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

Atrial tachycardia (AT) originating in the triangle of Koch is reported rarely and presents a potential risk of atrioventricular (AV) block during radiofrequency (RF) catheter ablation. Eight patients with AT in the triangle of Koch undergoing RF ablation are presented. There were five women and three men, ranging in age from 32 to 74 years. One patient had bicuspid aortic valve disease, and the other seven patients had no structural heart disease. At electrophysiological study, AT was inducible in all eight patients. In one patient, AV nodal re-entrant tachycardia was also inducible. The site of AT was located by recording the earliest atrial activation during AT and successful RF ablation. Fluoroscopy confirmed the corresponding site to the region of the triangle of Koch. The earliest atrial activation was 35+/-9 ms before the surface P wave, and was recorded at the apex of the triangle of Koch near the bundle of His in six patients and midway between the bundle of His and coronary sinus os in two patients. At the successful RF application site, His potential was not recorded in any patient. The mean AV ratio was 5:1 (range 1:1 to 12:1). RF ablation at the successful site resulted in accelerated junctional rhythm in four of the eight patients and successfully terminated AT in all eight patients, with first-degree AV block in one patient. In conclusion, AT from the triangle of Koch is a distinct entity and RF ablation can be successfully performed; however, a potential risk of AV block remains.
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PMID:Radiofrequency ablation of atrial tachycardia originating from the triangle of Koch. 1065 32

Turner's syndrome is associated with congenital heart disease in a third of cases. Several reports of aortic dilatation and of death by dissection or rupture of the aorta have been published. The authors undertook a prospective study to assess the incidence of cardiac malformations and aortic dilatation in genetically confirmed Turner's syndrome. Twenty-six out of 34 patients recalled (76%), aged 7 to 30 years (average 17 +/- 6 years) accepted their inclusion in this study and underwent clinical examination, ECG, chest X-ray and echocardiography. Thirteen patients had a monosomy 45X and 13 a mosaic or structural abnormality. Six had a history of cardiovascular disease (operated coarctation: 2 cases, kinking: 2 cases, Hypertension: 2 cases). Eight patients (30%) had one or several anatomical cardiovascular abnormalities: bicuspid aortic valve (19.2%), abnormalities of the aortic isthmus (kinking or coarctation) (15.4%), aortic regurgitation (7.7%), mitral stenosis (3.8%), partial anomalous venous drainage (3.8%), patent ductus arteriosus (3.8%) and left superior vena cava (11.5%). Systematic evaluation of the aorta resulted in the diagnosis of dilatation of the ascending aorta in 1 case and dilatation of the sinus of Valsalva in 2 other cases. The authors conclude that echocardiographic evaluation is essential after the diagnosis of Turner's syndrome. It should be repeated regularly to detect dilatation of the aorta which carries the risk of serious complications, such as rupture or dissection of the aorta.
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PMID:[Heart malformations and vascular complications associated with Turner's syndrome. Prospective study of 26 patients]. 1085 54

Atrial septal defect (ASD) accounts for 30-40% of congenital heart disease in adults diagnosed after the age of 40 and is after bicuspid aortic valve and mitral-valve prolaps the most common congenital cardiac malformation in adults. We have discussed current views on the pathological role of ASD in adults and controversies regarding its treatment. It is expected that increasing understanding of ASD pathophysiology, improved diagnostic methods and the possibility of transcatheter closure of interatrial defects will improve the treatment of patients with ASD.
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PMID:[Atrial septal defect in adults--opinions, procedures and controversies]. 1147 59

Using polarization microscopy and morphometrical methods, the influence of hypertension on the collagenous structures in the Lamina fibrosa of bicuspid valves of 14 middle-aged persons (30 to 50 years) were examined. The measurements were performed on histological sections. A group of 14 middle-aged subjects free from heart disease served as the control group. Furthermore, the results were compared to earlier findings on the histological biomorphosis of the atrioventricular valves. The following changes were observed and quantitatively determined: a) an enhancement of the percentage of the mechanically more resistant collagenous fibers (unsilvered, type I collagen), b) a stronger lateral aggregation of the collagenous fibrils of both types I and III collagen, c) a significant decrease of the total numbers of collagenous fibers per measuring area, and d) a significant decrease of the portion of silvered fibers (type III collagen) per measuring area for both sexes. The fiber density distributions confirm the observed changes: in the hypertension group the collagenous fibers are less densely distributed than in the control group. The observed regression of the content of collagenous fibers in the hypertension group is probably due to the anti-hypertensive treatment. Following the findings the turn-over of type III collagen is stronger influenced than that of type I collagen. The initial results determined in human heart valves confirm findings in animal models and characterize them with regard to the collagen types mentioned.
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PMID:[Changes in the collagen structures of human heart valves in relation to age and hypertension]. 1182 87

