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

The clinical significance of atrial fibrillation was analyzed in cases with chronic or acute heart disease and its significance at the acute and chronic stages of the disease was investigated in various disease groups. The types of disease, number of patients, and incidence of atrial fibrillation were: atrial septal defect (92, 14.1%), mitral valve disease (128, 79.7%), nonrheumatic valvular disease (32, 56.2%), aortic regurgitation (71, 2.8%), aortic stenosis (10, 10.0%), hypertrophic cardiomyopathy (181, 11.6%), dilated cardiomyopathy (111, 37.8%), acute myocardial infarction (823, 9.0%), healthy subjects (31,886, 0.3%). A histopathological and electron-microscopic evaluation of the atrial heart muscle revealed that the advancement of the morphological changes was closely related to the occurrence of atrial fibrillation. Decrease in size of F waves in the electrocardiogram correlated well with the extent of right and left atrial fibrosis. Also, it was noteworthy that the atrial fibrillation in cases with dissecting aneurysm (n = 60) was an expression of the myocardial damage due to the infiltration of the bleeding into the right atrium. Intra-atrial electrogram in 48 patients with various heart diseases revealed that the electric potentials obtained from various parts of the atrium varied to a great extent and finally the patient's condition transformed to that of atrial standstill. We conclude that atrial fibrillation is an expression of some important aspect of the progression of heart disease and is not directly associated with hemodynamic overloading to the atrium. A strategy for quinidine treatment was also introduced.
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PMID:Natural history of atrial fibrillation. 344

A retrospective study was undertaken to assess the influence of known ischaemic heart disease on the operative and the long-term survival of patients undergoing elective repair of an abdominal aortic aneurysm. One hundred and seventy-one patients underwent elective surgery between June 1977 and December 1983. The patients were divided on routine clinical grounds into cardiac and noncardiac groups. Ninety-five patients had a history of heart disease and/or an abnormal resting pre-operative ECG. Seventy-six patients had no history of heart disease and a normal pre-operative resting ECG. Two of the seven operative deaths were due to myocardial infarction with one each from the cardiac and noncardiac groups. Eight patients suffered an acute myocardial infarction with five from the cardiac and three from the noncardiac group and this was not significantly different. The overall survival of 95% at 1 year and 76% at 5 years closely follows the age/sex matched Australian population. The survival at 1 year in the cardiac group was 97% and 95% in the noncardiac group. The 5 year survival was 72% and 79% respectively. During follow-up to December 1984, 11 patients died from ischaemic heart disease with six from the cardiac and five from the noncardiac group. No significant difference was found between the two groups in the incidence of myocardial infarction or the short- and long-term survival. This study does not support a more aggressive approach to coronary artery disease in the pre-operative management of patients with abdominal aortic aneurysm.
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PMID:Abdominal aortic aneurysms and coronary artery disease: is a more aggressive approach indicated? 347 78

A 55-year-old Caucasian woman suddenly developed substernal chest pain at rest accompanied by pallor, diaphoresis, nausea, and vomiting. Physical examination was otherwise unremarkable. The resting ECG showed T-wave inversion in all anterior leads which returned to normal 24 h after the onset of the symptoms. The pain was eliminated promptly by sublingual isosorbide dinitrate. "Impending" acute myocardial infarction was diagnosed. Coronary arteriography, however, failed to reveal any change in any major coronary artery but an apical aneurysm of the left ventricle was detected. As the complement-fixation test for Chagas' disease was positive, the diagnosis of chronic Chagas' heart disease was then established. This unusual clinical manifestation of Chagas' disease is thought to be the consequence of a transient imbalance in the cardiac autonomic nervous system, which is considered to play a central role in the pathogenesis of chronic Chagas' heart disease. In addition, the present case may alert clinicians to the thus far neglected atypical chest pain, which is frequently seen in chagasic patients but whose etiology remains obscure.
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PMID:Chronic Chagas' heart disease presenting as an impending myocardial infarction: a case favoring the neurogenic pathogenesis concept. 359 60

