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

To assess the validity of the quantitative 201Tl scintimetry in various diseases of the heart (coronary heart disease with and without myocardial infarction, non-coronary cardiomyopathy, scleroderma heart disease and asymmetric septal hypertrophy with IHSS), the 201Tl myocardial uptake values for five standardized projections (a) were correlated with the grade of LAD stenosis, (b) the pattern of myocardial wall motion and (c) were compared with the 201Tl uptake values derived from normal patients. Significant reduction (c) of 201Tl myocardial uptake could in individual cases be evaluated in acute myocardial infarction (95%), in dys- and akinesia (90%), in hypokinesia (71%), in scleroderma heart disease (50%), in non-coronary cardiomyopathy (50%) as well as in normokinesia (28%) when associated with LAD stenosis. The mean values (b) of 201Tl uptake in normo- and hypokinesia significantly differed between these two groups and from those evaluated in dys- and akinesia. The latter group showed the lowest 201Tl uptake values computed which in some cases were very close to the mean mediastinal 201Tl uptake. The correlation (a) of individual 201Tl values demonstrated that 201Tl distribution in the myocardium is not only equivalent to myocardial ""perfusion'' but is corresponding with the myocardial function. In non-coronary cardiomyopathy reduced 201Tl values sometimes could not be separated from values in coronary heart disease (and myocardial infarction). A regional increase of myocardial mass as in septal hypertrophy correlated well with an augmented 201Tl uptake when referred to the 201Tl storage in the mediastinum.
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PMID:Evaluation of myocardial function with the 201thallium scintimetry in various diseases of the heart. A correlative study based on 100 patients. 14 51

In 94 patients with prominent left axis deviation, there was a marked disparity in the mean angles determined by the maximum magnitude of the deflections and that determined by areas. There was also considerable variation in the angle of the maximum vector in the frontal plane (frontal plane angle) and the angle of 50 msec vector in the frontal plane. Similar results were observed in 17 cases of ostium primum atrial septal defect. These differences contrasted with the findings in a normal group of 50 subjects where a close correlation was found. The initial vector was directed to the right in approximately 80% of normals and 60% of the patients with LAD indicative of conduction defects in the left anterior fascicular or its distal ramifications. We conclude that a rightward orientation of the 5--10 msec vector (i.e. causing a Q wave in lead 1) should not be required for diagnosis of left anterior fascicular block. The spatial orientation of the initial vector was always anterior in the control subjects. In these 'normals', as well as in the patients with left axis deviation, the initial vector varied markedly in its azimuth direction (right or left) when superiorly directed; but when inferiorly directed in the normal subjects it was virtually always directed rightward. From these data we were unable to construct rigid criteria which would reliably distinguish aberrant excitation patterns manifested by gross left axis deviation in the electrocardiograms of patients with established heart disease from subjects without defined heart disease. Old infarction patterns, anterior, inferior, and lateral were not obscured by the associated anterior fascicular block.
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PMID:The interpretation of gross left axis deviation in the electrocardiogram. 49 84

Echocardiographic suprasternal relationships of the transverse aortic arch (TAA), right pulmonary artery (RPA) and left atrium (Y' LAD) were validated and angiographic-echocardiographic measurement correlations were made for each structure. Normal values were determined with respect to body surface area. In normals, regardless of age or body size, mean dimensional TAA/RPA ratio was 1.2:1 and Y' LAD equaled the anterior-posterior, or Z axis, left atrial dimension (Z LAD)- TAA/RPA ratio was increased in aortic stenosis and tetralogy of Fallot and was decreased in ventricular septal defect, atrial septal defect and pulmonary stenosis. Ratio did not correlate with lesions severity as assessed by cardiac catheterization except in pulmonary stenosis. Discrepant Y' LAD values (usually increased Y' LAD and decreased Z LAD) occurred in children with various forms of heart disease. Some had sternal compression but others had normal chests. Children with pectus excavatum showed similar compression. These findings underscore the need for incorporation of a suprasternal examination into the standard echocardiographic examination of children.
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PMID:Suprasternal notch echocardiography. Assessment of its clinical utility in pediatric cardiology. 83 4

