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

Percutaneous transluminal angioplasty (PTA), already widely used in stenosis of peripheral, renal or coronary arteries, has now been extended to congenital heart diseases. Thus, in pulmonary or aortic orificial stenosis this simple and fairly safe method has proved to be a suitable alternative to surgery. In other cases it may be used for tiding the patient over a critical period pending surgery. Finally, PTA may be performed as a palliative treatment of lesions that are too complex for surgery or carry an excessively high operative risk. This applies to the two cases reported here, where PTA enabled us to dilate: the ductus arteriosus in a patient with single ventricle--an application which, to our knowledge, has not yet been reported--and a strongly stenotic pulmonary orifice associated with a complex heart disease. In both cases PTA was successful both haemodynamically and angiographically and was followed by marked clinical improvement. The published cases of complex congenital heart diseases where PTA has been used are reviewed.
Arch Mal Coeur Vaiss 1987 Apr
PMID:[Percutaneous transluminal angioplasty in complex congenital cardiopathies. Apropos of 2 cases]. 295 33

Trisomy 21 accounts for 3 p. 100 of reasons for admission to the Paediatric Cardiology unit of the St Luc University Clinics, Brussels. In a series of 142 cardiac children with trisomy 21 evaluated by catheterization between 1969 and 1987, 54 p. 100 of the cardiac malformations observed consisted of persistent common atrioventricular canal (complete in 45 p. 100 of the cases). The other heart diseases were ventricular septal defect (23 p. 100), atrial septal defect of the ostium secundum type (10 p. 100) and tetralogy of Fallot (9 p. 100). In 40 p. 100 of the patients other cardiovascular abnormalities were associated with these predominant intracardiac shunts. These findings were in agreement with those usually reported in the literature. At the time of investigation (mean age 24 months), pulmonary vascular resistance had already reached a pathological level in 88 p. 100 of the cases. Oxygen tests only slightly improved these results, which suggested that the conditions were favourable to the early development of a pulmonary obstructive vascular disease in Down's syndrome, thus darkening the prognosis of congenital heart disease in mongoloid children. In this series to overall mortality rate of corrective surgery was 23 p. 100. The risk was maximum in infants aged less than 3 months with severe and rapidly symptomatic lesions. The outcome in patients successfully operated upon was satisfactory, with benign residual lesions.(ABSTRACT TRUNCATED AT 250 WORDS)
Arch Mal Coeur Vaiss 1988 May
PMID:[Congenital heart diseases and obstructive pulmonary vascular diseases in Down's syndrome. Apropos of 142 children with trisomy 21]. 297 Feb 49

Right ventricular systolic pressure is an important parameter in paediatric cardiology. A critical haemodynamic situation is attained if it exceeds the systemic pressure: strain proximal to severe pulmonary stenosis or the result of pulmonary hypertension. In these circumstances, the patient must be closely followed up at the least, and appropriate treatment, often surgical, has to be instituted. Ambulatory methods of assessing this parameter are either unreliable, like the surface electrocardiogram, or relatively complex, like certain ultrasonic methods. We therefore looked for a method relating the systolic pressures of the two ventricles and the end systolic geometry of the left ventricle as assessed simply from a short axis view of the left ventricle at the level of the junction between the chordae and papillary muscles. Two orthogonal diameters are measured and the ratio of the two dimensions calculated: this ratio which we call the "septal curvature" reflects left ventricular compression by the pressure that the right ventricle exerts through the interventricular septum. Seventy-two children aged 6 hours to 18 years (average 5.2 years) hospitalised for pre or post-operative investigation of congenital heart disease were evaluated by this method. The results were compared by statistical analysis with the ratio of ventricular pressures measured directly almost simultaneously during cardiac catheterisation. In general, a linear relation was observed between septal curvature (x) and ratio of pressures (y); y = 0.88, x - 0.63 and R = 0.92.(ABSTRACT TRUNCATED AT 250 WORDS)
Arch Mal Coeur Vaiss 1986 May
PMID:[Evaluation of the systolic pressure of the right ventricle by echocardiographic study of left ventricular geometry]. 309 70

