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

Nurses caring for the patient with CAD are most effective when they recognize that many factors affect psychosocial adjustment to heart disease, with age and gender as two prominent influences. Likewise, spouses of patients with CAD require special attention and assessment so that their caregiving and recovery from a cardiac-related event is successful. Caregiving spouses have been found to have more mood disturbance, less satisfaction with marriage and family, and lower levels of social support than patients, suggesting that attention to their concerns is paramount.
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PMID:Psychosocial adjustments of coronary artery disease patients and their spouses: nursing implications. 154 93

As of October 1989, over 560 patients with end-stage heart disease have received heart transplants at Stanford. In addition, 70 patients have received heart-lung transplants (H-L Tx) and 5 patients received single-lung transplants for end-stage pulmonary disease. Cyclosporine A (CsA) significantly improved survival, especially during the first posttransplant year. All patients now receive maintenance CsA, prednisone (P), and azathioprine (AZA). Fourteen-day prophylactic OKT3 significantly reduces early rejection after heart transplantation. One-year survival for cardiac transplants is 82% using CsA and 73% for our recent H-L Tx group. All 5 patients are alive after single-lung transplantation. Children with heart transplants and patients bridged to transplant with a Novacor ventricular assist system have a 1-year survival rate similar to routine heart transplant patients. Beyond the first year, heart transplant mortality continues at 5% per year. Transplant coronary artery disease (Tx CAD) accounts for 33% of the mortality, and other patients require retransplantation for Tx CAD. Cytomegalovirus contributes to the development of TX CAD and antiviral agents are being used for the early treatment of CMV infections. Cytomegalovirus is also thought to contribute to obliterative bronchiolitis (OB), the late complication that threatens H-L Tx patients. Surveillance bronchoscopy and pulmonary function tests can be used to detect early lung infection and rejection. Hopefully this will lead to improved late graft function. Future immunosuppressive efforts will be directed toward decreasing the morbidity and mortality after the first year in both heart and lung transplant patients.
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PMID:Heart and heart-lung transplantation: the Stanford experience. 248 25

Myocardial perfusion scintigraphy with 201-TL was performed in a group of subjects affected by exercise-induced, rate-dependent left bundle branch block (LBBB). The aim of the study was: to define the significance of the exercise-induced conduction abnormality: "primitive" or "ischemic". 14 patients, aging 28-58 years (x = 42), 8 with chest pain (4 typical angina, 4 atypical angina) and 6 without any symptoms were studied. None had history of prior myocardial infarction or clinical and echocardiographic signs of heart disease. LBBB appeared at a heart rate ranging from 70 to 160 beats/min. 6 patients showed repolarization abnormalities (ST changes, deep and negative T wave) suggestive for ischemia, during successive QRS normalization. 201-TL-uptake was normal in 5 subjects; in the remaining 9 ones reversible TL defects were demonstrated in the septum (6), in the septum and apex (2), in the septum and inferior-apical wall (1). No patients had irreversible impaired perfusion. All the patients had normal coronary angiography, with negative ergonovine test for coronary artery spasm. In conclusion, in the majority of our subjects (64%) with exercise-induced LBBB, a reversible TL-uptake defect, usually located in the septum without diagnostic value of obstructive CAD, has been observed. Further studies will establish if the TL-defect is only an "apparent phenomenon" due to contraction abnormality secondary to LBBB, or, on the contrary, an expression of myocardial ischemia with normal coronary vessels as a consequence of the LBBB.
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PMID:[Study of myocardial perfusion by means of scintigraphy with thallium-210 in left bundle branch block induced by exertion]. 366 78

This article reviews the clinical features of heart disease in the diabetic in three categories: (1) coronary atherosclerosis (CAD), (2) autonomic neuropathy, and (3) cardiomyopathy. Particular attention is given to current methods of noninvasive assessment of cardiac function in juvenile diabetics.
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PMID:Juvenile diabetes and the heart. 637 92

This article reviews the clinical features of heart disease in the diabetic in three categories: (1) coronary atherosclerosis (CAD), (2) autonomic neuropathy, and (3) cardiomyopathy. Particular attention is given to current methods of noninvasive assessment of cardiac function in juvenile diabetics.
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PMID:Exercise and the patient with Type I diabetes mellitus. 672 29

Visualization of the lumen of the coronary arteries by angiography has greatly expanded the ability of the physician to evaluate the extent of disease in patients suspected of having an ischaemic cardiac disorder. Criteria for coronary angiography have been developed in part by reviewing the experience in the Coronary Artery Surgery Study, CASS. During a five year period at 15 participating sites 24959 consecutive patients undergoing angiography for suspicion of coronary artery disease were enrolled. Chest pain was the dominant symptom in more than 80%. Unstable angina occurred in more than 1/3 of patients classified as definite or probably angina pectoris. The majority of patients were in Canadian Class 2,3. In a study previous reported by CASS a mortality of 002 and a morbidity (myocardial infarction) of 003 was found; presence of left main disease increased mortality 6.8 times. In males, 79% had significant and 12% no CAD; left main disease occurred in 9%. In females 45% had significant and 40% no CAD; left main disease occurred in 4%. The distribution of 1,2 and 3 vessel disease will be presented. From these data and a survey of clinical experience during the past several years, 10 indications for visualization of the coronary artery anatomy by angiography have been developed. These indications are presented for discussion.
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PMID:[Indications for coronary arteriography]. 706 86

