increased P-R segment (7 cases) and prolonged P-wave duration (4 cases). Right bundle branch block was, however, more prevalent in group I (44%) than in group II (5%), and is thought to result mainly from a paucity of conduction fibres in the atrialized right ventricle in Ebstein's anomaly and partly, in group II especially, from septal fibrosis. In both groups R-wave deflections in V3R and V1 were reduced, probably because of a clockwise cardiac rotation and paucity of right ventricular muscle mass.
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PMID:Electrocardiographic abnormalities in Ebstein's anomaly. Deductions based on comparison with endomyocardial fibrosis. 621 1

Forty-nine cases of Wolff-Parkinson-White syndrome (WPW) were diagnosed out of 10 750 patients with cardiac disease (0.45 p. 100), 24 cases out of 3 761 congenital malformations and 25 cases in the 6 989 patients with acquired heart disease. Right ventricular pre-excitation was recorded in 31 cases; 13 in the lateral zone, 12 in the posterior paraseptal zone and 6 in the anterior paraseptal zone. Left ventricular pre-excitation was recorded in 18 cases: 8 in the lateral zone, 5 in the anterior paraseptal and 5 in the posterior paraseptal zones. WPW and congenital heart disease: Out of 20 cases of Ebstein's anomaly, 5 cases of WPW were observed: 4 right posterior and 1 right lateral pre-excitations. Out of 218 cases of hypertrophic obstructive cardiomyopathy, 7 cases of WPW were observed, 4 of which were congenital. Three cases of WPW were recorded in 699 patients with ventricular septal defects. Out of 1 348 cases of atrial septal defect, 5 cases of pre-excitation were recorded, including 3 right posterior pre-excitations associated with an ostium primum defect. Pre-excitation was also observed in isolated cases of corrected transposition of the great arteries, supravalvular aortic stenosis, aortic incompetence and patent ductus arteriosus. Pre-excitation and acquired heart disease: Five cases of pre-excitation were recorded out of 305 cases of dilated cardiomyopathy (1.62 p. 100). Eleven cases of pre-excitation were recorded in a total of 3 471 cases of valvular heart disease (0.31 p. 100): 9 in rheumatic valve disease and 2 in mitral valve prolapse. Nine cases of pre-excitation were observed in 2 850 cases of coronary artery disease. Intermittent Wolff-Parkinson-White syndrome: Ventricular pre-excitation masks the ECG changes of complete right bundle branch block in Ebstein's anomaly, complete left bundle branch block in aortic incompetence and dilated cardiomyopathy, and the in-complete right bundle branch block often seen in mitral valve prolapse. The characteristic appearances of WPW depend on the zone of pre-excitation. Right ventricular hypertrophy observed in ventricular septal defect with pulmonary stenosis and mitral stenosis may be masked by right lateral pre-excitation. Changes of inferior wall myocardial infarction may be masked by left anterior wall pre-excitation. On the other hand, the effects of WPW on left ventricular hypertrophy are variable, high amplitudes of the resultant forces seeming to depend on late and isolated activation of one of the left ventricular walls.
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PMID:[Wolff-Parkinson-White syndrome and cardiopathies]. 624 Feb 36

The relationship of infection with Trypanosoma cruzi to ECG abnormalities was studied in a defined population in rural Bahia, Brazil. Of 644 individuals 10 years of age or older who had complement fixation tests for antibodies to T. cruzi and ECGs, 53.7% were seropositive. ECG abnormalities were more common in seropositive individuals than in seronegative individuals, and more common in men than in women. The peak prevalence rate of abnormal ECGs occurred among seropositive individuals between 25 and 44 years of age; in this age group ECG abnormalities occurred 9.6 times more frequently among seropositive individuals than among seronegative individuals. The most common abnormalities were ventricular conduction defects, and right bundle branch block with or without fascicular block occurred in 10.7% of the infected population. PR intervals were longer in seropositive individuals than in seronegative individuals. Ventricular extrasystoles were slightly more common in seropositive individuals. A declining prevalence rate of abnormal ECGs among older seropositive individuals suggested selective mortality due to Chagas' heart disease.
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PMID:Relationship of electrocardiographic abnormalities and seropositivity to Trypanosoma cruzi within a rural community in northeast Brazil. 633 65