The preliminary results of our experience with the "inverted" subxiphoid approach for 2D echocardiographic visualisation of patent ductus arteriosus (PDA) in premature neonates and infants are reported. Eight premature ventilated neonates weighting 870 to 1,200 g with an isolated PDA were examined by this technique using a mechanical sector scanner and a 7.5 MHz transducer; three views were obtained (left ventricular outflow tract or "long axis"; an oblique view through the two atria and aortic arch; short axis view of the ventricles). A PDA was directly visualised in 6 of the 8 patients. It was possible to measure its diameter and observe its tortuous or rectilinear trajectory; the outcome of Indomethacin therapy or surgical ligature could also be evaluated. In the 2 patients in whom the PDA was not visualised, there were no clinical symptoms or echocardiographic signs of shunt: these PDA were therefore probably extremely small. In the neonate and infant, it is relatively easy to demonstrate a PDA by this approach. The PDA can also be followed up in "ductus dependent" congenital heart disease during treatment with Prostaglandin E. In conclusion, the subxiphoid approach represents an interesting alternative for the visualisation of PDA, especially in premature neonates in whom the suprasternal and parasternal views are often difficult to obtain.
Arch Mal Coeur Vaiss 1986 May
PMID:[Value of the subxiphoid approach in 2-dimensional echocardiography for the diagnosis of ductus arteriosus in premature infants and infants]. 309 73

A 72 year old woman was admitted with decompensation of a hypertensive cardiopathy and treated with diuretics. She developed recurrent syncopal torsades de pointes during the 24th hour which were reduced by a bolus intravenous injection of 3 g of magnesium sulphate (Mg SO4). There was a recurrence 30 minutes later which regressed after a second injection of 3 g of Mg SO4. A continuous intravenous infusion of 18 g/day of Mg SO4 prevented further recurrences of the arrhythmia. Biochemical analysis showed intra and extracellular magnesium deficiency at the time of the torsades de pointes but the intracellular potassium was normal. The QT interval was prolonged but this parameter did not change after the bolus of Mg SO4. It returned to normal progressively afterwards. The clinical course was uncomplicated with no recurrences. Metabolic correction was obtained in 3 days. This observation raises the question of the mechanisms relating diuretic therapy, magnesium and torsades de pointes.
Arch Mal Coeur Vaiss 1986 Jun
PMID:[Treatment of torsade des pointes by intravenous magnesium]. 309 33

24-h ECG recordings were studied in 60 patients suffering from salvos of repetitive ventricular tachycardia (VT), in order to determine the parameters affecting the repetitive response in ventricular arrhythmias. The tracings were analysed with the use of ATREC II system allowing the systematic study of 15 RR intervals and the heart rate in the 3 min preceding each type of event. The mean number of events taken into account per patient and per 24h of recording amounted to 673 +/- 521 for isolated ventricular extrasystoles, to 568 +/- 461 for paired ventricular extrasystoles and 435 +/- 810 for bursts of VT. The whole group was divided into two groups according to the absence (A) or presence (B) of associated cardiopathy. Group A included 30 patients with a mean age of 42 +/- 17 years, group B included 30 patients with a mean age of 42 +/- 17 years, group B included 30 patients with a mean age of 57.4 +/- 12 years. Three major factors responsible for the repetitive activity could be disclosed: The heart rate preceding isolated ventricular extrasystoles was lower than that preceding the salvos of VT (p less than 0.01) the duration of which increased in a linear way with the sinus rate; Duration of the cycle preceding the last sinus beat before the bursts (long duration in 77% in group A and in 57% in group B). In 60% of cases in group A and 40% in group B the coupling interval was all the more long as the response was repetitive.(ABSTRACT TRUNCATED AT 250 WORDS)
Arch Mal Coeur Vaiss 1986 Sep
PMID:[Determining factors of the repetitive bursts in ventricular tachycardia]. 309 77

