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

Perinatal outcome of 223 pregnancies complicated by maternal cardiac disease, over a 5-year period has been studied. Mean birth-weights of these babies were compared to the Institute's reference neonatal weight curves at different periods of gestation and found lower than the reference. The mean difference of 150 g was statistically significant. The incidence of prematurity, small for gestational age and perinatal mortality was analyzed according to the risk factors i.e. type, duration and severity of symptoms. The perinatal outcome was directly proportional to the severity of symptoms, irrespective of the type and duration of heart disease.
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PMID:Effect of maternal cardiac disease on perinatal outcome. 322 4

The Italian death rates and years of potential life lost (YPLL) for all causes and for 12 selected aggregations of causes are reported for 1979 and 1983, with the latter compared to United States data. Cancer is the leading cause of YPLL in Italy (23.8 per cent of total YPLL), followed by unintentional injuries (16.3 per cent) and heart disease (11.2 per cent). Rates of YPLL for all causes decreased 12.0 per cent from 1979 to 1983, the strongest declines in absolute terms being observed for prematurity and unintentional injuries, and in percentage decline for pneumonia and influenza, and infectious diseases; during the same period, YPLL for diabetes increased. The rates of YPLL are higher for males than for females (rate ratio = 1.9) especially for causes related to lifestyle factors. Premature mortality is lower in Italy than in the USA, because of the striking difference in mortality from injuries and heart diseases.
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PMID:Years of potential life lost (YPLL) before age 65 in Italy. 340 20

As techniques for saving very low birth weight babies improve, there will be a need to maintain babies with cardiac lesions on continuous infusions of prostaglandins until they gain enough weight so that corrective surgery can be performed. An organized approach to overcome the problems of prematurity through primary nursing is essential when caring for the very low birth weight baby with congenital heart disease requiring long-term prostaglandin therapy.
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PMID:Nursing interventions. The nurse's role in the care of a 730 g baby treated with prostaglandins for 62 days for a coarctation of the aorta. 350 15

Polymorphic ventricular arrhythmias (PVAs) initiated by programmed electrical stimulation may be a nonspecific response or evidence of ventricular electrical instability. To determine if PVAs initiated in patients with spontaneous sustained ventricular tachycardia or fibrillation differ from those which are clearly a nonspecific response in structurally normal hearts, the initiation, characteristics, and relationship to ventricular repolarization of PVAs greater than five beats in duration were evaluated in 32 patients without structural heart disease and in 36 patients with spontaneous sustained ventricular arrhythmias more than 9 days after myocardial infarction. Patients received one to four extrastimuli during sinus rhythm and right ventricular pacing. In a comparison with patients who completed the same steps (defined by the basic drive cycle length and number of extrastimuli) in the stimulation protocol, there was no difference in the cumulative risk of initiation of a PVA between the patients with and those without heart disease at any step. This risk was 51% vs 38% for patients who received two or fewer extrastimuli at four basic cycle lengths (p = NS). PVAs were initiated by the same mean number of extrastimuli (2.3 +/- 0.5 vs 2.6 +/- 0.9 p NS) with the same degree of prematurity in both groups. Forty-four percent of the PVAs in the myocardial infarction group had a cycle length greater than 250 msec or a coupling interval of the first tachycardia beat to its initiating stimulus greater than 320 msec as opposed to only one (6%) in the group without heart disease (p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Can potentially significant polymorphic ventricular arrhythmias initiated by programmed stimulation be distinguished from those that are nonspecific? 371 80

To define settings in which use of prostaglandin E1 before transfer from a community hospital to a tertiary care center benefits neonates with possible heart disease, information theory was used to predict the probability of a favorable response to prostaglandin therapy from the limited information of clinical variables. Records of 250 patients, newborn to 7 days old, with suspected heart disease were reviewed to assess six clinical variables (cyanosis, respiratory distress, heart murmur, pulse contour, hepatomegaly and prematurity). According to the anatomic and hemodynamic cardiovascular condition, each case was categorized as to whether a favorable response to prostaglandin E1 could be anticipated. Information content of each clinical variable with respect to prostaglandin responsiveness was determined, and patients were classified according to the most informative clinical variable. Stepwise extraction of information proceeded until remaining clinical variables added no significant information. Bayes' rule gave estimates of probability of prostaglandin-responsive defect in final subgroups for use in decision analysis. Cyanosis, murmur, small volume pulses and prematurity gave information about prostaglandin-responsive defects. Decision analysis indicated that frequency of poor outcome is minimized by early prostaglandin treatment of cyanotic term infants with a murmur or poor pulses, regardless of how ill they appear, and by treating any critically ill term newborn who has either cyanosis or poor pulses. Acyanotic patients with normal pulses are best untreated with prostaglandin until after definitive diagnosis is made. Advantage to either course was not seen in some small subgroups. Information theory with decision analysis is a rigorous approach to identify relevant clinical variables and define their roles in critical decisions in pediatric cardiology.
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PMID:Application of information theory to decision analysis in potentially prostaglandin-responsive neonates. 376 Mar 86