In emergency surgery, the essential prerequisites for success are speed, promptitude and precision. For this reason diagnosis must be equally prompt and precise and may require not only clinical examination but also a number of instrumental examinations designed to confirm or even to formulate the diagnosis which is usually the case in precordialgias of cardiovascular origin. In such syndromes ultrasound cardiography is particularly advantageous for the following reasons: it is non-invasive, provides immediate results and any number of examinations can be performed on the patient in bed. Since such ultrasound techniques are also reliably accurate, they constitute the method of choice when the patient's condition is critical, when a serial study of a single patient is required and when the results are required immediately, as is the case in emergency heart surgery. Four types of ultrasound cardiography are currently available for the diagnosis of precordialgias of cardiovascular origin: 1) one dimensional M-mode echocardiography; 2) two dimensional real time echocardiography; 3) Doppler ultrasound cardiography; 4) the echo-Doppler system in which Doppler ultrasound cardiography is combined with one or two dimensional echocardiography. Acute precordial pain of cardiovascular origin may be due to the following pathological conditions: 1) ischaemic cardiopathy especially acute myocardial infarction and transitory myocardial ischaemia; 2) acute pericarditis; 3) aortic stenosis; 4) idiopathic hypertrophic subaortic stenosis; 5) mitral prolapse; 6) dissecting aneurysm of the aorta; 7) pulmonary thromboembolism. In all these cases the single and two dimensional image and Doppler ultrasound cardiography provide highly sensitive and specific information that is, in some cases, decisive for diagnosis and in others confirms the diagnosis already formulated. In addition these techniques may provide valuable prognostic data. Ultrasound cardiography is indeed useful in all cardiological emergencies, such as those caused by cardiomegaly, new and developing murmurs, peripheral embolisms, cardiac traumas and arrhythmias. It is therefore suggested that every Emergency and Intensive Care Unit should be able to use the resources offered by ultrasound cardiography in diagnosis.
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PMID:[Emergency ultrasound cardiography in acute precordial pain of cardiovascular origin]. 362 31

Prodromal symptoms within four weeks prior to an acute event leading to coronary care unit admission have been studied in 276 consecutive patients interviewed within 24 hours after arrival at hospital. Coronary heart disease (CHD) was diagnosed in 237 patients, 140 of whom did develop acute myocardial infarction (AMI) (Group 1) and 97 who did not (Group 2). Of the remainder, 15 had miscellaneous heart diseases (Group 3) and 24 no heart disease (Group 4). Unstable angina pectoris was equally frequent among CHD patients with and without development of AMI and was related to a higher hospital mortality in AMI patients. Less specific symptoms occurred with equal frequency in the four groups. Patients who developed AMI were not possible to identify by prodromal symptoms.
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PMID:Predictive value of prodromal symptoms in myocardial infarction. 363 Jul 76

Although the decline in ischemic heart disease mortality is now entering its third decade, there has been no definitive information on the experience of Mexican Americans, the nation's second largest minority group. Earlier studies carried out in the 1970s were hampered by the unavailability of satisfactory population data beyond 1970. In the present study we have used 1970 and 1980 census data to compute death rates in Mexican Americans and non-Hispanic whites from Texas for the periods 1969-1971 and 1979-1981. All four sex-ethnic groups showed statistically significant declines in death rates due to all causes, due to total ischemic heart disease, and due to acute myocardial infarction between 1969-1971 and 1979-1981. Declines in the latter two causes of death were least marked in Mexican American men. This sex-ethnic group was also the only one that failed to show a decline in death rates due to chronic ischemic heart diseases. The fact that Mexican Americans have been shown to be less well informed about and less likely to adopt lifestyle changes aimed at reducing heart disease risk than non-Hispanic whites may account for the less striking mortality decline observed in Mexican American men, but is harder to reconcile with the apparent equal decline in Mexican American women compared with non-Hispanic whites.
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PMID:Secular decline in death rates due to ischemic heart disease in Mexican Americans and non-Hispanic whites in Texas, 1970-1980. 367 49

