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)

Intravenous isosorbide-5-mononitrate (IS-5-MN) was administered to 24 patients, mean age 73, with severe respiratory distress after pulmonary edema and acute left heart failure. The condition was due to ischemic cardiopathy in 18 patients (4 with acute myocardial infarctions), congestive cardiomyopathy in 3, hypertensive cardiopathy in 2, and mitral valvular disease in 1. Therapy consisted of an intravenous (i.v.) bolus dose of IS-5-MN, followed by a continuous infusion (mean 8 mg/hour over 24 hours) of i.v. furosemide and additional oxygen. Clinical data were recorded as well as blood gas values and repeated chest radiographs. All patients survived and improved markedly; only 6 needed mechanical ventilation. Most patients had fast respiratory relief, with no untoward reaction, except a brief decrease of blood pressure in a ventilated patient taking morphine. These data indicate that i.v. IS-5-MN is effective and safe for the management of severe acute cardiogenic pulmonary edema.
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PMID:Emergency treatment of severe cardiogenic pulmonary edema with intravenous isosorbide-5-mononitrate. 334 37

Various types of pulmonary venous return abnormalities have been described in the literature. This report presents a case in which a 4-h-old neonate presented with cyanotic heart disease and respiratory distress. This neonate was subsequently shown to have complete absence of the pulmonary veins (CAPV), a previously undescribed malformation. The case summary describes the physical findings, radiographic and electrocardiographic features, cardiac catheterization data, and results from autopsy. A discussion of the case, theories of embryological etiology for this malformation, and differential diagnoses follow. Surgical treatment for CAPV is not yet possible.
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PMID:Complete absence of pulmonary veins. 336 80

In this study, ultrasound Doppler color flow mapping systems were utilized to examine flow in the pulmonary artery in 31 premature and term infants (aged 4 hours to 9 months) with patent ductus arteriosus accompanying respiratory distress syndrome, as an isolated lesion, or with patent ductus in association with other cyanotic or acyanotic congenital heart disorders. The flow mapping patterns were compared with those of a control population of 15 infants who did not have patent ductus arteriosus. In unconstricted ductus arteriosus, the flow from the aorta into the pulmonary artery was detected in late systole and early diastole and was distributed along the superior leftward lateral wall of the main pulmonary artery from the origin of the left pulmonary artery back in a proximal direction toward the pulmonary valve. In constricted patent ductus arteriosus, or especially in a ductus in association with cyanotic heart disease, the position of the ductal shunt in the pulmonary artery was more variable, often directed centrally or medially. Waveform spectral Doppler sampling could be performed in specific positions guided by the Doppler flow map to verify the phasic characteristics of the ductal shunt on spectral and audio outputs. Shunts through a very small patent ductus arteriosus were routinely detected in this group of infants, and right to left ductal shunts could also be verified by the Doppler flow mapping technique. This study suggests substantial promise for real-time two-dimensional Doppler echocardiographic flow mapping for evaluation of patent ductus arteriosus in infants.
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PMID:Real-time Doppler color flow mapping for detection of patent ductus arteriosus. 353 Dec 87

Prior to echocardiography, the recognition of serious heart disease in the cyanotic newborn or young infant could be extremely difficult. The profound hemodynamic changes taking place in the heart and lungs after birth influence the clinical manifestations of many cardiac disorders, and sometimes suggest the existence of a cardiac disorder when none is present. Real time echocardiography has revolutionalized the diagnosis of the cyanotic infant. If the reason for the infant's cyanosis or respiratory distress is not apparent from the history, physical examination, laboratory values, and chest radiograph; real time echocardiography should be performed to exclude or diagnose cyanotic congenital heart disease and persistent fetal circulation. This will prevent misdiagnosis in cyanotic infants and assure rapid and appropriate treatment.
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PMID:Radiologic and real time echocardiographic evaluation of the cyanotic newborn. 368 8

A malformed male neonate with partial trisomy 15q dist (q22----qter), because of malsegregation of a balanced translocation (7; 15) (p22; q22) in his mother, is described. Comparison of this patient with thirteen previously published cases of this trisomy reveals a pattern of common features including: peculiar craniofacial dysmorphism--facial asymmetry, antimongoloid slant, narrow or short palpebral fissures, prominent nose, long upper lip, micro or retrognathia, high arched palate, low set ears, malformed ears, protuberant occiput--, abnormal fingers and toes, short neck, mental and growth retardation, cardiopathy, respiratory distress etc.. The main clinical findings seem to be similar enough to justify the establishment of a new entity of partial trisomy 15q dist syndrome.
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PMID:Partial trisomy for the distal part of the long arm of chromosome 15--a new syndrome? 373 22