Sixteen patients, aged 4 to 42 years, operated for congenital heart disease, presented, months or years after surgery, complete atrioventricular (11 cases) or sinoatrial block (5 cases). Six patients had transient complete atrioventricular block in the immediate postoperative period, the maximum duration of which was less than 30 days. The late postoperative period was defined as at least 6 months after surgery. The period between surgery and the implantation of a pacemaker varied from 9 months to 19 years, average 6,3 years. Analysis of long term electrocardiographic studies distinguished three types of progression: --group I: alternation of sinus rhythm and conduction defect until definitive block, sometimes presenting with syncope; --group II: sudden, severe conduction defect after a long period of sinus rhythm; --group III: progressive lengthening of the PR interval. Seven patients developed syncope; 4 had dizziness, 2 were short of breath; only 3 were asymptomatic. All underwent permanent pacing. The incidence of late conduction defects appears to be 1 to 2% of operated patients. The causes include progressive fibrosis, slow sclerosis extending over conduction pathways which are congenitally fragile. Most late blocks are of an advanced degree. Some may be responsible for unexplained sudden death. It is therefore desirable to avoid this complication by the judicious and considered implantation of a cardiac pacemaker. Some authors mention the following factors in deciding on the indications for pacing: --complete, transient atrioventricular block during the operation or the immediate postoperative period; --ECG appearances of right bundle branch block and left anterior hemiblock, or trifascicular block; --His bundle studies.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Severe postoperative heart blocks appearing late. 16 cases]. 641 89

The clinical and electrophysiologic characteristics of 6 patients who had repetitive monomorphic ventricular tachycardia (VT) after a remote myocardial infarction (group A) were compared with those of 22 patients who had this arrhythmia without structural heart disease (group B). VT had a right bundle branch block morphologic pattern in 5 of 6 group A patients and a left bundle branch block morphologic pattern in all group B patients. Endocardial catheter activation mapping was performed in 4 group A patients and in 9 group B patients during VT. In all group A patients, the site of VT origin was on the border of the previous infarction; in all group B patients VT originated at the right ventricular outflow tract. Pacing and programmed stimulation induced VT in 5 of 6 group A patients and 7 of 22 group B patients (p = 0.03). Isoproterenol infusion provoked VT in 4 group A patients and 9 group B patients. Type I antiarrhythmic agents suppressed VT in 4 group A patients and in 14 group B patients, whereas propranolol suppressed VT in 3 of 3 group A patients tested and in 12 of 20 group B patients. Verapamil suppressed spontaneous VT in 1 group A patient and in 4 group B patients. During a mean follow-up of 19 months for group A and 40 months for group B, no patient had died suddenly or had cardiac arrest.
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PMID:Repetitive, monomorphic ventricular tachycardia: clinical and electrophysiologic characteristics in patients with and patients without organic heart disease. 649 64

A slight middle slurring in V1 and/or V2 with rS morphology (R less than S) in these leads, without right or left bundle branch block is a nearly ignored electrocardiographic finding. The purpose of this work is to provide a prospective and electrocardiographic analysis of this finding. We followed 200 subjects with middle slurring in V1 and/or V2, in the absence of bundle branch block (study group), (age: 41.5 +/- 19 years, follow-up period: 5.7 +/- 2.5 years) and 200 subjects with rS morphology in V1-V2 without the middle slurring (control group), (age: 39.8 +/- 20 years, follow-up period: 5.2 +/- 2 years). The age, sex, prevalence of organic heart disease, QRS duration and follow-up period did not show significant differences between the two group. In the study group there was a higher prevalence of vertical axis (P less than 0.001), of S1S2S3 morphology (P less than 0.001) and of terminal r wave in a VR (P less than 0.05) compared to control group. During the follow-up period, a right bundle branch block appeared in 19 subjects of study group (incomplete in 15 and complete in 4) and in 2 (complete) of control group (P less than 0.001). A left bundle branch block appeared only in one patient of study group and in one of control group. We conclude that the isolated slight middle slurring in V1-V2 expresses an initial involvement of the right bundle branch system and increases the likelihood of appearance of right bundle branch block.
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PMID:Slight middle slurring in V1-V2 without bundle branch block. An electrocardiographic and follow-up study. 651 Jun 18

A long term follow-up study of arrhythmic graduates from junior or senior high schools under the Heart Disease Program in Osaka was performed by mailing questionnaires. The age of the total 515 subjects ranged from 20 to 38 years, 26.9 years on an average. From 397 graduates (77%), answers to questionnaires were obtained. We could confirm 92 graduates were alive (18% of total subjects) among the 118 graduates who did not return their answers to the questionnaires. The following is what we could confirm through the present study: The prognoses of simple premature beats, Wenckebach type heart block and complete right bundle branch block are good in young adults. The prognosis of sick sinus syndrome does not warrant an optimistic prognosis even in young adults. The prognosis of WPW syndrome in young adults is not always fair if they have a history of paroxysmal tachycardia. From 95 to 97% of the graduates with arrhythmia as a whole answered that their daily lives are quite similar to those of healthy people. Attitudes toward daily life and medical checks were also studied.
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PMID:Follow-up study of the arrhythmic graduates from the schools under the heart disease program for students in Osaka. 651 48


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