The cinecoronarograms, ventriculograms and electrocardiograms of 164 consecutive patients (32 patients without heart disease and 132 patients with coronary artery disease) have been analyzed. Total left ventricular function was assessed by the ejection fraction. Regional myocardial function was determined by a system of hemiaxes. 89 patients with complete obstruction of the right coronary artery (RC) and/or the anterior descending branch of the left coronary artery (LAD) were divided into subgroups with good, poor and no coronary collaterals. Total and regional left ventricular function was normal in patients with well collateralized coronary occlusions. Patients with poorly collateralized or non-collateralized occlusions had impaired left ventricular function. Patients with poorly collateralized coronary occlusions showed no difference in left ventricular function when compared to patients with coronary occlusions without collaterals. Combined occlusions of the RC + LAD without collaterals were not found. Good coronary collaterals have a protective effect on total and regional myocardial function, thus improving the prognosis in complete coronary artery obstruction.
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PMID:[The effect of the collateral circulation on the total and regional myocardial function in coronary disease]. 100 67

Clinical and electrocardiographic findings were analyzed in 100 consecutive cases of LAD. Below the age of forty years, LAD was uncommon, but its incidence increased continuously thereafter. The most frequent primary clinical diagnosis was arteriosclerotic heart disease. The functional mechanism producing LAD most often was LAHB, responsible in about 40 per cent. Approximately half the instances of LAHB were associated with old myocardial infarction of septal, anterior, or lateral regions, but half were seen in the absence of infarction or clinical coronary sclerosis and are presumed due to primary degenerative processes within these specialized conducting fibers. Approximately one-sixth of the instances of LAD were due to loss of inferior forces following inferior myocardial infarction. Typical left ventricular hypertrophy was a distinctly uncommon cause of LAD. Last, in 24 patients with LAD the mechanism or cause was not evident initially, of which two were subsequently shown to represent a very mild degree of LAHB. Also it is suggested that asymmetric myocardial hypertrophy of the anterior wall may account for some instances of LAD not otherwise explained.
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PMID:Left-axis deviation: etiologic factors in one-hundred patients. 111 74

A 66-year-old man, who had atrial septal defect (ASD) associated with severe coronary artery disease, underwent closure of ASD and concomitant coronary artery bypass grafting (LIMA-LAD & SVG-RCA). Response to surgery was excellent, with improvement of cardiac function and returning to NYHA functional class I, while, preoperatively, the patient had been limited due to symptoms related both to large left to right shunt flows (Qp/Qs 3.04) and to left ventricular dysfunction because of severe myocardial ischemia as well as previous inferior myocardial infarction. SAD is the most common form of congenital heart disease requiring surgery in adults, accordingly it should be remembered that some of the elderly patients with ASD might have obvious or occult coronary artery disease at the time of diagnosis and operative intervention.
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PMID:[A case of successful surgery of atrial septal defect combined with coronary artery bypass grafting]. 278 42

21 patients with LAD-stenoses of at least 70% and 21 patients with LAD-stenoses and additional intramural anterior wall infarctions were studied. 20 patients without heart disease or after successful transluminal coronary angioplasty and 18 patients with intramural anterior wall infarction after successful transluminal dilatation of the LAD (remaining stenosis maximal 30%) served as controls. The normal range of global and regional left ventricular ejection fraction response to exercise was defined based on the data of 25 further patients without relevant coronary heart disease. Thus, a decrease in global ejection fraction and regional wall motion abnormalities were judged pathological. All patients were comparable with respect to age, ejection fraction at rest and work load. Myocardial ischemia could be detected by the exercise ECG in 81% of all patients without infarction and in 71% of patients with infarction. The corresponding values for global left ventricular ejection fraction were 76% and 81%, respectively, and for regional ejection fraction 95% in both groups. No false-positive exercise ECGs were observed in the healthy controls and 2 (11%) in the corresponding group with intramural infarction. The global ejection fraction was pathological in 1 (5%) healthy subject without infarction and in 3 (17%) corresponding patients with infarction. Sectorial analysis revealed 5 and 22%, respectively. Our findings suggest that the exercise ECG has a limited sensitivity to detect myocardial ischemia in patients with isolated LAD-stenoses and intramural myocardial infarction. Radionuclide ventriculography yields pathological values more often; however, false-positive results also occur more frequently.
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PMID:[Comparison of effort-ECG and radionuclide ventriculography in relation to the detection of myocardial ischemia in isolated stenoses of the anterior interventricular branch]. 336 39

