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

From 1978 to 1980, 260 healthy subjects, 40-79 years of age, underwent 24 h ambulatory electrocardiography in order to determine the prevalence and complexity of ventricular premature beats (VPBs) in adults without apparent heart disease. The number of types of VPBs seem in 5% or less were considered 'abnormal' and the present follow-up study undertaken in order to assess the significance of such 'abnormal' VPBs as predictors of subsequent ischaemic heart disease (IHD). Information concerning cardiac events within the follow-up period was available in 237 subjects. Nine were lost to follow-up and 24 refused clinical examination. IHD was documented in 13 (eight myocardial infarction, five angina pectoris). 'Abnormal' VPBs occurred in six out of 13 (46%) who later developed IHD compared to only 24 out of 213 (11%) without IHD (P less than 0.001). The presence of either more than 900 VPBs 24 h-1 or ventricular tachycardia of more than three beats, identified five out of 13 patients with IHD (sensitivity 38%), whereas 210 out of 213 with no evidence of IHD at follow-up were identified (specificity 98%). Four out of seven who initially had more than 900 VPBs 24 h-1 had IHD on follow-up. Our results have demonstrated a strong positive association between 'abnormal' VPBs observed in a random 24-h electrocardiographic recording of apparently healthy subjects 40-79 years of age and subsequent IHD. They also suggest that a 24-h ECG may be useful for the assessment of coronary risk even in asymptomatic subjects.
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PMID:Predictive value of ventricular premature beats for subsequent ischaemic heart disease in apparently healthy subjects. 171 40

Palpitations are a nonspecific symptom and do not necessarily imply serious heart disease. The vast majority of palpitations are benign. Goals in evaluation include detecting and identifying an arrhythmia, clarifying symptom severity, and defining the extent of underlying heart disease. If palpitations are infrequent and not accompanied by angina, congestive heart failure, or syncope, outpatient transtelephonic monitoring yields useful clinical information in most patients and is more cost-effective than Holter monitoring. Patients with major symptoms require hospitalization for aggressive cardiac evaluation and, possibly, electrophysiologic testing to guide treatment.
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PMID:Palpitations and arrhythmias. Separating the benign from the dangerous. 172 76

Thirty-one patients, mean age 54 years, had been on chronic ambulatory peritoneal dialysis (CAPD) for an average of 38 months. Mean values (mg/dl) for triglycerides (567), total-C (267), LDL-C (133), and Apo-B (154) were elevated, and HDL-C (30) were low. The low values for total-C/Apo-B and LDL-C/Apo-B suggest an increase in the number of low density lipoprotein (LDL) particles, rather than in the amount of cholesterol per LDL particle. Without knowledge of lipids, ischemic heart disease for the 31 patients was categorized into five grades in the following manner. All patients were graded based on history (angina, myocardial infarction, and bypass surgery), electrocardiogram (EKG), and echocardiography. In addition, five patients underwent coronary angiography, the results of which were considered in their grading. The five grades were assigned as follows: Grade I, no evidence (n = 15); Grade II, angina with EKG ischemia (n = 4); Grade III, myocardial infarction (MI) (n = 1); Grade IV, MI with dyskinesia-akinesia on echo (n = 4); Grade V, severe three vessel disease on angiography, or multiple infarcts, or Grade IV with heart failure (n = 7). Only Apo-B (r = 0.56) and total-C/HDL-C (r = 0.57) correlated with severity of grade, with p less than 0.001. When patients with and without detectable ischemic heart disease were compared by stepwise logistic regression, Apo-B was the only variable that independently predicted heart disease (p = 0.001). However, contribution of the lipid changes induced by CAPD has not been established.
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PMID:Ischemic heart disease, serum cholesterol, and apolipoproteins in CAPD. 175 Dec 58

The incidence of angina pectoris was investigated and the treadmill test was carried out to assess the presence of myocardial ischemia and heart pump function in 238 patients suffering from mitral and aortal heart disease. Comparison with the coronarography readings has demonstrated that the diagnostic value of the painful syndrome in the health status and anamnesis does not exceed 24%. The appearance of an angina pectoris attack in combination with ischemic alterations on the ECG raised the diagnostic value up to 50%. The authors have distinguished a symptom-complex including the development of angina pectoris, appearance of the ischemic signs on the ECG with the integrity of heart pump function, increasing the diagnostic value of the test up to 83-100%. The integrity or insufficiency of heart pump function were shown to allow differentiation between atherosclerotic and relative coronary insufficiency. The conclusion is drawn about the necessity of carrying out the treadmill test according to the program in patients suffering from heart disease with suspected coronary insufficiency.
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PMID:[The diagnosis of coronary failure in patients with aortic and mitral valve defects]. 175 2

Generalized expectancies about control are examined as a possible independent risk factor for coronary artery disease in a sample of subjects undergoing coronary angiography. This characteristic is also examined as a possible underlying component of the Type A behavior pattern which may contribute to the latter's association with heart disease. Regression analyses adjusting for age, sex, income and known risk factors for heart disease (hypertension, serum cholesterol, smoking, diabetes, angina, family history of CHD, hostility and Type A behavior pattern) indicate that having a stronger belief in personal mastery or control is an independent predictor of more severe coronary atherosclerosis. This characteristic, however, is not significantly related to the Type A behavior pattern.
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PMID:Personal control and coronary artery disease: how generalized expectancies about control may influence disease risk. 179 80