In a retrospective series of 960 cases of tricuspid regurgitation studied by two-dimensional echocardiography 6 patients presented a systolic defect of valvular coaptation. The origin of this defect varied: one case was due to carcinoid, two to rheumatic cardiopathy, two to papyraceous right ventricle and one to sclerodermia associated with pulmonary arterial hypertension. The mechanism of the lacking coaptation varies according to the etiology: valvular retraction in carcinoid cardiopathy, right-ventricle dilatation, dilatation of the tricuspid ring and altered kinetics of the right ventricle in the other cases. Changed contractility of the right ventricle is the only element allowing to distinguish tricuspid regurgitation with and without a coaptation defect. Clinically this abnormality always points to an advanced stage of severe tricuspid regurgitation.
Arch Mal Coeur Vaiss 1986 Sep
PMID:[Major tricuspid insufficiency and absence of systolic valvular coaptation. Echocardiographic study. Apropos of 6 cases]. 309 83

The diagnostic value of magnetic resonance imaging (MRI) was assessed in 30 patients with congenital heart disease, including 7 patients with postoperative sequellae. The images obtained by synchronizing the MRI spectrometer with the electrocardiogramme were recorded in 2 or 3 different planes (sagittal, frontal and transverse) and compared to clinical, angiographic and/or echocardiographic data. The MRI provided high resolution tomographic images enabling spatial reconstitution of the heart by the use of different planes. These images were particularly useful for showing the position and dimensions of the ventricles (both chamber size and wall thickness) and their relationship to the atria and great vessels. These results confirm the value of this new non-invasive imaging technique in the diagnosis of congenital heart disease, not counting the additional information on blood flow and tissue characterisation that will soon become available.
Arch Mal Coeur Vaiss 1986 Oct
PMID:[The contribution of magnetic resonance imaging in congenital heart diseases]. 310 66

There are relatively few reported studies of continuous electrocardiographic recordings by the Holter method in children. We report our experience of 296 24-hour recordings in 160 patients (average age 10.5 years), investigated for suspected or known cardiac arrhythmias. One hundred and ten patients (68.75%) had no organic heart disease and 6 patients (3.75%) had acquired lesions. Eighty-three patients (52%) were symptomatic. Sixty-three patients (39%) had normal recordings; 97 patients (61%) had a total of 126 arrhythmias. There were 45 cases of atrioventricular block, 24 cases of sinus node dysfunction, 39 cases of supraventricular arrhythmias and 18 cases of ventricular arrhythmias. Overall, 47.6% of these rhythm disturbances were diagnosed by Holter monitoring. This technique was particularly valuable in the diagnosis of arrhythmias in symptomatic patients, patients with arrhythmogenic cardiac lesions and in the detection and surveillance of postoperative arrhythmias in congenital heart disease, of pacemakers, of congenital atrioventricular block and of the chronic arrhythmias of childhood.
Arch Mal Coeur Vaiss 1986 Oct
PMID:[Continuous electrocardiographic recording with the Holter method in children. Indications and results]. 310 70

The authors report two unusual new cases of corrected transposition of the great arteries diagnosed in patients 72 and 80 years of age respectively, presenting with symptoms of cardiac failure of recent onset. Both patients had mild or moderate regurgitation of the systemic atrio-ventricular valve, associated in one case with aortic regurgitation. This association would appear to be fortuitous although already reported in six occasions. The diagnosis was made by echocardiography and confirmed by catheterisation in one case, and by digitised intravenous angiography in the other. These cases are of interest for three reasons: They are very rare: there have been only 20 comparable cases reported in patients over 40 years of age, the eldest being 73. This is probably explained by the high frequency of associated malformations. They illustrate the decisive role of echocardiography in the diagnosis of congenital heart disease, even in the adult. They constitute a "natural experimental model" of a right ventricle submitted to systemic pressures and tend to show that, in the absence of other abnormalities giving rise to an additional pressure or volume overload, the right ventricle is capable of long term adaptation to this situation. These observations indicate a favourable long-term prognosis for children who have undergone "corrective" surgery at atrial level for simple transposition and in whom the right ventricle is required to assume the function of the systemic ventricle for the rest of their life.
Arch Mal Coeur Vaiss 1986 Oct
PMID:[Corrected transposition of the great vessels in aged adults. Apropos of 2 patients aged 72 and 80]. 310 74


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