To define settings in which use of prostaglandin E1 before transfer from a community hospital to a tertiary care center benefits neonates with possible heart disease, information theory was used to predict the probability of a favorable response to prostaglandin therapy from the limited information of clinical variables. Records of 250 patients, newborn to 7 days old, with suspected heart disease were reviewed to assess six clinical variables (cyanosis, respiratory distress, heart murmur, pulse contour, hepatomegaly and prematurity). According to the anatomic and hemodynamic cardiovascular condition, each case was categorized as to whether a favorable response to prostaglandin E1 could be anticipated. Information content of each clinical variable with respect to prostaglandin responsiveness was determined, and patients were classified according to the most informative clinical variable. Stepwise extraction of information proceeded until remaining clinical variables added no significant information. Bayes' rule gave estimates of probability of prostaglandin-responsive defect in final subgroups for use in decision analysis. Cyanosis, murmur, small volume pulses and prematurity gave information about prostaglandin-responsive defects. Decision analysis indicated that frequency of poor outcome is minimized by early prostaglandin treatment of cyanotic term infants with a murmur or poor pulses, regardless of how ill they appear, and by treating any critically ill term newborn who has either cyanosis or poor pulses. Acyanotic patients with normal pulses are best untreated with prostaglandin until after definitive diagnosis is made. Advantage to either course was not seen in some small subgroups. Information theory with decision analysis is a rigorous approach to identify relevant clinical variables and define their roles in critical decisions in pediatric cardiology.
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PMID:Application of information theory to decision analysis in potentially prostaglandin-responsive neonates. 376 Mar 86

Two infants with pulmonary atresia are presented, wherein a large, vertically oriented patent ductus arteriosus, acting as the only source of pulmonary blood supply, compressed the left bronchus, causing significant respiratory distress. Hyperinflation of the left lung was the clue to this circumstance. After bronchographic confirmation, surgical repair was accomplished by placement of aortopulmonary shunts and division of the patent ductus. Other causes of airway compression in congenital heart disease are briefly reviewed. The embryology of the ductus arteriosus is discussed, emphasizing its anatomic configuration and physiologic role in pulmonary atresia.
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PMID:Bronchial compression by a patent ductus arteriosus associated with pulmonary atresia. 387 62

Catheterization of the umbilical artery is a common procedure in neonatal intensive care units. The authors studied the records of 100 consecutive newborns who underwent this procedure to review the indications for and complications of umbilical artery catheterization and to discuss preventive measures and alternative techniques. Only polyvinylchloride barium-impregnated catheters were used (nos. 3.5 and 5.0 French). The commonest indications were respiratory distress syndrome, asphyxia and congenital heart disease. Of the 100 infants, 75 weighed less than 2500 g. Ampicillin and calcium were the commonest medications infused (70 and 65 babies respectively). There were three major complications, two of which were gangrene of the lower extremity. Amputation of the foot was necessary in one and amputation of the toes in the other. The third complication was the development of gluteal necrosis. In all three cases, catheter placement was low and the infusion was ampicillin. In two of the babies, calcium was also administered. Minor complications were seen in 32 cases, with vascular spasm in the lower limb being the most common. All catheter tips were cultured; there was bacterial colonization in 13%, Staphylococcus epidermidis being the commonest organism. Proven necrotizing enterocolitis was seen in eight infants and was suspected in eight others. Blanching is a serious sign and was seen in the three infants with major complications. The infusion should be stopped immediately. When necrotizing enterocolitis is suspected, the catheter should be removed.
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PMID:Catheterization of the umbilical artery in neonates: surgical implications. 397 Dec 40

Blood gas and acid base values in cord blood are not predictive for neonatal cardiopulmonary adaptation on the extrauterine life. The oxygen-cardiorespirography shows objectively the state of adaptation. By this monitoring beat-to-beat heart rate, respiratory rate, thoracic impedance and the transcutaneous PO2 are measured. 16 of 337 newborns had severe cardiopulmonary problems (11 respiratory distress, 5 congenital heart disease), which was seen in at least one of the parameters. In 10 of 16 infants a pathological pattern was recognized by oxygen-cardiorespirography before clinical symptoms appeared. Additional information can be given by the hyperoxia test to differentiate healthy and sick newborns (respiratory problems and congenital heart disease). With two tcPO2-electrodes fixed on the thorax and abdomen, the shunt through an open ductus arteriosus can be estimated by different values.
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PMID:[Non-invasive monitoring of the cardiopulmonary status of newborn infants immediately following birth]. 399 Jan 52

The liver in children contains a greater amount of connective tissue in relation to parenchymal tissue than in adults and there is often more in the left than in the right lobe. Livers from 150 children who died between birth and 12 years of age, under different circumstances, were studied.The findings suggested that hypoxia was an important factor leading to increase in fibrous tissue in children's livers. Children who had cyanosis at birth and prolonged hypoxia associated with pathological conditions showed the highest ratio of connective tissue to liver parenchyma. The predominant non-hepatic lesions found were cyanotic congenital heart disease, coarctation of the aorta, acute respiratory distress, congenital malformation of the central nervous system, and shock after abdominal surgery.
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PMID:Hypoxia and asymmetrical fibrosis of the liver in children. 473 3


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