Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During a period of 28 months, all patients (79) who presented with bilateral bundle-branch block were selected for study from a private practice outpatient population. They were followed prospectively from the date of entry into the study and their charts were reviewed retrospectively. The average age of the participants was 73-3 years and they were observed clinically for a cumulative period of 4237 months (353-08 years). A high incidence of severe heart disease and death was noted among the study group. Twenty-four (30-3%) had a New York Heart Association functional classification of 3 or 4. Eight (10-1%) died. Only one patient died suddenly and he had had a stable electrocardiographic pattern of bilateral bundle-branch block for a period of 118 months (9 years 10 months). Seven patients required permanent pacemakers. In 6 instances death resulted from pump failure; in one it was the result of lung cancer. In none of these 7 individuals did rhythm disturbances contribute to death. In most cases vertigo was not of cardiac origin (88-2%). Eight patients had 11 major surgical procedures with no significant cardiac sequelae. Our observations suggest that elderly patients with chronic bilateral bundle-branch block should be managed conservatively. The prognosis in these patients appears primarily to be related to the degree of myocardial disease rather than to the conduction disorder.
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PMID:Chronic bilateral bundle-branch block. Long-term observations in ambulatory patients. 83 36

A random sample of 1,261 non-institutionalised persons aged 70-95 years in four Danish communes replied to questionnaires on health, functional ability, drug use, and living situation in October-November, 1986. Twenty-four % assess their health as excellent, 27%, 39% and 10% good, fair, or poor. Younger persons report better self-assessed health than older, males better than females irrespective of age. Chronic ailments are reported by 51%, most frequent hypertension (24%), heart disease (17%), and chronic bronchitis/asthma (12%). More females than males and more old than young report chronic ailments. Seventy-six % have experienced one or more physical symptoms during the past month, most frequently aching in back and hips (39%) aching in knee and feet (36%), vertigo (27%), swollen legs (25%), and headaches (19%). Fourty-six % report one or more mental symptoms during the past month, most frequently difficulties falling asleep (30%), fatigue without specific reason (21%), and depression (18%). Females report more symptoms than men, older persons report more symptoms than younger. Fourty-nine % report difficulties in hearing during conversations among several persons, 24% in conversations with one other person. Twenty-three % have difficulties reading printed text. Fifty-nine % report memory problems. Functional ability is described by 13 daily activities and 31% can perform all activities without trouble, 29% with some trouble but without help, whereas 13 and 27% need help for one, or more of these activities. More females than males and more older than younger need help.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Self-reported health status and drug use among the elderly]. 230 Oct 91

A sample of people aged 65 and over were interviewed at home and asked a series of questions aimed at identifying episodes of possible transient neurological dysfunction. During follow-up of respondents initially free from manifest cerebrovascular disease, no relationship was found between subsequent stroke and reported episodes of diplopia, transient numbness or weakness, non-rotatory dizziness or blackouts. There was an association of stroke with reported blurring or dimming of vision, statistically significant only for the sexes combined (relative incidence ratio 1.5), and a consistently increased risk in men and women reporting rotatory vertigo (relative incidence ratio 2.5). This relationship remained significant when adjusted for the association of rotatory vertigo with ECG evidence of heart disease. Thus rotatory vertigo is a risk factor for stroke but non-rotatory dizziness is not. Conversely a previous study of falling in the same population sample had shown an association with rotatory vertigo but not with non-rotatory dizziness.
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PMID:Transient neurological dysfunction and risk of stroke in an elderly English population: the different significance of vertigo and non-rotatory dizziness. 231 24