This longitudinal study examined the consequences of cardiovascular disease (CVD) in 145 U.S. Navy pilots who suffered a CVD incident during the 1972-79 time period. Results showed that one pilot died, one suffered a second acute myocardial infarction, and 32 pilots were hospitalized and/or retired with a physical disability because of CVD. The majority of subsequent CVD incidents occurred during a 12-month period after the initial CVD event; 35% had discontinued flying prior to the initial CVD incident. Percentages of pilots who either remained on active duty or were separated for nonmedical reasons ranged from 64.3% for pilots in the chronic ischemic heart disease sample to 97.6% for the symptomatic heart disease group. Thus, the majority of pilots were returned to duty either after the initial CVD incident or subsequent to the rehospitalization or physical evaluation board. In general, these findings reflected the high level of physical and mental well-being of the U.S. Navy pilot population.
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PMID:Longitudinal study of cardiovascular disease in U.S. Navy pilots. 370 72

The increasingly widespread use of cocaine in the United States has been accompanied and perhaps exacerbated by the misconception that the drug is not associated with serious medical complications. In particular, the potential for cocaine to precipitate life-threatening cardiac events needs to be reemphasized. We report the clinical and pathological findings in seven people in whom nonintravenous "recreational" use of cocaine was temporally related to acute myocardial infarction, ventricular tachycardia and fibrillation, myocarditis, sudden death, or a combination of these events. We also review data on 19 previously reported cases of cocaine-related cardiovascular disorders. Analysis of all 26 patients indicated the following findings: the cardiac consequences of cocaine abuse are not unique to parenteral use of the drug, since nearly all the patients took the drug intranasally; underlying heart disease is not a prerequisite for cocaine-related cardiac disorders; seizure activity, a well-documented noncardiac complication of cocaine abuse, is neither a prerequisite for, nor an accompanying feature of, cardiac toxicity of cocaine; and the cardiac consequences of cocaine are not limited to massive doses of the drug. Although the pathogenesis of cardiac toxicity of cocaine remains incompletely defined, available circumstantial evidence suggests that cocaine has medical consequences that are equal in importance to its well-documented psychosocial consequences.
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PMID:Acute cardiac events temporally related to cocaine abuse. 378 95

The occurrence of heart disease in uraemic patients was evaluated from study of 94 autopsied cases of chronic renal failure. The most common autopsy-ascertained causes of death were congestive heart failure (37%), acute myocardial infarction (13%) and tamponading pericarditis (8%). Death from congestive heart failure was significantly more common among the patients aged 60 or more than in the younger group. Hypertension was recorded in 59% of the patients, including all those with fatal myocardial infarction. Coronary arteriosclerosis was graded as absent to mild in about 40% of the patients. More severe grades occurred predominantly in the older patients. Tamponading pericarditis almost exclusively affected patients in haemodialysis. The authors conclude that most deaths among patients with end-stage renal failure were due to congestive heart failure. Ischaemic heart disease did not seem to be a more common cause of death than in the general population.
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PMID:Occurrence and significance of heart disease in uraemia. An autopsy study. 381 61

This is a review of relative indications and contraindications for the selection of patients for coronary arteriography. Patients with angina pectoris at rest ("unstable" angina pectoris) and after low levels of effort despite a good medical regimen, those with chest pain that cannot be distinguished from angina pectoris at low or moderate levels of effort with or without abnormal 201Tl perfusion scans or radionuclide ventriculograms during stress, and those with suspected significant left main coronary arterial stenosis based on exercise testing should undergo coronary arteriography. In addition, coronary arteriography is usually an important part of the clinical evaluation of the patient with unexplained and clinically important congestive heart failure, recent myocardial infarction treated with thrombolytic therapy, a mechanical complication of myocardial infarction requiring cardiac surgery, including a large ventricular septal defect, hemodynamically important mitral insufficiency, or a large ventricular aneurysm leading to heart failure, hemodynamically important valvular, subvalvular, or supravalvular heart disease in whom corrective surgery is contemplated, suspected anomalous origin or communication of a major coronary artery, and sudden death syndrome unrelated to acute myocardial infarction.
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PMID:Selection of patients for coronary arteriography. 390 56


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