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)

Secondary erythrocytosis of cyanotic congenital heart disease (CCHD) is pathologically different from primary erythrocytosis of polycythemia vera (PV). An association between elevated hematocrit and thrombosis has been established in PV patients, and treatment guidelines recommend maintaining hematocrit <45%. Although an association between elevated hematocrit and thrombosis has not been established in CCHD and secondary erythrocytosis, the current clinical practice is to phlebotomize these patients to hematocrit <65%. We report a 21-year-old woman with CCHD who presented with symptomatic erythrocytosis with numbness and tingling with hemoglobin 25.2 g/dl and hematocrit 75.8%. Her symptoms resolved with IV hydration. Other factors, including dehydration and iron deficiency, may precipitate hyperviscosity symptoms. The treatment is volume replacement and low-dose iron therapy, not phlebotomy. Repeated phlebotomy causes iron deficiency with microcytic erythrocytes, which increases the whole blood viscosity and, therefore, can potentially accentuate rather than decrease the risk for a cerebrovascular accident.
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PMID:Cyanotic congenital heart disease (CCHD) with symptomatic erythrocytosis. 1791 83

The incidence of fungal endocarditis is increasing. While the pathogenic mechanisms are not fully understood, infection is associated with underlying heart disease and is most often attributable to Candida species. Candidal endocarditis complications include heart damage, inflammation, and emboli with resulting ischemia and tissue death. Candidal endocarditis is difficult to diagnose as blood cultures are often negative. Treatment includes surgical intervention and antifungal therapy. This case study describes a 41-year-old female complaining of acute onset of pain with numbness and tingling in both lower extremities. Prior history was significant for mycotic valve aneurysm and replacement secondary to culture-negative endocarditis. Evidence of limb-threatening ischemia led to a bilateral thrombectomy. During the thrombectomy white debris, later identified as Candida albicans, was encountered. A transesophogeal echocardiogram revealed a pedunculated mass which was determined to be the source of infection. The patient was placed on micafungin and voriconazole and discharged with a diagnosis of C. albicans fungal infection with descending aorta fungal mass. This case study illustrates an unusual presentation of candidal endocarditis with discussion of disease epidemiology, pathogenesis, diagnosis, and treatment.
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PMID:Candidal endocarditis presenting with bilateral lower limb ischemia. 2295 12

Transient ischaemic attack (TIA) produces brief stroke-like symptoms due to temporary disruption of blood to the brain. It is characterised by focal symptoms, specific to one location or function, lasting less than 24 hours. TIAs are a warning sign that the individual is at risk of a stroke or myocardial infarction and national stroke guidelines recommend assessment at a neurovascular clinic within seven days. They are most severe at onset and gradually resolve. Symptoms usually involve loss of movement, speech or sensation rather than positive symptoms such as pins and needles. Despite the short duration of symptoms, ignoring the episode can have serious consequences. Risk of stroke is 8 per cent in the first seven days after a TIA and 12 per cent in the first month but the most likely cause of death post TIA is heart disease. The high level of risk means that patients should not drive during the month following a TIA.
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PMID:TIA offers a warning sign that a stroke may be on its way. 2773 79