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

The study concerns 127 consecutive patients, presenting congenital heart disease, with an age distribution from neonatal to 15 years (mean 5 years). With non-ionic Amipaque, 164 injections were performed, with ionic Isopaque Coronar 81. Isopaque Coronar caused in 51% of the cases a clear discomfort for the patient; with Amipaque the side-effects were reduced to 9% (p less than 0.001). The mean body temperature rise with Amipaque was only 0.09 degrees C, against 0.28 degrees C with Isopaque Coronar (p less than 0.001). The changes in the heart rate reached 8.35% with Amipaque and 15.2% with Isopaque Coronar (p less than 0.001). Amipaque caused a mean of 1.8 extrasystoles per injection; Isopaque Coronar 2.2 (p less than 0.05). The quality of the angiogram with Amipaque was quite better than with Isopaque Coronar (p less than 0.0025). The non-ionic Amipaque is a much safer and better tolerated compound that the ionic Isopaque Coronar for paediatric angiocardiography.
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PMID:Comparative study in angiocardiography in children, evaluating the side-effects of non-ionic and ionic contrast media. 49 18

Dyspnea is the medical term for the patient's or subject's complaint of shortness of breath. It encompasses the respiratory discomfort experienced in many different diease states as well as the shortness of breath felt by a normal subject during or after strenuous exercise. Several parameters which have been shown to correlate with the onset or severity of dyspnea are described, including reduced vital capacity, the ratio of minute ventilation to vital capacity, reduced breathing reserve, the work of breathing, and the oxygen cost of breathing. Attempts at quantitation of dyspnea have usually consisted of measuring physiological parameters associated with the sensation, such as the "dyspneic index". The direct measurement of respiratory sensations using modern psycho-physical methods is at an early stage of development. Since the observation that the existence of dyspnea is often unrelated to any disturbance of arterial blood gas composition, it has been generally held that the mechanism of dyspnea is primarily neurophysiological. The neural pathways may conceptually be divided into those which transmit the "dyspnea message" from the respiratory apparatus to integrating centers in the brain, and those concerned with subsequently bringing the sensation to the level of consciousness. It seems likely that there is no single sensing mechanism and neural pathway which will be able to explain dyspnea in the diverse populations of patients and subjects who experience unpleasant respiratory sensations. Three theories concerning mechanisms of dyspnea are briefly described: "length-tension inappropriateness", vagal afferent activity especially from the J-receptors, and the recent concept of diaphragmatic fatigue. Some specific characteristics of the shortness of breath experienced in certain disease states are described, including chronic bronchitis and emphysema, bronchial asthma, pulmonary fibrosis and congestive heart disease.
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PMID:Dyspnea. 50 81

Disorders of the peripheral vascular system often are associated with heart disease which may increase operative risk. The purpose of this study was to investigate the clinical usefulness of radionuclide angiocardiography for evaluation of cardiac function in patients with vascular disorders. This simple procedure provides measurements of cardiac output, pulmonary blood volume, and left ventricular end-diastolic volume, stroke volume, and ejection fraction with no significant risk or discomfort to the patient. A total of 22 patients with vascular disorders were studied by this technique. Five patients had systemic arteriovenous malformations. The cardiac output, end-diastolic volume, and stroke volume were documented to be greater than normal in these patients before operation. In three patients studied following closure of the arteriovenous fistula, the cardiac output, left ventricular end-diastolic volume, and stroke volume decreased. Postoperative changes in left ventricular ejection fraction were variable. A group of 17 patients with atherosclerotic vascular disease underwent cardiac evaluation. In nine patients with no history of cardiac disease, the lowest ejection fraction of 0.45 occurred in a patient with a saccular thoracic aneurysm, the only patient of the 22 who died after operation. A wide variation in ejection fraction was observed in patients with a history of cardiac disease which ranged from 0.32 to 0.86. Objective documentation of cardiac function by radionuclide angiocardiography would appear to enhance the management of patients with peripheral vascular disorders.
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PMID:Noninvasive radionuclide assessment of cardiac function in patients with peripheral vascular disease. 75 15

Echocardiography is a noninvasive diagnostic tool which has the capacity to provide reliable information on cardiac anatomy and function without risk or discomfort to the patient. The quality and quantity of information obtained in any given study is highly dependent upon the skill of the examiner. The anatomic and physiologic data obtained through its use in the severely ill infant allows immediate separation of infants with serious anatomic cardiovascular defects from those with conditions simulating heart disease. In some cardiac defects the echographic findings are specific enough to allow an accurate diagnosis.
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PMID:Echocardiography: its role in the severely ill infant. 77 82

