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

Non-cardiac chest pain is a frequent clinical problem. Between 10 and 50% of patients with anginal pain who are referred for arteriography are found to have normal coronary arteries. An oesophageal source of non-cardiac chest pain is reported in up to 60% of cases, most of which are attributable to gastro-oesophageal reflux disease. The exclusion of heart disease and the identification of an oesophageal origin of the pain may require an extensive work-up. The outcome in patients with non-cardiac chest pain is influenced by both the underlying diagnosis and the patient's perception of his or her symptom.
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PMID:Non-cardiac chest pain: a real clinical problem. 878 1

The biopsychosocial dimensions of esophageal diseases are recently being recognized. Globus sensation is not associated with augmented or spastic upper esophageal sphincter function, but patients do have a high level of somatic concern, anxiety, or depression. Spastic esophageal motility disorders are frequently triggered by both physiological and psychological stressors. In susceptible patients, anxiety increases the report of reflux symptoms, but not the actual amount of acid reflux, whereas relaxation therapy decreases both reflux symptoms and total acid exposure time. Patients with chest pain of unknown cause have increased somatic concern about heart disease, anxiety, depression, and esophageal specific visceral hypersensitivity to balloon distention. Psychotropic drug therapy to increase pain thresholds and modulate psychiatric disease and behavioral therapies are appropriate in selected patients with esophageal diseases.
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PMID:Psychophysiological interactions in esophageal diseases. 890 31

The authors, on a basis of experience acquisted since 1984 on two groups of patients, respectively 55 and 174 subjects with angina like chest-pain, individuated in the first group 45%, and 66.1% in the second group, the presence of GER-EMD with the execution of functional stationary manometric and 24 hour pH-metrical exams, without undergoing chemical, pharmacological, mechanical stimulation. They make note that 43 patients out of the second group, underwent, after a certain time, another cardiological study (negative for heart disease when recluted) due to graveness of the symptoms and 33 risulted holders of heart disease, 24 of whom also affected with EMD. The treatment with anti-H2 and procinethycs had succes in 39 patients out of 59, with GER; 10 patients underwent, with success, Nissen-Rossetti funduplication. Medical treatment with sublingual nifedipine was successful in 17 cases out of 56, with EMD; 19 underwent esophageal miotomy surgery commisurated on manometrical dates, with excellent results; 8 patients with hypertension of LES underwent pneumatic dilation with good results; 12 patients live, tolleratig angina like chest-pain. The final considerations are the following: it is not indispensable to look for contemperaly EMD and pain to afferm that pain is of esophageal origin; EMD must be clearly defined; the exclusion primarily of heart pathology must not exclude the possibility of the insorgence of heart desease, in the presence of EMD; the medical therapy, satisfactory in GER, is scarsely efficent in EMD, the decision for surgery must be taken on the gravity of pain associated with an esophageal pathology well defined with numerous diagnostic exams.
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PMID:[Clinical and therapeutic approaches in angina pectoris of esophageal origin]. 894 2

Catheter ablation of an accessory pathway and atrioventricular node modification using 550 kHz radiofrequency was attempted in 23 children and adolescents between five and 19 years of age (mean = 15.7 years). Fifteen children had accessory-pathway-mediated tachycardia and eight had atrioventricular node reentrant tachycardia. Accessory pathways were present in ten children. Two patients had associated congenital heart disease. Symptoms included disabling palpitations and episodes of syncope. Ablation was attempted from the right and left sides of the heart. Single-catheter technique was used in seven patients. Eleven of the 15 patients with accessory pathways were treated completely. Two patients had recurrences, and one of them died after the arrhythmia surgery. There were two failures. Two patients with incomplete interruption of the accessory pathways were followed up clinically. There were three cases with temporary systemic embolization and one with severe pain related to radiofrequency energy application. Atrioventricular node modification was done by fast-pathway ablation in six, and by slow-pathway ablation in two patients. Two patients with fast-pathway ablation had recurrences of clinical arrhythmia, and one of them underwent a successful second session. There were no complications associated with the procedure in this group of patients. Radiofrequency catheter application was initially successful in 21 (84%) out of 25 procedures, and ultimately curative in 16 (69%) out of 23 patients. There were some serious complications which resolved in the immediate post-procedure period. Radiofrequency catheter ablation appears to be a safe and successful method for the management of supraventricular tachycardia secondary to accessory pathways or atrioventricular node reentrant tachycardia in children and adolescents.
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PMID:Radiofrequency catheter ablation of accessory pathways and modification of atrioventricular node in children and adolescents. 899 76

Chest pain as a chief complaint is very common in most emergency departments. While well defined and numerous causes of chest pain in adults are previously described, the adolescent presenting with chest pain raises the possibilities of other causes. Previously undiscovered congenital anomalies are rare as causes of pain in this age group. A case of coarctation of the aorta, previously undetected in a teenager, is presented. The signs of congenital heart disease are usually present on history and physical examination, which can lead the emergency physician to the appropriate diagnosis.
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PMID:An unusual cause of chest pain in an adolescent presenting to the emergency department. 906 34