Hemodynamic and metabolic studies were performed in 15 patients without heart disease (controls, group A), in 21 patients with typical stress-induced anginal pain but normal coronary and left ventricular angiograms (angina pectoris with normal arteriogram, group B), and in 10 patients with angiographically proved coronary artery disease (CAD, group C). Coronary dilatory capacity, determined by measuring total myocardial blood flow at rest and during maximal coronary vasodilatation (dipyridamole, 0.5 mg/kg i.v.), was markedly reduced in group B and C patients. In group B patients, left ventricular catheter biopsy specimens revealed no evidence of small-vessel disease, but did show histologic alterations of mitochondria. During atrial pacing, the control subjects showed no changes in myocardial lactate uptake, whereas in group B patients, myocardial lactate production occurred. In contrast to controls, patients in group B showed a significant decline in ejection fraction and circumferential fiber shortening during isometric exercise. These findings suggest that myocardial ischemia is the cause of angina pectoris in patients who have angina but normal coronary arteriograms.
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PMID:Reduced coronary dilatory capacity and ultrastructural changes of the myocardium in patients with angina pectoris but normal coronary arteriograms. 747 37

RNA has clinical applications in virtually all forms of acquired heart disease and is also useful in the detection and quantitation of congenital left-to-right shunts. The method has achieved widespread acceptance for the qualitative and quantitative assessment of systolic ventricular function. It is also particularly well suited for identifying abnormal diastolic filling patterns typical of hypertrophic and ischemic heart diseases. To date, no single variable from any noninvasive or invasive procedure has been shown to have greater prognostic importance than the radionuclide exercise ejection fraction in patients with CAD.
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PMID:Radionuclide angiography. 795 Jan 75

Our purpose was to assess the efficacy and safety of intravenous ATP for the acute termination of paroxysmal supraventricular tachycardia. There were 14 women and 10 men, aged 38 +/- 15 years. Three patients had evidence of structural heart disease (Ebstein's anomaly associated to atrial septal defect, operated mitral stenosis with insertion of a mechanical heart valve and CAD respectively). Twelve patients had Wolff-Parkinson-White syndrome and another had undergone surgical ablation of an accessory pathway. At the time of electrophysiologic testing, ATP was administered during episodes of paroxysmal supraventricular tachycardia, via a central vein, in incremental doses of 5, 10 and 20 mg followed by a flush of 10 c.c. of isotonic saline. The mechanism of the arrhythmia was orthodromic AV reentrant tachycardia in 19 (79%), AV nodal reentrant tachycardia in 4 (16.6%) and atrial tachycardia in one patient. The mean frequency of the tachycardia was 174 +/- 33 b.p.m. A dose of 5 mg was effective in 16 patients (66%), 5 required 10 mg and two required 20 mg for termination of the tachycardia. In the patient with atrial tachycardia ATP was not effective. The average time after injection to termination of the arrhythmia was 16 +/- 8 seconds. Orthodromic AV reentrant tachycardia was interrupted in the AV node limb in all but one patient and AV nodal reentry was terminated in the "slow-pathway" in three of the four patients. Nine patients had premature ventricular complexes, isolated or in couplets, after the termination of the SVT. Three patients had immediate recurrence of the SVT.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Efficacy and safety of adenosine triphosphate in the control of supraventricular paroxysmal tachycardia]. 804 86

The average Korean diet is low in total fat, cholesterol, animal protein, and sugar, and high in total carbohydrate, and adequate in total protein. More foods are derived from vegetables than in any comparable Western countries. The nutritional status of Korean is good without evidence of any gross nutritional deficiency. The leading causes of death, currently, form a unique ranking of malignancies, accidents, and cerebrovascular diseases. Korean diet may account for the strikingly low incidence of heart disease. Studying the relationship between diet and these diseases may greatly aid our understanding of their pathogenesis and lead to improved prevention and treatment. Current changes in the Korean diet are a decreasing proportion of carbohydrates with increasing proportions of fat and animal protein and an increased content of cholesterol. The ratio of polyunsaturated to saturated fatty acid of Korean diet seems to fall in desirable range. The changes in plasma cholesterol levels and CAD mortality among Korean in the past 20 years seem to be a reflection of changes in diet. Similar changes could be seen in the Japanese population. In Korea, the incidence of CAD is still low compared with that in western countries. Recently, a slightly increased incidence of CAD has been observed in Korea. Thus, establishment of reliable biochemical markers and their cut-off values are needed for the Korean population. Several methods including TC, TG, HDL-C, LDL-C, HDL-C/TC, LDL-C/TC, LDL-C/HDL-C, Apo A-I, Apo B and Apo A-I/B for CAD were examined and found that Apo A-I/B ratio was a good biochemical marker for CAD in Korea. In the future, the Korean diet will probably continue to change. The changes are being influenced by economic development that have been emerging and growing stronger since 1980 and that will probably continue to be potent. The effect of these changes upon CAD is not clear at the present time. To detect a changing incidence of CAD and to evaluate the significance of diet will require continued close observation and use of more specific and sensitive methods. The Korean experience with diet and plasma lipids will be potentially valuable in appraising CAD of both developing and technically developed countries.
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PMID:Changes of plasma lipids and biochemical markers for coronary artery disease in Korea. 848 39


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