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

A case of pulmonary arteriovenous fistula associated with rheumatic mitral heart disease is presented. We have reviewed the literature and no published case with such association has been described. The loud mitral insufficiency murmur hide the continuous murmur of the fistula. The angiographic study demonstrated the A-V fistula. Retrospectively the diagnosis should have been suspected due to cyanosis, slight clubbing, the radiologic findings and the important Qs/Qt shunt. The associated pulmonary embolic phenomena made more difficult the diagnosis.
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PMID:[Arteriovenous fistula and rheumatic cardiopathy]. 47 2

We report 11 cases of bacterial endocarditis with muscular and articular manifestations seen over the past ten years. There was arthralgia in 7 cases, vertebral pain in 7 cases and myalgia in 3 cases. Arthritis consisted of a monoarthritis of the ankle in 2 cases and oligoarthritis in 2 cases. There were also 2 cases of lumbar spondylodiscitis and 1 of finger clubbing in the series. The underlying heart disease was a valvular lesion of the left side of the heart in 10 cases out of 11 and the organism isolated by blood culture was a streptococcus in 9 cases and a staphylococcus in 11. We emphasis the need for early diagnosis and appropriate antibiotic therapy, in the absence of which the course may be fatal in the short term, as it was the case in one of our own patients.
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PMID:[Articular and muscular manifestations of bacterial endocarditis. 11 cases (author's transl)]. 74 39

Hypertrophic osteoarthropathy should be considered in any child who presents with a non-inflammatory synovitis of the knees, ankles and wrists and particularly if there is finger clubbing or soft tissue hypertrophy of the fingers. It is rare to get the typical facial appearances until after adolescence. Alteration in epiphyseal growth is associated with the periosteal reaction, as is change in the shape of the patella; whether this leads to premature osteoarthrosis is not yet certain. Secondary disease is common in cyanotic congenital heart disease, but its frequency appears to be decreasing with early treatment of such children. Chest infections are also better controlled so again it is less common, but does still occur, particularly in cystic fibrosis in the older age group who have intractable chest infections. It is seen but rarely in disorders such as inflammatory bowel disease or pulmonary metastases, particularly from bone tumours.
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PMID:Hypertrophic osteoarthropathy in the paediatric age. 162 66

Cyanosis with digital clubbing and a systolic murmur were found in a five and a half-year-old. The usual causes of cyanosis, including congenital heart disease, were discussed. Correct diagnosis was, however, arteriovenous aneurysm of the lung which was seen on the pulmonary angiogram. The lung density on chest films and lack of echocardiographic evidence of congenital heart disease might have suggested this infrequent malformation. Permanent cure was achieved by removing the lower and middle lobes of the right lung.
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PMID:[A rare and little known cause of cyanosis: pulmonary arteriovenous aneurysm]. 174 57

During the last 26 years, 21 patients with cirrhosis of the liver with severe cyanosis and gross clubbing simulating congenital cyanotic heart disease were subjected to cardiac catheterisation and angiography, splenography, liver function tests and liver biopsy. One patient had tetralogy of Fallot in addition, which was satisfactorily corrected. He continued to be intensely cyanosed and dyspnoeic despite adequate surgical correction of his cardiac defect as demonstrated on cardiac catheterisation and angiocardiography. Portupulmonary fistulas could not be demonstrated in any patient. The cyanosis and clubbing were secondary to right to left intrapulmonary shunting across multiple tiny pulmonary arteriovenous fistulas in all cases. In 16 cases selective pulmonary angiography revealed discrete arteriovenous fistulas. In 5 cases the angiogram did not reveal any convincing evidence of pulmonary arteriovenous fistulas. In 2 of these 5 cases peripheral vein contrast echocardiography, which seems to be a sensitive investigation, demonstrated right to left intrapulmonary shunting. Open lung biopsy in one case showed evidence of pulmonary arteriovenous fistulas.
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PMID:Cirrhosis of liver simulating congenital cyanotic heart disease. 193 51

