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

Although both sudden death and acute myocardial infarction are almost always associated with long-standing obstructive coronary artery disease, both may originate in the myocardium. Spasm has been suggested as a factor contributing to sudden death. Not all persons dying of acute myocardial infarction have narrowed coronary arteries, nor do all persons with obstructed arteries die of heart disease. The first phase of acute myocardial infarction may well involve myocardial necrosis, followed by stasis and collapse of collateral circulation and occasionally by coronary occlusion.
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PMID:Sudden death and acute myocardial infarction: clues to differences in pathophysiology. 70 7

We evaluated the validity of body surface mapping (MAP) in assessing noninvasively the degree of myocardial ischemia in patients with significant coronary arterial stenosis following Kawasaki disease. Delay of ventricular depolarization was examined by a departure map (DM) using mean QRS map, and the sensitivity of this method in detecting myocardial ischemia was evaluated based on the findings of coronary arteriography (CAG). The other noninvasive measures were also evaluated. MAP was obtained in 29 patients with significant coronary arterial stenotic lesions, including coronary occlusion, segmental stenosis and localized stenosis of 75% or greater. Mean QRS map was obtained based on MAPs in 41 children without organic heart disease and in 22 patients with significant stenotic lesions. The departure index (DIi) was calculated by subtracting potentials at each lead from those of the mean QRS maps and divided by the standard deviation. Departure area (Da) was defined as an area with DIi of -2 or less. Each MAP was subdivided into nine sections, and Da greater than or equal to one-eighth of the anterior wall section, Da greater than or equal to one-third of the posterior and inferior wall sections or Da greater than or equal to half of the other sections were regarded as ischemic areas. Sensitivity in detecting ischemia by MAP was assessed by the CAG findings, which was also compared to the sensitivity of the electrocardiograms (ECG), ECG with dipyridamole administration (Dp-ECG), vectorcardiograms (VCG), Holter ECG (Holter), treadmill test (TM), Master's double step test (MD), two-dimensional echocardiography (2DE) and thallium myocardial imaging (TMI).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Diagnosis of myocardial ischemia in patients with a significant coronary arterial stenosis following Kawasaki disease]. 213 52

Several authors are in agreement that there is no relationship between calcium concentration in vitreous humor and time since death. Nowak and Balabanova (1989) however established such a relationship on a random sample of 19 cases suffering from heart disease (coronary occlusion) and quote Coe (1969, 1972) who "described also a correlation between PMI and calcium" which is completely wrong. The results of Nowak and Balabanova are compared to own results (n = 270, 69 deaths due to coronary artery disease), results of Sturner et al. (1972) and Schmidt (1988). In conclusion there is a statistically significant correlation between calcium concentration in vitreous humor and PMI (r = 0,356) but the range of scatter of the individual calcium values over the PMI is so great that it becomes clear that vitreous calcium is no aid in estimating the time since death.
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PMID:[Calcium concentration in vitreous humor--a means for determining time of death?]. 224 34

Epidemiologic studies provided evidence that increased heart disease mortality after carbon disulfide exposure is not only related to carbon disulfide-caused coronary sclerosis but they suggest that there would be reversible, direct cardiotoxic effects. In order to investigate such direct toxic effects of carbon disulfide on the cardiovascular system, in this study carbon disulfide was administered acutely and subacutely to rats. Blood pressure and heart rate in normotensive conscious unrestrained rats were not markedly influenced by both acute and subacute carbon disulfide administration. Depressant effects of carbon disulfide administration on intracardiac impulse generation and conduction as well as on contractile force were observed in urethane-anesthetized rats. The appearance of several forms of aconitine-induced arrhythmias was delayed after subacute treatment with carbon disulfide. In the coronary occlusion model, subacute carbon disulfide treatment reduced the survival rate accompanied by marked influences on arrhythmia development. Our results show that short term carbon disulfide exposure alters cardiac function in rats under physiological and pathophysiological conditions.
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PMID:Effects of carbon disulfide on cardiovascular function after acute and subacute exposure of rats. 236 Sep 2

Myocardial infarction in the perinatal period is a rare occurrence, usually associated with congenital heart lesions or isolated coronary artery abnormalities. In the absence of structural heart disease the most common etiologies are intrauterine asphyxia and thromboembolic coronary occlusion. A paradoxical embolus usually arises from a thrombus in the ductus venosus or umbilical vein and reaches the coronary circulation via normal fetal circulatory pathways. We describe a case of perinatal myocardial infarction due to thromboembolism of the coronary artery secondary to an intrauterine renal vein thrombosis. The difficulties encountered in making an accurate premortem diagnosis are emphasized as well as the poor prognosis of myocardial infarction in the perinatal period.
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PMID:Perinatal myocardial infarction: a case report and review of the literature. 374 37