The author separated a group of 22 patients with ischaemic ST depression revealed by Holter-monitoring without symptoms, and compared it with the results obtained by ergonometry testing. Angina pectoris, a key symptom on which were based many epidemiological and clinical studies, could not be considered as a reliable criterion for the evaluation of patients with ischaemic heart disorder. Non-invasive diagnostic methods (ergometry testing and Holter-monitoring) used by the author in this study were particularly significant in the establishment of early diagnostic of cardiac ischaemic disorder and detection of symptomatic and asymptomatic episodes of myocardial ischaemia. Asymptomatic myocardial ischaemia during ergometry testing and Holter-monitoring has equal importance in surviving of patients as ischaemia followed with angina pectoris. For that reason, early ischaemia are of great importance for patients' fate.
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PMID:[Correlation between the stress test electrocardiogram and Holter monitoring in asymptomatic myocardial ischemia]. 179 81

Heart disease remains the most common cause of morbidity and mortality in the United States. During the 1970s until the early 1980s, patients with angina pectoris refractory to medical therapy could only consider bypass surgery to relieve their symptoms. Beginning in the early 1980s, coronary balloon angioplasty became an alternative to bypass surgery in those with single vessel coronary artery disease and failure to medical therapy. In the mid-1980s, patients with multi-vessel coronary artery disease also were seen to benefit from balloon angioplasty. Now in the 1990s, balloon angioplasty's success is being compared to coronary bypass with prospective randomized trials. While balloon angioplasty has become relatively easy to perform due to advances in balloon, wire, and guiding catheter technology, many new interventional devices such as atherectomy and laser, are now available. The explosion in technology reflects our inability to prevent atherosclerotic disease and also reveals that while we can improve a patient's lifestyle and in some situations improve mortality rate, atherosclerotic disease remains a disease for which we have no cure.
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PMID:Coronary angioplasty and surgery for coronary artery disease. 181 28

Amiodarone, an anti-ischaemic and anti-arrhythmic drug, has been the object of numerous studies and seems to be highly effective in the treatment of severe ventricular arrhythmias on dilated cardiomyopathies, as well as of hypertrophic or ischaemic heart diseases. Some studies have shown a decrease in the incidence of sudden death in patients under amiodarone, but most of these studies were conducted on limited series with an insufficiently strict methodology. Contrary to other antiarrhythmic agents, amiodarone seems to be devoid of significant proarrhythmic effect and of depressant effect on cardiac function. Its anti-ischaemic activity has been demonstrated in exercise-induced and spastic angina. The side-effects of amiodarone are mainly extracardiac, and they may be a source of concern when they produce dysthyroidism or pulmonary pathology; however, they can be detected, or even prevented, by careful monitoring. Owing to its mechanism of action and its potential effectiveness, amiodarone deserves to be studied in patients at high risk of sudden death, especially those who suffer from severe ventricular arrhythmia on ischaemic cardiopathy with or without ventricular dysfunction. Three extensive clinical trials have been devised to determine with accuracy the effect of amiodarone on the mortality of patients who have survived a myocardial infarction or present with heart failure. At the end of these trials, it will perhaps be possible to evaluate the influence of a long-term amiodarone treatment on the mortality of patients whose life expectancy is shortened. The results obtained will be weighed against the side-effects of the treatment to obtain a benefit/risk ratio which, for the time being, is imperfectly known.
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PMID:[Does amiodarone have a benefit effect on mortality?]. 183 37

Beat-to-beat fluctuations of the spatial QRS-T angle, which are reported to be greater in patients with ischemic heart disease than in healthy subjects, are thought to be a helpful factor in diagnosing ischemic heart disease. In this study, we assessed the usefulness of the standard deviation of the spatial QRS-T angle per beat as an index of magnitude of the fluctuations. The subjects consisted of 27 patients with effort angina, 14 with vasospastic angina, 18 with the "chest pain syndrome" and 36 normal controls. The standard deviations of the spatial QRS-T angle were obtained for 10 consecutive stable beats at rest using Frank's orthogonal X, Y, Z scalar electrocardiogram. The results were compared with those of coronary angiography and exercise tolerance tests. Treadmill exercise tests were performed in all patients using Bruce's protocol to observe decreased ST levels and delta ST/HR indices. QRS-T angle deviation values were 8.10 +/- 8.64 degrees (mean +/- SD) in the effort angina group, 3.63 +/- 1.26 degrees in the vasospastic angina group, 4.13 +/- 1.70 degrees in the "chest pain syndrome" group, and 2.35 +/- 0.85 degrees in the normal control group; the groups of patients with heart disease showed significantly higher values (all p < 0.01) than did the control group. The effort angina group showed a significantly higher value than did the vasospastic angina group and the "chest pain syndrome" group (all p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Ischemic heart disease detected by the standard deviation of the spatial QRS-T angle and by treadmill exercise test]. 184 6

The case is reported of a 62 year-old male having a clinical history of grade II dyspnoea from 9 year ago and recently showing grade II angina. He had presented mild cyanosis. Suspecting the existence of coronary arteriosclerosis, and with the clinical diagnosis of tetralogy of Fallot based particularly on two-dimensional and M-mode echocardiography, and angio-hemodynamic study was made which confirmed the presence of congenital heart disease and also revealed significant coronary lesions of the circumflex and right coronary arteries. The patient underwent surgery which involved complete correction of the tetralogy of Fallot and the placing of two aortocoronary grafts onto the circumflex and right coronary arteries. Favorable progress was noted both immediately after operation and 6 months later. Although cases have been described of Fallot disease associated with acute myocardial infarction, we believe that this is the first time a patient has undergone myocardial revascularization at the same time as undergoing complete correction of the congenital heart disease.
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PMID:[Myocardial revascularization and complete correction of tetralogy of Fallot in an adult. A case report]. 185 65


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