Following community concerns regarding the status of children conceived by in vitro fertilization (IVF), 33 children who had received pediatric follow-up were seen for a psychosocial evaluation. Parents were interviewed in a semistructured format by a child psychiatrist regarding their child's development, child-centered problems, parental problems, marital issues, parenting experience, and experience of the IVF program. The Bayley Scales of Infant Development were administered to the children by a clinical psychologist. Children's ages ranged from 12 to 37 months (the majority between 12 and 20 months). There was a high incidence of prematurity and twins in the population seen. Twenty-two children had no current problems and seven presented minor problems. Of the four with significant developmental problems, two had been very low-birth weight infants with significant neurological problems and one had severe congenital heart disease. Overall Bayley Scale scores were within the normal range and parents as a group were seen to function well. Problems presented were in accordance with those expected in a population of this age range, particularly considering the high incidence of prematurity.
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PMID:In vitro fertilization children: early psychosocial development. 376 Jun 60

Of 350 patients who had extensive non-invasive and invasive cardiological diagnostic tests, 56 had completely normal results. 24-hour ECG monitoring of the latter revealed the following ventricular arrhythmias-ventricular extrasystoles (VES): 36% without, 23% with rare ones (less than 30/h), 5.4% with more than 30/h, 25% with polytopic VES, 7.1% with paired VES and 3.6% with ventricular tachycardia. There was no preferential VES pattern. Mean duration of VES was 0.15 s. There were no VES with a prematurity index of less than 1. Extending ECG monitoring to 96 hours (10 persons without heart disease) did not reveal any more significant VES, but registering for less than 24 hours definitely underestimated the frequency of VES in persons without heart disease. In those without angiographic evidence of heart disease 36% had complex and 5.4% frequent VES. Complex arrhythmias, however, are rare in the individual subject and generally not accompanied by frequent VES. Frequent complex arrhythmias or both frequent and complex arrhythmias, as well as VES with a prematurity index less than 1, are suggestive of organic heart disease.
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PMID:[Arrhythmias in subjects with a healthy heart]. 618

Prematurity index (PI), defined as the ratio of the coupling to QT intervals of isolated ventricular premature complexes (VPC) and those initiating ventricular tachycardia (VT) on 24-hour ambulatory ECG recording, was examined in 496 episodes of VT occurring in 122 patients. The PI of VPC initiating VT was less than 1 in only 62 (13%) of the VT episodes and occurred in 14 patients. Although the range of PI was similar for isolated VPC and those initiating VT, for individual patients the PI of VPC initiating VT was significantly longer than the PI of isolated VPC (P less than 0.01). This relationship was not affected by age, sex, presence of absence of heart disease, or drug therapy. The coupling interval of the first VT complex was longer than the first interectopic interval of the VT (VT1-VT2) in 88 (72%) patients; and, the VT1-VT2 interval correlated strongly with the average R-R during VT (r = 0.75), (p less than 0.001). The VT was irregular in 48 patients with 300 episodes of VT. Irregularity of the VT was significantly associated with shorter duration of VT (p less than 0.05). These results show that, for individual patients, the PI of VPC initiating VT tends to be longer than that of isolated VPC, and that the rate of VT is usually predictable from the duration of the first interectopic interval of the VT. These results may have mechanistic implications.
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PMID:The timing of ventricular premature complexes initiating chronic ventricular tachycardia. 650 54

Two neonates with esophageal atresia and agenesis of the right lung are described. Review of the literature on the subject revealed an additional 11 cases of esophageal atresia associated with severe pulmonary hypoplasia. All of the affected infants died. Half of the deaths were caused by congenital heart disease, and the others were due to prematurity combined with various other severe anomalies and respiratory complications.
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PMID:Esophageal atresia with pulmonary agenesis. 664 7

Sixteen patients with serologically proven Q-fever infection are reviewed. Fifteen had significantly raised antibody titres to both phase I and phase II Coxiella burneti antigens, indicating persistent or chronic infection. One patient, a premature infant who died, had raised phase II titres only, but is included together with the mother who had chronic Q-fever and was the presumed source of infection. Chronic Q-fever infection has previously been regarded as virtually synonymous with Q-fever endocarditis, but only seven of the patients in this survey had evidence of valvular endocarditis. In those who did, the infection had arisen on prosthetic valves or those affected by rheumatic or syphilitic heart disease. One patient had inexorably progressive destruction of an infected congenitally bicuspid aortic valve. Eight patients had infections associated with extra-valvular sites and several of these associations have not been previously described. These include extreme prematurity with perinatal death, possibly following transplacental infection, the sudden infant death syndrome (SIDS), multiple lower limb emboli from endocarditis of an abdominal aortic dacron graft, and colonization of ventricular endocardium following left ventricular myotomy/sub-aortic diaphragm resection. The current concept that chronic Q-fever is invariably associated with endocarditis is therefore untenable and the indications for phase I antibody screening should be extended to include patients other than those under investigation for 'culture-negative' endocarditis, for example those with unusual osteomyelitis of vertebrae.
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PMID:Chronic or fatal Q-fever infection: a review of 16 patients seen in North-East Scotland (1967-80). 687 20


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