This study was designed to determine the reasons for the variability of the incidence of congenital heart disease (CHD), estimate its true value and provide data about the incidence of specific major forms of CHD. The incidence of CHD in different studies varies from about 4/1,000 to 50/1,000 live births. The relative frequency of different major forms of CHD also differs greatly from study to study. In addition, another 20/1,000 live births have bicuspid aortic valves, isolated anomalous lobar pulmonary veins or a silent patent ductus arteriosus. The incidences reported in 62 studies published after 1955 were examined. Attention was paid to the ways in which the studies were conducted, with special reference to the increased use of echocardiography in the neonatal nursery. The total incidence of CHD was related to the relative frequency of ventricular septal defects (VSDs), the most common type of CHD. The incidences of individual major forms of CHD were determined from 44 studies. The incidence of CHD depends primarily on the number of small VSDs included in the series, and this number in turn depends upon how early the diagnosis is made. If major forms of CHD are stratified into trivial, moderate and severe categories, the variation in incidence depends mainly on the number of trivial lesions included. The incidence of moderate and severe forms of CHD is about 6/1,000 live births (19/1,000 live births if the potentially serious bicuspid aortic valve is included), and of all forms increases to 75/1,000 live births if tiny muscular VSDs present at birth and other trivial lesions are included. Given the causes of variation, there is no evidence for differences in incidence in different countries or times.
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PMID:The incidence of congenital heart disease. 1208 85

The incidence of infective endocarditis (IE) is thought to be around 4/100,000 person years in the general population, and 15/100,000 over the age of 50 years. The risk of acquiring IE is higher among patients with valvular heart disease (e.g., rheumatic valves, bicuspid aortic valves, myxomatous degeneration, etc.), congenital heart disease (e.g., coarctation, patent ductus arteriosus, ventricular septal defect, etc.), prosthetic cardiac valves, and among intravenous drug abusers. Staphylococcus aureus is one of the most common infective agents of IE, and most commonly originates from nosocomial sources, e.g., intravenous and arterial catheters, pacemaker leads, and prosthetic valves. Endocarditis caused by S aureus has a mortality rate of approximately 20% to 40%. In up to 40% of patients, IE caused by S aureus is associated with embolic complications. The risk of death increases with the development of complications. The epidemiology and microbiology of S aureus are changing rapidly, and resistance to antibiotics, especially methicillin, is becoming more widespread. In this review we will focus on the epidemiology, microbiology, and pathogenesis of S aureus IE, and also summarize the current guidelines for diagnosis, treatment, and prophylaxis of this clinical condition.
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PMID:An update on the epidemiology, pathogenesis and management of infective endocarditis with emphasis on Staphylococcus aureus. 1242 17

We report the case of a rare congenital anomaly, a double-orifice mitral valve, in a 23-year-old woman who was asymptomatic and had no history of heart disease. Transthoracic and multiplane transesophageal echocardiography revealed 2 functionally normal orifices of equal size, the least frequent anatomic presentation of this anomaly. We prescribed antibiotic prophylaxis because of the concomitant presence of a mildly stenotic bicuspid aortic valve and recommended annual follow-up examinations to monitor both lesions for possible progression.
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PMID:Well-functioning double-orifice mitral valve in a young adult. 1259 5

Patients with congenital heart disease are increasingly surviving to adulthood and present interesting challenges during cardiac catheterization. Situs inversus with dextrocardia is a type of cardiac malposition most likely to exist with a structurally normal heart. We present the case of a patient with complete situs inversus and bicuspid aortic valve stenosis, a hitherto unreported association. Prototypical findings in this cardiac malposition are illustrated for proper recognition with emphasis on technical tips for left and right heart catheterization.
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PMID:Complete situs inversus and bicuspid aortic valve stenosis. 1266 50

We report the case of a 16-year-old pregnant patient with severe aortic stenosis and pulmonary congestion clinically uncontrolled, in whom percutaneous balloon aortic valvuloplasty was used as the first choice of treatment in an emergency procedure. The clinical findings, pathophysiology, diagnostic features, and indications for percutaneous treatment are reported. Severe congenital aortic stenosis is rare in children and young individuals. Bicuspid aortic valve occurs in 3% to 6% of patients with congenital heart disease; when associated with commissural fusion, significant stenosis may be present in childhood. The association of severe congenital aortic stenosis and pregnancy is difficult to control clinically, carrying a high risk of maternal and fetal mortality, mainly when manifested with symptoms of pulmonary congestion 1,2.
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PMID:Percutaneous balloon aortic valvuloplasty in a pregnant adolescent. 1497 98

The etiology of valvular heart diseases (VHD) has changed in the last 50 years in the industrialized countries. A significant reduction in the incidence of rheumatic fever and its sequelae, increase in life expectancy, recognition of new causes of VHD and advancement in technology are responsible for the metamorphosis of the etiology of VHD. Heritable disorders of connective tissue (marfan syndrome, Ehlers-Danlos syndrome, adult polycystic kidney disease, floppy mitral valve/mitral valve prolapse); congenital heart disease (bicuspid aortic valve); inflammatory/immunologic disorders (rheumatic fever, AIDS, Kawasaki disease, syphilis, seronegative spondyloarthropathies, systemic lupus erythematosus, antiphospholipid syndrome); endocardial disorders (nonbacteremic thrombotic endocarditis, infective endocarditis, endomyocardial fibroelastosis); myocardial dysfunction (ischemic heart disease, dilated cardiomyopathy, hypertrophic cardiomyopathy); diseases and disorders of other organs (chronic renal failure, carcinoid heart disease); aging (calcific aortic stenosis, mitral annular calcification); postinterventional valvular disease; drugs and physical agents are all clinical entities associated with VHD. It should be emphasized that VHDs still constitute a major health problem which will increase with the aging population.
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PMID:Etiology of valvular heart disease. 1503 Feb 51


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