Relative Cross-sectional area Differences (RCD) and Relative mean Velocity of Contraction (RVC) are easily, quickly and precisely determined by means of impulse-reflected ultrasound. They were recognized to be highly invariant under physiological conditions and thus were considered as sensitively regulated heart-dynamic-parameters. (his paper reports about a total of 395 examinations on patients with myocardial disease and on normal subjects. Various pathogenic factors are included excepting patients with myocardial infarction. In all subgroups there is a decrease of RCD and RVC with increasing degrees of cardiac disease. Correlating the angiocardiographically determined left-ventricular ejection fraction with both parameters, they show a significant linear relationship. Even in clinically latent myocardial disease the echocardiographic parameters are defnitely reduced. Small changes of myocardial function, e.g. under digoxin and in different degrees of uremic heart disease with uremic cardiomyopathy, can be recognized by RCD and RVC under exclusion of extracardiac factors. Physical tests during exercise confirm the observed trends. The typical changes of the echocardiographic parameters in myocardial disease, permitting a sharp discrimination of pathologic values with their small physiological variability, identify RCD and RVC as sensitive parameters of the mechanical function of the myocardium in the range of validity that was examined. The described properties and the lack of discomfort to the patient suggest a number of important indications of this method.
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PMID:[Heart diagnostics using M-mode echography. Continuing registration of transverse internal left ventricular diameters. II. Determination in patients with myocardial insufficiency with special reference to ischemic heart disease]. 100 90

The presence of myocardial involvement is rare in benign Duchenne type of progressive muscular dystrophy (Becker's muscular dystrophy). We describe two brothers suffering from Becker's muscular dystrophy, both of whom presented with dilated cardiomyopathy. The first case is a 39-year-old male who had suffered from gait disturbance from the age of 17. When 37 years old, he was found to have heart disease. When he first came to our hospital, pseudohypertrophy of the calves was present. Chest radiography, electrocardiogram, ultrasonocardiography and clinical feature indicated Becker's muscular dystrophy with dilated cardiomyopathy. The second case is the younger brother of the 37-year old male. He suffered from leg weakness. He came to our hospital with the chief complaint of discomfort of the anterior chest. Pseudohypertrophy of the calves was present. Chest radiography, electrocardiogram, ultrasonogram indicated dilated cardiomyopathy.
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PMID:[The two brothers' case of dilated cardiomyopathy with benign Duchenne type of progressive muscular dystrophy (Becker's type)]. 157 Apr 30

Mitral valve prolapse is a common cardiac disorder that can readily be diagnosed by characteristic auscultatory and echocardiographic criteria. Although many diseases have been associated with mitral valve prolapse, most affected individuals have the primary form of the disorder. Mitral valve prolapse is an inherited condition commonly associated with myxomatous degeneration of the mitral valve and its support structures. Complications of mitral valve prolapse, including cardiac arrhythmias, sudden death, infective endocarditis, severe mitral regurgitation (with or without chordae tendineae rupture), and cerebral ischemic events, occur infrequently considering the wide prevalence of the disorder. Panic disorder is a specific type of anxiety disorder characterized by at least three panic attacks within a 3-week period or one panic attack followed by fear of subsequent panic attacks for at least 1 month. It too is a common condition with a prevalence and age and gender distribution similar to that of mitral valve prolapse. Panic disorder and mitral valve prolapse share many nonspecific symptoms, including chest pain or discomfort, palpitations, dyspnea, effort intolerance, and pre-syncope. Chest pain is the symptom in both conditions that most commonly brings the patient to medical attention. The clinical description of chest pain in patients with mitral valve prolapse is highly variable, possibly reflecting multiple etiologies. Chest pain in panic disorder is usually characterized as atypical angina pectoris and as such bears resemblance to the chest pain commonly described by patients with mitral valve prolapse. Multiple investigative attempts to elucidate the mechanism of chest pain in both conditions have failed to identify a unifying cause. Review of the literature leaves little doubt that mitral valve prolapse and panic disorder frequently co-occur. Given the similarities in their symptomatology, a high rate of co-occurrence is, in fact, entirely predictable. There is, however, no convincing evidence of a cause-effect relationship between the two disorders, nor has a single pathophysiologic or biochemical mechanism been identified that unites these two common conditions. Until specific biologic markers for these disorders are identified, it may be impossible to do so. The lack of a proven cause-and-effect relationship between mitral valve prolapse and panic disorder and the absence of a unifying mechanism do not diminish the clinical significance of the high rate of co-occurrence between the two conditions. Primary care physicians and cardiologists frequently encounter patients with mitral valve prolapse and nonspecific symptoms with no discernible objective cause who fail to respond to beta-blockade. Panic disorder should be considered as a possible explanation for symptoms in such patients.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Mitral valve prolapse, panic disorder, and chest pain. 189 9

