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

The authors analysed clinically 108 patients (61 males and 47 females), aged below 50 years treated at the department of neurology, because of acute cerebral ischaemia. Attention is called to risk factors such as arterial hypertension, heart disease, atherosclerosis, obesity and diabetes which may be the cause of earlier development of ischaemic changes in the central nervous system. In the analysed group in 18 cases cerebral thrombosis, in 23 cases embolism, in 31 cerebral circulatory failure were diagnosed. In 36 cases the cause could not have been established.
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PMID:[Acute cerebral ischemic disease in patients under the age of 50]. 88 1

Systemic disorders (eg, cardiac, hematologic) are commonly recognized as predisposing and sometimes actual precipitating events in cerebral ischemia. From available studies, the incidence of precipitation is not clear. To determine this, we undertook a comprehensive investigation of all patients with ischemic brain disease for a one-year period. Results reveal that brain ischemia is more commonly precipitated by systemic illness than usually supposed, particularly transient ischemic attacks of the vertebrobasilar circulation and completed infarcts in the carotid distribution. Cardiac disorders outnumber all other precipitating events. As they are more amenable to therapy than atherosclerosis, a diligent search for such precipitating events is warranted in patients with ischemic symptoms.
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PMID:Associated systemic factors in cerebrovascular ischemia. 93 99

Stroke ranks third as a cause of death in much of the industrial world, surpassed only by heart disease and cancer. Thrombotic and embolic arterial occlusions are the leading causes of cerebral infarction. Once a major cerebral infarction has occurred, therapy is limited to the prevention of complications and rehabilitation. Identification and treatment of stroke-prone patients are now not a standard part of medical practice. However, the proper management of the patient with acute cerebral ischemic or progressing stroke is a subject of debate. Treatment of progressing or acute cerebral ischemia is aimed at prevention of infarction in areas of the brain that are still viable. A number of therapeutic strategies are currently being investigated in the management of ischemic stroke.
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PMID:Medical management of acute cerebral ischemia in the elderly. 186 4

Movement from the supine to the upright position brings about the transfer of blood from the upper to the lower body. Cardiac output and central arterial pressures are reduced causing, in the normal subject, a reflex increase in sympathetic and a decrease in parasympathetic activity. Increased sympathetic activity facilitates cardiovascular and skeletal muscular adjustments aimed at maintaining cerebral blood flow. If there were no compensatory cardiovascular changes, the reduced cardiac output due to the pooling of blood into the dependent regions of the body would result in cerebral ischemia and loss of consciousness (postural hypotension). This situation is most often experienced in the elderly population and can have quite a debilitating influence on daily living activities. It is known that as humans age, the efficiency of bodily functions often becomes impaired. It is also known that exercise can improve the function of the cardiovascular system as shown by an improved work capacity and lowered incidence of heart disease and high blood pressure. These exercise-related changes suggest that exercise may have implications in the management of postural hypotension. However, recent studies have given conflicting accounts regarding the relationship between regular exercise and postural adaptation, with some studies describing an impaired adaptation in athletes. The purpose of this paper is to summarize, in detail, the influences of age and physical fitness on postural adaptation.
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PMID:Influence of age and physical training on postural adaptation. 264 54

Platelet aggregation inhibitors have been more extensively and better studied than all other treatments used in the prevention of cerebral ischaemia. It has been demonstrated that both aspirin (300 mg/day) and ticlopidine (500 mg/day) are effective in the secondary prevention of cerebral ischaemic accidents associated with atherosclerosis, with a 20 and 30 p. 100 respectively reduction of risk. At the moment, there is no evidence that these compounds are effective in the primary prevention or treatment of cerebral infarction in the acute phase. The best way of preventing thromboembolic stroke of cardiac origin is to treat the responsible heart disease and prescribe anticoagulants. However, several studies are in progress to evaluate the effectiveness of aspirin in the primary and secondary prevention of cerebral thromboembolism due to non-valvular atrial fibrillation.
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PMID:[Platelet antiaggregants in cerebral ischemic pathology]. 268 44

Longitudinal monitoring of the electrocardiogram by Holter's method is indicated in particular for the diagnosis of intermittent dysrhythmia which may be related to the symptom of syncope in elderly patients. Transient dysrhythmia with subsequent cerebral ischemia may be the cause of altered consciousness, vertige, presyncopes, or true syncopes. Transient dysrhythmias may be therefore considered after elimination of other causes of syncopes as their aetiology, in particular in elderly patients and old age groups where organic heart disease is already present. In those instances Holter's ECG is a useful non-invasive examination method which makes it possible to start appropriate treatment, and later by using serial monitoring, it makes it possible to follow up the effectiveness of antiarrhytmic treatment, or to follow up the function of an implanted cardiostimulator (pacemaker).
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PMID:[The significance of longitudinal Holter electrocardiogram monitoring in the differential diagnosis of syncope in elderly patients]. 274 63