A 34 year old female had a history of dizziness and presyncope. She had many risk factors for atherosclerosis including smoking 30 packs of cigarettes/year, using oral contraceptives (OCs) for almost 10 years, somewhat elevated blood sugars, strong family history of heart disease and diabetes, and hypertension. During an examination in 1983, she had an elevated blood pressure in the right arm but a reading could not be found in the left arm. The physician heard a grade III rough, blowing systolic bruit over the right subclavian artery moving into the right carotid artery. Pulses of both carotid arteries were normal. Heart sounds were normal. While the right brachial and radial pulses were fine, there were none on the left side. Laboratory tests showed a serum cholesterol of 258 mg/dl, a fasting blood sugar of 92 mg/dl, a white blood cell count of 8400, and a normal differential count. The arch aortogram showed a 50-60% stenosis beginning at the innominate artery and a completely occluded left subclavian artery at its origin. Physicians performed an aortoinnominate bypass operation using a Dacron prosthetic graft. This operation alleviated the symptoms, but 2 years later she had bilateral dysesthesias in her upper arms and vertigo returned. Her right arm became more and more limp while her left arm did so mildly. The aortoinnominate graft and the left subclavian artery were occluded. Physicians did coronary angioplasty using the right transfemoral route and corrected both lesions in her brachiocephalic system. they used a technique which eased safe crossing of the occluded subclavian segment (covering the catheter tip with a J curve guidewire). Following the operation, the patient had superb brachial and radial pulses in both arms. Physicians advised her to discontinue using OCs and tobacco products. At months 1 and 5, the symptoms were gone and vital signs were fine.
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PMID:Percutaneous transluminal angioplasty for innominate artery stenosis and total occlusion of subclavian artery in Takayasu's-type arteritis. 256 38

Carotid sinus syncope was diagnosed during a 2-year period in 21 men and 5 women, aged 51 to 80 years, who had experienced 1 to 30 syncopal episodes during periods of time which varied from 1 day to 6 years. In 19 of these patients there was evidence of organic heart disease. Carotid sinus hypersensitivity of the cardioinhibitory type was present in 14 patients, the vasodepressor type in 1 patient, and a mixed type in 7 patients. In four patients with the cardioinhibitory response, the possibility of the vasodepressor response was not excluded. A pacemaker was placed in 17 patients, deferred in 4 patients and refused by 5 patients. Follow-up of patients with pacemakers over 9.5 +/- 7.0 (SD) months revealed recurrence of symptoms in two patients due to a previously unrecognized vasodepressor response. Follow-up of the patients without pacemakers was brief (4.6 +/- 3.7 months), and they remained asymptomatic, except for one patient with recurring vertigo.
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PMID:Carotid sinus syndrome: an overlooked cause of syncope. 401 27

Congenital or idiopathic complete A-V block with no detectable heart disease may be complicated by near syncope, syncope or sudden death. The proposed predictive "risk factors" of these events have not proved sufficiently reliable so far. This study was undertaken in order to re-evaluate the correlation between symptoms and clinical and electrophysiological data with particular regard to the junctional recovery time in 10 patients (4 M; 6 F; mean age 24.4 +/- 9.6 at our first observation) with congenital or idiopathic complete A-V block. Patients were divided into 2 groups: group A (3 M; 3 F; mean age 27.8 +/- 10.6 at our first observation) with patients who complained of vertigo, near syncope or syncope before our study; group B (1 M; 3 F; mean age 19.2 +/- 4.1 at first observation) without cardiovascular symptoms before our study. In group A, Holter monitoring revealed periods of asystole longer than 3000 ms in 2, and ectopic ventricular arrhythmias mainly during effort in 2; ergometric stress test performed in 3 patients demonstrated ectopic ventricular arrhythmias in 2 (those who had ectopic ventricular arrhythmias at rest). In all patients the site of the block was suprahisian (demonstrated by electrophysiologic endocavitary study) with a normal H-V interval; mean junctional recovery time was 4.600 +/- 1.620 ms and corrected junctional recovery time was 3.088 +/- 1.500. Four patients had vertigo during the electrophysiologic endocavitary study. After Atropine 0.02 mg/Kg i.v. junctional recovery time and corrected junctional recovery time decreased respectively to 1052 +/- 238 and 166 +/- 38 ms (the measurement was made in 5 patients). In group B Holter monitoring revealed periods of asystole longer than 3000 ms in 1 case. All patients had ectopic ventricular arrhythmias, confirmed by the stress test. In this group too, the block was suprahisian (electrophysiologic endocavitary study) with normal H-V. Mean junctional recovery time was 5162 +/- 2408 ms; and corrected junctional recovery time 3687 +/- 2202. Two patients complained of dizziness during the electrophysiologic endocavitary study. After Atropine 0.02 mg/Kg i.v., junctional recovery time and corrected junctional recovery time decreased respectively to 1300 +/- 356 and 260 +/- 145 ms. Four group A and 1 group B patients received a permanent pacemaker and have remained asymptomatic since.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Clinico-electrophysiologic relations in isolated complete atrioventricular block, congenital or idiopathic]. 637 52