Pre-test probability for coronary artery disease can readily be determined using the patient's history, risk profile and resting ECG. The present study shows that this can be reliably done for both sexes. With pre-test probability of greater than 70% relevant coronary stenoses were found in both sexes in approximately 90%. With pre-test probability values of less than 60% this was only true in 20%. There seems to exist, however, a subgroup of female patients with rather atypical complaints but causing severe discomfort, showing normal coronary arteries it angiography. In these, subsequent myocardial metabolic studies and/or myocardial biopsy may reveal certain anomalies. Normal coronary arteries in women with chest pain therefore do not exclude any cardiac disorder. However the diagnoses to be expected from these sophisticated methods bear no consequences in terms of therapy. From a pragmatic point of view, therefore, it is suggested (for both sexes) to use pre-test probability in the selection for coronary angiography in order to detect organic coronary stenoses that can be managed by adequate treatment.
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PMID:[Significance of the anamnesis in women suspected to have coronary heart disease]. 203 36

It is now recognized that dietary carbohydrate components influence the prevalence and severity of common degenerative diseases such as dental problems, diabetes, heart disease and obesity. Fructose and sucrose have been evaluated and compared to glucose using glucose tolerance tests, but few such comparisons have been performed for a "natural" sugar source such as honey. In this study, 33 upper trimester chiropractic students volunteered for oral glucose tolerance testing comparing sucrose, fructose and honey during successive weeks. A 75-gm carbohydrate load in 250 ml of water was ingested and blood sugar readings were taken at 0, 30, 60, 90, 120 and 240 minutes. Fructose showed minimal changes in blood sugar levels, consistent with other studies. Sucrose gave higher blood sugar readings than honey at every measurement, producing significantly (p less than .05) greater glucose intolerance. Honey provided the fewest subjective symptoms of discomfort. Given that honey has a gentler effect on blood sugar levels on a per gram basis, and tastes sweeter than sucrose so that fewer grams would be consumed, it would seem prudent to recommend honey over sucrose.
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PMID:Differential effects of honey, sucrose, and fructose on blood sugar levels. 200 97

The effects of two potent vasodilating drugs, captopril (C) (25 mg tid), nicardipine (N) (20 mg tid), and placebo (P) were evaluated and compared, in 10 men (mean age of sixty-five years) with intermittent claudication from moderate to severe multilevel chronic occlusive arterial disease (COAD) of the lower extremity, by use of the Doppler ultrasonic method, at rest and after Carter's exercise test. All the examined subjects were normotensive, without diabetes or cardiopathy; all have been smokers. The eight-week total protocol consisted of an initial two-week placebo run-in period followed by two active drug phases and a two-week placebo phase, according to a double-blind, randomized, crossover design. At the end of each two-week period, ankle-arm index (AAI) and, following exercise, onset of lower extremity discomfort time (ODT), duration of exercise (ET), decrease of ankle systolic pressure after test (APD), and recovery time (RT) were determined. Moreover, at rest, just after exercise, and after recovery, simultaneous common femoral artery velocity waves were recorded and analyzed by a quantitative approach to detect the peripheral vasomotor adjustments. None of the patients required the withdrawal of the active treatments. Compared with P, C significantly reduced APD and RT, and N reduced RT and AAI; furthermore N caused a significant decrease in ODT, whereas C showed a trend, although not statistically significant, to increase ODT. Neither active therapy modified ET. These results suggest that C and N have different short-term effects on peripheral circulation in COAD. During exercise, C induces hemodynamic improvement in the ischemic lower extremity probably by inhibition of the sympathetic system and consequent reduction in collateral vessel vasoconstriction.
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PMID:Assessment of captopril and nicardipine effects on chronic occlusive arterial disease of the lower extremity using Doppler ultrasound. 305 83


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