The increase in pain threshold is one of the most significant hypothesis regarding the origin of silent ischaemic cardiopathy. The relations between silent ischaemia and aging aren't clear, although age is considered a risk factor in this pathology, in relation to a supposed peripheral neuropathy. In our study we evaluated the trend of pain threshold and of pain tolerance in subjects affected by silent ischaemic cardiopathy; we especially considered the role of aging. We studied 15 subjects with silent ischaemic cardiopathy and 15 with symptomatic cardiopathy; we evaluated the pain threshold and tolerance in three points using short and low frequency transcutaneous electrical impulses. All subjects were male; the exclusion criterion was a high level of anxiety and depression. Pain threshold values were measured with the same method in 40 healthy subjects, 5 per each decade and ranged from 10 to 90 years. Our data show a significant difference in pain threshold and tolerance between subjects affected by silent and non silent cardiopathy (33.9 +/- 12.9 mA vs 25.0 +/- 12.6 mA: p = 0.001 in the comparison of thresholds, and 66.8 +/- 20.9 mA vs 45.0 +/- 21.8: p = 0.000 in the comparison of tolerances). Regarding the higher significance of our data, compared with other studies, we considered the importance of our particular stimulation method and of the uniformity of the studied group. We didn't note any correlation between pain threshold and age. These data suggest that the differences evident between subjects with silent and symptomatic cardiopathy are linked to a different modulation of central pain perception uncorrelated with age.
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PMID:[Silent cardiopathy and aging. Assessment of pain threshold and tolerance]. 906 94

A majority of African-American women over the age of 50 are obese, have at least one chronic disease, and experience mobility difficulty. Using self-reported data from the 1992 Health and Retirement Study of 1,150 African-American women aged 30-70 years, this report first compares chronic disease prevalence and severity, pain, sensory deficits, and mobility difficulty across four categories of body mass index and, second, investigates whether body mass index affects the association of chronic disease with mobility difficulty. Body mass index was categorized as low, medium, high, and severe, being equal to 19-24 (20%), 25-29 (38%), 30-34 (24%), and 35 or over (18%), respectively. There were few differences when comparing the medium category with either the low or high category. Those in the severe body mass index category, however, reported significantly more frequent and severe hypertension, diabetes, cancer, heart disease, arthritis, pain, sensory deficits, and mobility difficulty than did those in the medium body mass index category. Obesity did not appear to affect the association between chronic disease and mobility difficulty. The relatively high rates of mobility difficulty observed among the severe body mass index group appear to be more likely a result of relatively high chronic disease prevalence and severity than to a disproportionate impact of these on mobility.
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PMID:Distribution and association of chronic disease and mobility difficulty across four body mass index categories of African-American women. 914 58

In 1980, two carotenoids, beta-carotene (BC) and canthaxanthine (CX) with and without pro-vitamin A activity, respectively, were orally administered to female Swiss albino mice and were found to substantially prevent skin carcinogenesis induced by benzo(a)pyrene (BP). This preventive effect was observed in darkness by means of photocarcinogenic enhancement (PCE) following UV (300 to 400 nm) irradiation. In 1984, the same experiment produced antitumorigenic activity when applied to breast carcinogenesis induced in mice by 8-methoxypsoralen (8-MOP) plus UV-A light and, in 1985, when directed toward gastric carcinogenesis induced in rats by N-methyl-N'-nitro-N-nitrosoguanidine (MNNG). These data suggested a rationale for human intervention to prevent, by carotenoid supplementation, a second primary malignancy after the primary malignancy has been radically excised. In the 1980s, a pilot clinical study (15 cases) showed a longer than expected disease-free interval in all surviving patients. It was also subsequently found that, if treated daily with 20 mg of BC and intermittently with retinol 150 to 300,000 IU daily for seven days just prior to menses, women suffering from cyclical mastalgia were relieved from pain, without any toxic side effects. When BC was given in high daily doses (60 mg) to 60 drug addicts suffering from AIDS-related complex (ARC), they recovered from their objective and subjective symptoms (but not from lymphadenopathy) with improvement in their general health and increased performance status. At higher doses, BC (with or without hyperthermia) was effective even in patients in advanced stages of AIDS. A debate has arisen concerning a recent statement by the U.S. Government that "beta-carotene supplements do not protect Americans against cancer or heart disease, and may actually increase the risk of deadly lung tumors in smokers".
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PMID:Carotenoids in cancer, mastalgia, and AIDS: prevention and treatment--an overview. 921 91

Electrocardiographic changes, left ventricular wall motion abnormalities, myocardial ischemia, myocytolysis and arrhythmias have been well documented in patients with cerebral bleed. These complications may be related to stimulation of autonomic nervous system and central nervous system. We report a case of a 38-year-old back woman without previous heart disease, taken to emergency unit with headache and subarachnoid Haemorrhage. One day after, she complained of retroesternal pain. An electrocardiographic tracing showed significant and diffuse ST-T wave abnormalities. The patient remained stable with no neurologic or cardiac deficits. She was treated with bed rest, nimodipine, isossorbide propranolol and is symptomless six months of follow-up.
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PMID:[Signs of myocardial ischemia associated with subarachnoid hemorrhage]. 924 29

The purpose of this descriptive study is to develop a profile of patients with adhesive capsulitis and to describe the patients' perceived clinical progression. A total of 32 patients diagnosed with adhesive capsulitis and 31 control subject completed anonymous questionnaires designed to elicit demographic data as well as medical information. The adhesive capsulitis and control samples were selected from the same facilities in an effort to reduce bias. Data comparing the adhesive capsulitis group with the control group was analyzed using the Odds Ratio and Taylor Series Confidence Interval for Odds Ratio. Twenty-seven patients (84.4%) diagnosed with adhesive capsulitis fell within the age range of 40-59 years. Diabetes and heart disease appeared to be more prevalent in patients diagnosed with adhesive capsulitis as compared with the control group and general population. The majority of patients with adhesive capsulitis (90.6%) reported a perceived clinical progression that started with a pattern of pain followed by loss of motion. Age and concomitant medical conditions appeared to be most correlated with the occurrence of adhesive capsulitis. Possible reasons for the prevalence of diabetes and heart disease in adhesive capsulitis patients are discussed.
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PMID:A profile of patients with adhesive capsulitis. 926 13


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