Non-selective opacification of the coronary arteries is often adequate for practical purposes in children, especially for studying the coronary circulation before operating congenital heart disease. However, selective coronary angiography is essential to demonstrate some abnormalities of distribution poorly visualised by the non-selective method and especially in cases of coronary anomalies or acquired coronary disease before procedures of reimplantation of revascularisation. The indications must be carefully considered and the technique particularly adapted using paediatric catheters and trained personnel skilled in retrograde arterial catheterisation in children. 51 selective coronary angiographies were carried out in 47 children 1 to 13 years old, including 12 children under 3 years of age. In 33 cases (23 Fallot's tetralogy the object was to detect coronary abnormalities not observed on non-selective opacification (3 LAD arteries arising from the right coronary, 1 single coronary artery) or to determine their anatomical relationships in complex cardiac malformations (5 cases). There were 5 cases of isolated congenital or acquired coronary disease with signs of ischaemic heart disease in 3 cases (LAD arising from the pulmonary artery and antero-septal infarction, calcified aneurysms and antero-lateral infarction in Kawasaki disease, pseudoxanthoma elastica with multiple coronary stenosis and severe angina). The investigation was indicated for complications of cardiac surgery in 2 children and in 4 cases selective coronary angiography was performed to assess the results of coronary reimplantation.
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PMID:[Selective coronary angiography in children. Technic and indications]. 392 68

The prevalence of myocardial bridging in patients with angina pectoris but normal coronary arteries was evaluated in 1780 patients who consecutively underwent coronary angiography. 62 patients (3.5%) were free of coronary atherosclerosis or other organic heart disease. In four of these patients systolic narrowing of the LAD was present. The other 58 patients received 0.2 mg nitroglycerin (NTG) intracoronarily and 30 micrograms/ml orciprenalin (ORC) intravenously up to a heart rate of 130/min. Repeated angiography revealed systolic compression of the LAD due to myocardial bridging (MB) in 40% (25 of 62). The length of MB raised from 1.4 +/- 0.9 cm to 2.1 +/- 1.1 cm (p < 0.001) after NTG and to 2.8 +/- 1.1 cm (p < 0.001) after ORC. Coronary luminal stenosis increased from 48 +/- 29% to 67 +/- 25% after NTG (p < 0.001) and to 83 +/- 18% (p < 0.001) after ORC. The prevalence of myocardial bridging in 40% of patients with stress-induced angina pectoris but normal coronary arteries is high. Nearly always coronary compression by myocardial bridging is only evident after adrenergic stimulation or after afterload reduction. Therefore, NTG and ORC are useful drugs to facilitate diagnosis of myocardial bridging by increasing coronary compression.
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PMID:[Incidence of myocardial bridges after adrenergic stimulation and decreasing afterload in patients with angina pectoris, but normal coronary arteries]. 782 70

Cerebral embolism is one of the major complications of atrial fibrillation (Af). We studied patients with Af, retrospectively, as to the factors related to cerebral embolism. We examined 82 cases with transthoracic echocardiography (TTE) and trans-esophageal echocardiography (TEE) as well as ambulatory (Holter) ECG and 12 leads ECG. Thirty-three patients had cerebral ischemic attack (CIA), including 14 patients with mitral stenosis (MS) and 19 patients with other heart disease or lone Af (NonMS). The CIA group of NonMS were older than other groups. Both the CIA and NonCIA groups had the same frequency of paroxysmal and chronic Af. In the CIA group, there was a tendency of small amplitude of f wave and longer RR interval than the NonCIA group with ambulatory ECG. The CIA group also had larger left atrial cavity size and aortic diameter with TTE. TEE revealed thrombus formation in 29 cases, and the CIA group had a higher occurrence rate of thrombus than NonCIA group. TEE also detected a fuzzy echo in the left atrium in 88% of the CIA group and 42% of the NonCIA group. The risk factors of cerebral embolism could not be made clear in this study, but a fuzzy echo and thrombus in the left atrium with TEE are specific findings of cerebral embolism. Therefore, older patients with paroxysmal Af, large LAD, AOD, small f wave or long RR interval need to be examined by TEE to detect LA thrombus or a fuzzy echo, which are probably major risk factors of cerebral embolism.
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PMID:[Risk factors of cerebral embolism in patients with atrial fibrillation]. 834 57


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