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

Cardiovascular conditions of 27 patients with primary hyperparathyroidism have been examinated. Hypertension has been found to be the only alteration significantly present (33,33% of patients), while heart disease are uncommon. Hypertension is often present without concomitant disease of the kidney. Blood pressure became normal in only one case over nine (11,11%) after parathyroidectomy.
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PMID:[The electrocardiogram and arterial hypertension in primary hyperparathyroidism]. 44 May 71

Low bone mass, in the asymptomatic patient, predicts future fracture risk as well as high cholesterol or high blood pressure predicts the risk of heart disease or stroke. In patients without fractures, osteoporosis can be diagnosed based on the extent of reduction in bone mass below mean peak bone mass of healthy young individuals. As bone mass decreases, fracture risk increases exponentially. Prevention of the first fracture is a clinical goal. Clinical situations in which an assessment of bone mass and fracture risk affects therapeutic decisions include estrogen deficiency, vertebral abnormalities, radiographic osteopenia, asymptomatic primary hyperparathyroidism, and longterm corticosteroid therapy. Serial measurements can also be used to monitor the effects of osteoporosis treatment in certain situations. The appropriate technique and skeletal site for bone mass measurements should be chosen based on the patient's circumstances. A clinical interpretation can enhance the value of computer-generated bone mass measurement reports and enhance decision making.
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PMID:Consensus of an international panel on the clinical utility of bone mass measurements in the detection of low bone mass in the adult population. 866 48

Impairments in cardiovascular, respiratory and kidney function are considered as risk factors for complications following surgery. As the indication for surgery in asymptomatic primary hyperparathyroidism (HPT) is controversial, 123 patients undergoing surgery for HPT and 104 control subjects scheduled for common surgical procedures were evaluated pre-operatively. Compared with the age- and sex-matched control group, serum calcium (P < 0.001), creatinine (P < 0.01) and glucose (P < 0.02) were all increased in the HPT group, while peak expiratory flow (PEF) was decreased (P < 0.04). Furthermore, the patients with HPT, compared with controls, were more often receiving antihypertensive medication (P < 0.005) and were more likely to have a history of congestive heart disease (P < 0.01), thromboembolic diseases (P = 0.05), stroke (P = 0.06) or diabetes mellitus (P < 0.02). Increased frequencies of ST-segment depression (P < 0.001) and T-wave abnormalities (P = 0.05) at electrocardiography together with an increased prevalence of heart enlargement visible at chest radiography (P < 0.01) were also seen in the HPT group when compared with the controls. All HPT patients and controls survived, but one HPT patient suffered a myocardial infarction in the post-operative period. In conclusion, the present study showed the pre-operative risk factor profile to be altered in HPT subjects with impairments in both cardiovascular and respiratory functions as well as in kidney function and glucose control. These findings should be kept in mind when the indications for surgery in asymptomatic patients with HPT are discussed.
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PMID:Pre-operative evaluation of risk factors for complications in patients with primary hyperparathyroidism. 871 37

Low bone mass predicts future fracture risk as well as high cholesterol or high blood pressure can predict the risk of heart disease or stroke. Prevention of the first fracture should be a clinical goal. In patients without fractures, osteopenia and osteoporosis can be diagnosed based on the extent of reduction in bone mass below mean peak bone mass of young healthy individuals. As bone mass decreases, fracture risk increases exponentially. Clinical situations in which an assessment of bone mass and fracture risk affects therapeutic decisions include estrogen deficiency, vertebral abnormalities, radiographic osteopenia, asymptomatic primary hyperparathyroidism, and long-term corticosteroid therapy. Serial measurements can also be used to monitor the effects of osteoporosis treatments. The appropriate technique and skeletal site for bone mass measurements should be chosen based on the patient's circumstances and the precision of measurement. A clinical interpretation can enhance the value of computer-generated bone mass measurement reports and improve decision making.
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PMID:Clinical utility of bone mass measurements in adults: consensus of an international panel. The Society for Clinical Densitometry. 879 8