The objectives of this study were: first, to determine the platelet morphology in the peripheral circulation of patients with cyanotic congenital heart diseases and thus its possible link to the development of hypertrophic osteoarthropathy. Second: to test the mathematical model which proposes that in normal individuals megakaryocytes are fragmented in the lungs. We prospectively studied 14 patients with cyanotic heart disease and clubbing of the 20 digits, and compared them with 14 randomly assigned controls. We measured the platelet count, mean platelet volume (MPV) and platelet volume distribution curve (PVDC). Patients had a significantly lower platelet count (x +/- SD, 171,528 +/- 81,810 vs 319,929 +/- 69,460, p less than 0.001) and larger MPV (11.028 +/- 3.09 vs 8.414 +/- 0.79, p less than 0.005). The PVDC of the controls were uniform, in all cases showing a log-normal configuration. The patient's curves were different; they lost the log-normal shape and demonstrated a heterogeneous platelet population. These findings agree with the mathematical model which proposes that in normal individuals platelets are generated in the lungs, and also suggest a role for the macrothrombocytes in the pathogenesis of cardiogenic hypertrophic osteoarthropathy.
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PMID:Macrothrombocytes in the peripheral circulation of patients with cardiogenic hypertrophic osteoarthropathy. 205 70

We describe a simple method that defines with numbers the drumstick deformity of the digits. We measured 2 circumferences on each of the 10 fingers at the nail bed (NB) and at the distal interphalangeal joint (DIP), the sum of the 10 ratios NB:DIP was termed Digital Index. Intraobserver variation of the Digital Index was small, with a Pearson's correlation coefficient of R = 0.979; interobserver variation was also not significant (R = 0.999). Making use of this Digital Index, we studied 22 patients with digital clubbing associated with cyanotic congenital heart disease and 66 healthy controls. Digital Index clearly separated patients from controls, 10.73 +/- 0.32 vs 9.33 +/- 0.27 (means +/- SD). The Index was independent of age or sex. Patients with hypertrophic osteoarthropathy had significantly higher indices than patients with clubbing alone.
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PMID:Digital clubbing: a numerical assessment of the deformity. 274 91

During the last 25 years, 20 patients with cirrhosis of liver with severe cyanosis and gross clubbing simulating congenital cyanotic heart disease were subjected to cardiac catheterization and angiography, splenography, liver function tests, and liver biopsy. No portopulmonary fistulas could be demonstrated. The cyanosis and clubbing were secondary to right to left intrapulmonary shunting across multiple tiny pulmonary arteriovenous fistulas. In 15 cases, selective pulmonary angiography revealed discrete arteriovenous fistulas. In five cases, the angiogram did not reveal any convincing evidence of pulmonary arteriovenous fistulas. In two of these five cases, peripheral vein contrast echocardiography demonstrated right to left intrapulmonary shunting and seems a sensitive investigation. Open lung biopsy in one case showed evidence of pulmonary arteriovenous fistulas.
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PMID:Cirrhosis of the liver simulating congenital cyanotic heart disease. 279 83

Cyanosis is frequently encountered in the neonate or infant. Most often it is due to congenital heart disease or primary lung disease. Pulmonary arteriovenous malformation is an unusual cause of cyanosis. Polycythemia and clubbing are associated findings. The treatment is excision or embolization if the disease is not too extensive.
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PMID:Cyanosis due to pulmonary arteriovenous malformation. 305 75

The skeletal manifestations of clubbing of the digits have been occasionally noted and only briefly discussed in the literature. We investigated the radiographic features of digital clubbing in 37 patients with diverse diseases including cyanotic congenital heart disease, lung malignancy-associated hypertrophic osteoarthropathy, and idiopathic cases. We identified two types of bone changes--osteolysis or bone dissolution, and bone formation or hypertrophy. The changes were more evident in the feet than in the hands, and the degree of soft tissue change did not always reflect the underlying osseous abnormalities. The relationship of these changes (ie, osteolysis, hypertrophy) to each other appear to depend in part on the underlying disease as well as the time course or disease duration. Thus, clubbing and hypertrophic osteoarthropathy may not represent distinct entities; our data suggest that they may be stages in an evolving, more generalized process of new bone formation or hypertrophy followed by osteolysis or atrophy affecting many parts of the skeleton.
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PMID:The skeletal manifestations of clubbing: a study in patients with cyanotic congenital heart disease and hypertrophic osteoarthropathy. 390 7


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