The results of Holter monitoring in 100 patients with transient and focal cerebral ischemia were studied retrospectively. Atrial fibrillation (AF) was found in five patients compared with two from a group of 100 age and sex-matched control patients. Four of these had a previous history of AF or showed AF on the standard electrocardiogram. Episodic forms of sick sinus syndrome, which have also been related to cerebral embolism, were found in 32 of the TIA patients against 13 of the controls (p less than 0.0025). Sick sinus syndrome was of the bradyarrhythmia-tachyarrhythmia type in 14 of the TIA patients and in three of the controls (p less than 0.01). The relationship between TIAs and transient sinus node dysfunction could not be explained by concomitant heart disease. It is not yet clear whether the relationship is causal or indirect.
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PMID:Holter monitoring in patients with transient and focal ischemic attacks of the brain. 293 8

In a 6 month prospective study of 232 patients with cerebral ischaemia, 100 (43%) had a prior history of heart disease. In 22 of the patients with prior heart disease an unsuspected cardiac disorder was subsequently detected (6 atrial fibrillation, 13 cardiomegaly or left ventricular hypertrophy and 3 ischaemic heart disease). In patients without prior heart disease, 47 (20%) were found to have cardiac disease: 6 atrial fibrillation, 31 cardiomegaly or left ventricular hypertrophy 9 ischaemic heart disease and 1 left bundle branch block. Previously unsuspected or asymptomatic cardiac disease is common in patients with cerebral ischaemia.
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PMID:Clinically unsuspected cardiac disease in patients with cerebral ischaemia. 295 10

The occurrence of cerebrovascular diseases under the age of 50 years has been analyzed. It has been found that 230 cases of cerebrovascular diseases have been established between 1970 and 1976 in the 7th district of Budapest. With reference to clinical forms transitory cerebral ischemia and thrombosis of the cerebral arteries showed highest frequency. Risk factors were compared to those in patients over the age of 50 years. The matched pair analysis was used to determine relative risk and objective real circumstances. In this analysis the McNemar test was found positive in numerous cases. Based on the results the multifactorial origin was considered responsible of arteriosclerosis, hypertension, heart disease, diabetes mellitus, alcohol consumption, and smoking being the most important factors.
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PMID:[Cerebrovascular diseases in patients under 50 years of age]. 350 May 50

Many cardiac disorders can cause acute cerebrovascular insufficiency. The spectrum of potentially embolic cardiac conditions is wide; early recognition may determine a definite change in the management and prognosis of patients. In recent years the relevance of echocardiography in the screening of patients with cerebral ischemia has been emphasized. In order to identify potentially embolic cardiac conditions, 180 consecutive non selected patients with cerebrovascular insufficiency, underwent a clinical cardiological evaluation and an echocardiogram. The study population included 132 men and 48 women; the mean age was 51.7 years (range 19 to 72 years). A technically adequate echocardiogram was obtained in 153 patients. In 131 patients echocardiography was negative; cardiac lesions were detected in 22 patients (14.4%): mitral stenosis in 2, calcified aortic stenosis in 1, valvular endocarditis vegetations in 3, dilatative cardiomyopathy in 2, hypertrophic cardiomyopathy in 4, mitral valve prolapse in 4, regional left ventricular diskynesia in 5, mitral anulus calcification in 1. Patients were divided into 3 groups according to the results of cerebral angiography: 68 patients with normal angiography (Group I), 54 patients with atheromasic lesions on cerebral angiography (Group II), 31 patients in whom cerebral angiography was not performed (Group III). A higher incidence of cardiac diseases was found in the patients of Group I. The lack of lesions on cerebral angiography and the presence of embolic high-risk cardiac conditions strengthened a causal relationship of the cardiac disorder with cerebrovascular insufficiency in 10 of the 23 patients. In the mean follow-up period of 18 months of these 10 patients who underwent cardiac surgery or anticoagulation, no further attacks of cerebrovascular insufficiency were observed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Cardiopathy and acute cerebrovascular insufficiency. Prospective study with two-dimensional echocardiography]. 404 42


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