The purpose of this study was to determine the percentage of centres of excellence (COEs) in Germany that achieved, for selected diagnoses and interventions, annual hospital or surgeon threshold volumes associated with a lower mortality rate. A systematic review and evaluation of the literature identified the most relevant study for each diagnosis and intervention selected. Each diagnosis and intervention was only considered if the most relevant source yielded a threshold volume associated with a reduced mortality rate. COEs received questionnaires on the annual volume of such diagnoses and interventions for each department, providing physician (median), and senior consultant in 1999. For most of the diagnoses and interventions considered, the percentage of COEs meeting their respective threshold volumes exceeded 50%. Exceptions were carotid endarterectomy (performed in departments of general cardiac surgery) and liver transplantation. The percentage of providing physicians and senior consultants performing to the desired standard remained above 75% for most of the diagnoses and interventions. Exceptions were surgeons dealing with carotid endarterectomy, correcting congenital heart disease (both performed in departments of general cardiac surgery), and correcting primary hyperparathyroidism. That a smaller percentage of centres for general cardiac surgery, liver transplantation, and primary hyperparathyroidism operates at their threshold volumes may be due to a relative oversupply of centres specialising in these treatments as well as a the lack of regional centres with a high referral rate. Due to the country-specificity of studies performed on the relationship between volume and mortality rate, it is highly recommended that Germany-specific volume-outcome studies be performed particularly in specialties with relatively low case volumes.
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PMID:[The relationship between provider volume and mortality rate: volume data of German centres of excellence]. 1167 97

Primary hyperparathyroidism (pHPT), caused by solitary parathyroid adenomas in 85% of cases and diffuse hyperplasia in most of the remaining cases, overproduces parathyroid hormone (PTH), which mobilizes calcium to the blood stream. Renal stones, osteoporosis and diffuse symptoms of hypercalcaemia, such as constipation, fatigue and weakness are well-known complications. However, in Western Europe and North America, patients with pHPT are nowadays usually discovered during an early, asymptomatic phase of the disease. It has been reported that patients suffering from symptomatic pHPT have increased mortality, mainly due to an overrepresentation of cardiovascular death. pHPT is reported to be associated with hypertension, disturbances in the renin-angiotensin-aldosterone system, and structural and functional alterations in the vascular wall. Recently, studies have indicated an association between pHPT and heart disease, and studies in vitro have produced a number of theoretical approaches. An increased prevalence of cardiac structural abnormalities such as left ventricular hypertrophy (LVH) and valvular and myocardial calcification has been observed. Associations have been found between PTH and LVH, and between LVH and serum calcium. LV systolic function does not seem to be affected in patients with pHPT, whereas any influence on LV diastolic performance needs further evaluation. The aim of this review is to clarify the connection between pHPT and cardiac disease.
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PMID:Primary hyperparathyroidism and heart disease--a review. 1547 92

The role of primary hyperparathyroidism (PHPT) in heart disease is still somewhat uncertain in many respects. Patients with PHPT seem to have an increase in mortality and this seems mainly due to an overrepresentation of cardiovascular death. PHPT is reported to be associated with hypertension, disturbances in the renin-angiotensin-aldosterone system, cardiac arrhythmias as well as structural and functional alterations in the vascular wall. There is an increased prevalence of cardiac structural abnormalities such as LVH and functional properties of the heart may be affected by the hyperparathyroid condition as well. We report the case of a 65-year-old woman with no cardiac risk factors apart from her age and type 2 diabetes who presented in cardiogenic shock. Extensive evaluation for the aetiology of the cardiomyopathy revealed solely a diagnosis of primary hyperparathyroidism. Cardiac manifestations of primary hyperparathyroidism have been reported before but to our knowledge this is the first description of severe left ventricular function secondary to PHPT. We believe that this atypical presentation of primary hyperparathyroidism causing left ventricular cardiomyopathy warrants further attention, and that a diagnosis of primary hyperparathyroidism should always be considered in patients with systolic as well as diastolic left ventricular dysfunction, and no other obvious cause.
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PMID:Primary hyperparathyroidism and the cardiovascular system. 1691 43