Between 1969 and 1978 7,000 patients underwent cardiopulmonary bypass at Bellevue and University Hospitals. In seven of these patients, sudden loss of hearing in one ear developed immediately after the operation. Four of the seven patients showed improvement in hearing after the initial loss, although in no case did the hearing return completely to normal. None of the patients had vertigo but two were listless postoperatively. Two of the operations were for congenital heart disease; the remainder were coronary artery bypass procedures. All of the affected patients were male. There was no predilection as to which ear was affected. The most likely cause is particulate emboli generated by cardiopulmonary bypass. Other possible sources of emboli include air, antifoam, fat, and particulate matter from calcified valves and the aorta. Improvement in the kind of pump and the addition of various filters in the period between 1969 and 1978 did not eliminate unilateral hearing loss. The relationship between cerebral emboli and decreased consciousness after operations is also discussed.
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PMID:Unilateral sudden loss of hearing: an unusual complication of cardiac operation. 696 51

In 2793 respondents aged 65 and over in a survey of a geographically defined community, who were asked about falls in the preceding twelve months, the estimated annual prevalence rate (persons) of falls was 28.0%. Standardized for age, the rate was twice as high in women as in men. Rates increased with age but more steeply in men than in women. Compared with non-fallers, fallers had been in more recent contact with their general practitioner, showed higher prevalence of problems with mobility and daily living, a more frequent history of stroke and heart disease, and had more episodes of non-rotatory vertigo, double vision, faints and blackouts and episodes of weakness or numbness. Fallers also showed more frequent evidence suggestive of cognitive impairment. More fallers than non-fallers were taking diuretics and tranquilizers and these associations merit further study.
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PMID:Factors associated with falls in the elderly: a community study. 727 Mar 21

The efficacy and safety of oral cibenzoline were evaluated in 42 patients aged 67 +/- 7 (55-80) and with recurrent symptomatic atrial fibrillation for at least a year and for which at least one previous anti-arrhythmic agent had been stopped for inefficacy or intolerance. Cibenzoline was administered for 6 months at the dose of 260 to 390 mg per day in patients aged under 70, with the possibility of reducing this dose in those aged over 70. Clinical, electrocardiographic and 24-hour Holter evaluation took place at inclusion and after 3 and 6 months' treatment or at the time of trial termination for documented recurrence (atrial arrhythmia persisting for 60 seconds or more). The mean duration of atrial fibrillation was 5.6 +/- 5 years (1-26). It was related to ischemic (22%), valvular (17%), hypertensive (17%), hypertrophic (7%) or dilated (7%) heart disease. No etiology was found in 45% of cases. All patients had taken at least one anti-arrhythmic agent in the past (mean of 2 drugs, range 1 to 6). All patients were symptomatic, the commonest symptoms being palpitations (82%), chest pain (28%), feelings of vertigo (11%) or episodes of acute dyspnea (9%). Thirteen patients (31%) had a documented recurrence (> 60 seconds) during the six months of the trial. Recurrence occurred during the first months of treatment in the majority of patients (11 out of 13). The number of symptomatic patients decreased considerably during treatment with cibenzoline, with the disappearance of palpitations in 83% of cases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Study of the efficacy and tolerability of oral administration of cibenzoline in the prevention of recurrence of symptomatic atrial fibrillation]. 817 84

In most cases psychosomatic patients are not vitally threatened. Nevertheless almost half of the emergency patients have got psychical disturbances (e.g. neurotic heart disease, states of hyperventilation or vertigo). A reason is not only the personal development of early childhood. More often the problems are to be found within strained relations. The physical illness can be conceived as an (unconscious) attempt to master a conflict or loss, as narcissistic reparation, as adaption-effort or even as self destruction Selye's theory of stress presents the linkage between the organ pathology and the influence of the psychosocial situation. Examples of medical cases explain these correlations.
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PMID:[Ongoing conflict situations and physical disease]. 1054 55


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