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

A clinical scoring method for assessing adult respiratory distress and the need for mechanical ventilation was matched against simultaneous blood-gas analysis in 27 patients with grave heart disease. The results showed little correlation between the two. Possible reasons for this are discussed.
Anaesthesia 1976 Apr
PMID:A clinical scoring system for adult respiratory distress. Preliminary report of its use in heart disease. 127 7

Twenty-four patients with severe, 24 with moderate, and 24 without heart disease were selected for measurements of systolic time intervals (STI) and blood pressure before and during anesthesia. In all patients anesthesia was induced with thiopental, 4 mg/kg. After tracheal intubation, 12 patients from each heart-disease class received halothane-N2O-O2 (halothane) and 12 patients from each class morphine-d-tubocurarine-N2O-O2 (MS-dTc). Thiopental increased the pre-ejection period (PEP), decreased left ventricular ejection time (LVET), and accelerated heart rate (HR). These changes were similar in patients with and without heart disease. Halothane and and MS-dTc lowered systolic blood pressure and increased PEP/LVET. With halothane but not with MS-dTc these changes were more pronounced in patients who had heart disease. Changes of the PEP/LVET ratio during halothane anesthesia were a better discriminating variable among patients without, with moderate, and with severe heart disease than were changes in systolic blood pressure.
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PMID:On-line systolic time intervals during anesthesia in patients with and without heart disease. 127 14

The patient with congenital heart disease who presents for noncardiac surgery requires careful evaluation and planning to avoid adverse perioperative events. This chapter presents a physiological approach to the management of anesthesia for the most common congenital heart lesions. The various congenital heart defects are categorized into lesions resulting in: (1) left-to-right shunting; (2) right-to-left shunting; (3) complete mixing of pulmonary and systemic circulation; (4) complete separation of the pulmonary and systemic circulations; (5) increased myocardial work; and (6) mechanical obstruction of the airway.
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PMID:Noncardiac surgery in the patient with congenital heart disease. 134 72

Manipulation, premedication, and chemoprophylaxis for fiberoptic bronchoscopy vary among institutions. We analyzed the actual conditions by means of a questionnaire distributed to 29 institutions. With regard to premedication, a combination of atropine sulfate and sedatives, such as hydroxyzine hydrochloride, was the most common method. In cases with heart disease and elderly subjects, a lower dosage or omission of atropine was common. In cases with marked anxiety, narcotics were prescribed. Bronchofiberscopic examination was performed under local anesthesia at all institutions. Lidocaine 4% was used for anesthesia of the orolarynx, and 2% was used for the tracheobronchus. For prophylaxis of infection, 19 of 29 institutions prescribed antibiotics routinely or under certain circumstances. ECG was used in 14 institutions, and percutaneous oxygen monitoring in 5 institutions. It is concluded that the manipulation and premedication for fiberoptic bronchoscopy vary between institutions. It is necessary to determine more efficacious and safer methods for fiberoptic bronchoscopy.
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PMID:[Manipulation, premedication, and chemoprophylaxis for fiberoptic bronchoscopy]. 140 73

Ketamine and fentanyl were used for surgery of esophageal hiatus hernia in a 9 month old boy with single ventricle (asplenia syndrome). The patient was orally premedicated with diazepam 2.5 mg, and intravenously with atropine 0.04 mg. General anesthesia was induced with ketamine-fentanyl-pancuronium-100% oxygen, and maintained with fentanyl-pancuronium-100% oxygen. The total dose of ketamine or fentanyl was 0.8 mg.kg-1 or 15 micrograms.kg-1, respectively. Systolic blood pressure and heart rate of the patient were stable during ketamine-fentanyl anesthesia. Arterial oxygen saturation measured by pulse oximetry was over 90% and arterial oxygen tension was above 60 mmHg during the operation. Ketamine-fentanyl anesthesia might be useful for non-cardiac surgery of a child with cyanotic congenital heart disease.
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PMID:[Anesthetic management of an infant with a single ventricle (asplenia syndrome) for non-cardiac surgery]. 146 Jul 57

Catheter ablation of the atrioventricular node is a therapeutic technique for the treatment of patients with drug-refractory supraventricular tachyarrhythmias. In our Arrhythmia Unit 25 patients (8 women, 17 men) aged (mean +/- DE) 56 +/- 10 years have undergone fulguration of the atrioventricular junction since 1986. The more frequent treated rhythm disturbance was atrial flutter or fibrillation, with uncontrolled rapid ventricular response. Absence of organic heart disease was diagnosed in 9 patients; the remainder had valvular heart disease (2), cor pulmonale (2), cardiomyopathy (7), hypertensive heart disease (2) and Wolff-Parkinson-White syndrome (3). Under general anesthesia 1.8 +/- 0.8 shocks/patients were delivered along 1.2 +/- 0.7 sessions/patient. In 23 of 25 patients (92%) complete atrioventricular block was achieved, and a pacemaker was implanted. There were no complications. The other 2 patients were referred to surgery for cryoablation of the atrioventricular junction. Patients were followed for an average of 21 +/- 12 months. Four patients have died: two due to congestive heart failure, which was present prior to the ablation procedure, the third because of a metastatic carcinoma, and the fourth had a sudden death 14 months after the procedure (he had dilated cardiomyopathy and Wolff-Parkinson-White syndrome). The remainder in chronic stable complete atrioventricular block are asymptomatic for arrhythmias and without antiarrhythmic medication.
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PMID:[The interruption of atrioventricular conduction by cardiac fulguration in patients with supraventricular tachycardias. The mid- and long-term results]. 154 59