Substantial evidence indicates that T wave alternans is an intrinsic property of ischemic myocardium. The electrophysiologic basis appears to be spatial and temporal heterogeneity of repolarization resulting from changes in action potential morphology rather than in activation sequence. Ischemia-induced changes in postrepolarization refractoriness and depressed electrical restitution of action potential duration have also been implicated. The main underlying ionic basis for T wave alternans during coronary occlusion appears to be derangements in intracellular cycling of calcium. Accumulation of potassium in the extracellular space adjoining ischemic cells and disruption in electrogenic sodium-calcium exchange may also be involved. In humans, T wave alternans has been observed in Prinzmetal's and classical angina, angioplasty, and bypass graft occlusion. Under these conditions associated with acute myocardial ischemia, alternans is restricted to the ischemic zone, and alternation in action potential morphology is an underlying factor. Recently, repolarization alternans has been shown to be a statistically significant predictor of the results of electrophysiologic testing and arrhythmia-free survival in individuals with and without organic heart disease. Collectively, these observations provide a rationale for quantitation of T wave alternans magnitude for assessment of vulnerability to life-threatening ventricular arrhythmias both in response to and independent of the effects of myocardial ischemia.
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PMID:Electrophysiologic basis for T wave alternans as an index of vulnerability to ventricular fibrillation. 805 49

A 56-year-old male cigarette smoker, without other risk factors for arterial disease and no history of heart disease or thrombotic events, was admitted as an emergency case because of chest pain shortly after a fall. He had a right coronary artery occlusion, which was managed with angioplasty and stenting. A large thrombotic occlusion in the distal aorta probably occurred simultaneously with the coronary occlusion, became symptomatically manifest and was diagnosed when the chest pain subsided after stenting. This thrombus was successfully treated with the new platelet inhibitor abciximab.
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PMID:[Large arterial thrombosis. Rapid recanalization with a new thrombocyte inhibitor]. 941 Oct 93

In spite of recent advances in secondary prevention, sudden cardiac death has remained a major public health problem as the majority of fatalities occur in subjects without a history of severe heart disease. Abrupt rupture of a vulnerable plaque resulting in thrombotic occlusion of a coronary artery is a common cause of sudden death in this population. Coronary occlusion does not, however, invariably lead to sudden death but may cause acute myocardial infarction or exacerbation of chest pain. Extensive studies in experimental animals and increasing clinical evidence indicate that autonomic nervous activity has a significant role in modifying the clinical outcome. Sympathetic hyperactivity favours the genesis of life-threatening ventricular tachyarrhythmias while vagal activation exerts an antifibrillatory effect. Strong afferent stimuli from the ischaemic myocardium impair arterial baroreflex and may lead to dangerous haemodynamic instability. Studies with a human angioplasty model have shown that there is wide interindividual variation in the type and severity of autonomic reactions during the early phase of abrupt coronary occlusion, a critical period for out-of-hospital cardiac arrest. The site of the occlusion is not a significant determinant of the reactions, whereas the severity of a coronary stenosis, adaptation or ischaemic preconditioning, beta-blockade and gender seem to affect the autonomic reactions and occurrence of complex ventricular arrhythmias. Clinical and angiographic factors are, however, poor predictors of autonomic reactions in an individual patient. Recent studies have documented a hereditary component for autonomic function, and genetic factors may also modify the clinical manifestations of acute coronary occlusion.
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PMID:Autonomic mechanisms and sudden death after abrupt coronary occlusion. 1048 Jul 54

Parathyroid hormone (PTH) influences the calcium metabolism. The idea of cardiovascular effects of PTH is not new. Target cells for PTH are cardiomyocytes and smooth muscle cells. Evidence from previous studies suggest that many patients with heart disease have elevated PTH concentrations. Our objective was to determine PTH status in patients with coronary artery disease (CAD). We compared intact PTH levels in 109 CAD patients with 103 healthy people by electrochemiluminescence immunoassay. Mean values of PTH in healthy Thais and CAD patients were 37.4 +/- 17.9 and 40.2 +/- 21.8 respectively. No statistical difference was shown. In addition, we compared PTH levels among various numbers of coronary occlusion and also found no differences. We propose that intact PTH concentrations in CAD patients are not higher than in the healthy population.
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PMID:Comparison of parathyroid hormone in angiographically-demonstrated coronary artery disease patients and healthy Thais. 1119 99

The macroscopic structure of the right ventricle includes a transverse basal loop for the free wall, and oblique septal components, originating from the descending and ascending segments of the apical loop. Data is presented that determines why right ventricular function is related principally to intraventricular septal function, and why right ventricular failure is magnified by septal stunning caused by poor myocardial protection. The background of this architectural/functional change can explain normal right ventricular function, the relationship of right ventricular performance to pulmonary vascular resistance, experimental studies that characterize right ventricular performance after architectural free wall ablation, right ventricular disconnection, right coronary occlusion, and free wall replacement. These basic science studies are related to perioperative right ventricular performance, involving methods of myocardial protection, protamine reaction, right coronary occlusion and reperfusion, right ventricular dyskinesia, chronic aortic and mitral valve replacement (MVR) replacement, congenital heart disease, right and left ventricular assist devices (LVADs), and transplantation. The predominant focus is related to the septum and how it can be evaluated perioperatively. Septal evaluation by echocardiogram should become an essential feature during intraoperative management.
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PMID:The structure and function of the helical heart and its buttress wrapping. VII. Critical importance of septum for right ventricular function. 1180 36


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