Transient cardiovascular changes, including angina-like electrographic signs, are inducible by electrical stimulation of discrete sites in the prefornical region of the lateral hypothalamus (LH) of cats. Repeated stimulation may result in neurogenic cardiac infarction and myocardial bleeding. Thirty Swiss breed locally grown cats were studied under alpha-chloralose anesthesia in pairs, one as control and one experimental, with only the latter receiving multiple stimulations. ECG in lead II and arterial blood pressure were recorded on a Grass polygraph (USA). Electrical stimulation was delivered to a LH target at Fr 9.0, L2.5, D-1 to -2, by means of stainless steel wire electrodes. Stimulation consisted of 15-sec trains of square wave pulses at 100 Hz, 0.2-0.5 msec duration, and threshold currents of 0.05-0.1 mAmp. Stimulation at these LH sites induced small blood pressure changes, often with a small increase or no change in heart rate, presumably a manifestation of baroreceptor dysfunction. Repeating this stimulation greater than 6 times was shown to be pathogenic: on gross examination a darkened area was seen, mostly on the upper ventricular surface of the heart. Microscopic examination of such sites revealed subendocardial bleeding and sometimes also microinfarcts. Scanning electron microscopy revealed an unusually large number of contractures of the myofilaments. Biochemical analysis showed diffusion of catecholamines from nerves. Total myocardial blood flow increased following such stimulation, proportional to the stimulus intensity. It is pointed out that this is not contradictory to the sharply localized ischemic changes assumed to be responsible for the cardiopathy.
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PMID:Hypothalamic etiology in sympathetically induced pathogenic cardiovascular changes in the cat. 160 70

We report the use of adrenaline in a 62-year-old woman with carcinoid heart disease who underwent double valve replacement. She was given an intravenous infusion of octreotide throughout the peri-operative period. Following the termination of cardiopulmonary bypass she developed profound hypotension which proved to be refractory to various therapies but responded to adrenaline. Adrenaline is said to be contraindicated in carcinoid syndrome, but we would suggest the consideration of its use in such cases where the hypotension may result from myocardial depression rather than from a carcinoid crisis.
Anaesthesia 1992 Jun
PMID:Hypotension following valve replacement surgery in carcinoid heart disease. 809 3

We investigated atrial natriuretic peptide (ANP) and cyclic guanosine monophosphate (cGMP) in patients undergoing elective direct current cardioversion (CV group) due to atrial fibrillation (n = 9) or atrial flutter (n = 3). Anesthesia for cardioversion (CV) was induced with propofol 1.5 mg/kg. Conversion was achieved in all patients. Before CV all patients had elevated ANP and cGMP plasma levels. After CV the concentrations of ANP and cGMP decreased significantly within 15 and 30 minutes (p less than 0.01), respectively. Only one patient in the CV group showed increasing ANP and cGMP levels although his heart rate had decreased after CV and his blood pressure remained stable. High concentrations of ANP and cGMP might possibly be a compensatory mechanism of cardiac dysfunction. To study the influence the anesthetic agent on plasma levels of ANP and cGMP, we investigated six patients anesthetized with propofol for high-density radiation (HDR group). The data from this control group showed that propofol did not influence the plasma levels of ANP and cGMP. ANP correlated statistically significantly (p less than 0.05) with cGMP in both groups (r = 0.88 and 0.76 in the HDR and CV groups, respectively). In addition, we found a cGMP release of 149.6 +/- 17.6 per mol ANP in the HDR group, in the CV group the release was 109 +/- 54.2 cGMP per mol ANP. This phenomenon could be due to minor response of target cells to ANP stimulation (receptor down-regulation) in patients with heart disease. In conclusion, ANP and cGMP levels decreased after successful cardioversion.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Values of atrial natriuretic peptide (ANP) and cyclic guanosine monophosphate (cGMP) in cardioversion]. 166 Oct 54

Despite the widespread clinical success in open-heart surgery, bleeding after cardiopulmonary by-pass (CPB) has been a common problem especially in cyanotic congenital heart disease. Recently, there have been reports demonstrating that treatment with high doses of aprotinin reduces postoperative bleeding. We studied the effect of aprotinin on postoperative bleeding in patients with tetralogy of Fallot who had undergone total correction in the Department of Thoracic and Cardiovascular Surgery of the Hacettepe University Faculty of Medicine, and compared our results with those in the literature. Ten patients out of 20 in the study were given high doses of aprotinin and were compared with the remaining 10 patients who had not received the drug. Standard anesthesia, perfusion and surgical techniques were used in all operations. The total amount of bleeding in the aprotinin-treated group was found to be 1530 ml, while in the other group it was 4185 ml (p < 0.05). The total quantity of blood transfused in the aprotinin-treated patients was 3250 ml while it was 5865 ml in the control group (p < 0.05). No significant effect of aprotinin was found on Hb, Hct, PT, aPTT and thrombocyte counts (p > 0.05). However, the effect of the drug on bleeding and coagulation time was found to be statistically significant (p < 0.05).
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PMID:The effect of aprotinin (trasylol) on postoperative bleeding in cyanotic congenital heart disease. 172 22


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