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Query: UMLS:C0018799 (
heart disease
)
34,133
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Seventy-nine patients without ventricular preexcitation but with documented paroxysmal supraventricular tachycardia were analyzed. Electrophysiologic studies suggested atrioventricular (A-V) nodal reentrance in 50 patients, reentrance utilizing a concealed extranodal pathway in 9, sinus or atrial reentrance in 7 and ectopic automatic tachycardia in 3. A definite mechanism of tachycardia could not be defined in 10 patients (including 7 whose tachycardia was not inducible). The three largest groups with inducible tachycardias were compared in regard to age, presence of organic
heart disease
, rate of tachycardia, functional bundle branch block during tachycardia and relation of the P wave and QRS complex during tachycardia. A-V nodal reentrance was characterized by a narrow QRS complex and a P wave occurring simultaneously with the QRS complex during tachycardia. Reentrance utilizing a concealed extranodal pathway was characterized by young age, absence of organic
heart disease
, fast heart rate, presence of bundle branch block during tachycardia and a P wave following the QRS complex during tachycardia. Sinoatrial reentrance was characterized by frequent organic
heart disease
, a narrow QRS complex and a P wave in front of the QRS complex during tachycardia. In conclusion, a mechanism of paroxysmal supraventricular tachycardia could be defined in most patients. Observations of clinical and electrocardiographic features in these patients should allow prediction of the mechanism of the tachycardia.
Am J
Cardiol
1978 May 22
PMID:Clinical, electrocardiographic and electrophysiologic observations in patients with paroxysmal supraventricular tachycardia. 66 9
The time interval between tricuspid valve closure and pulmonary valve opening, termed the isovolumic contraction time of the right ventricle, was evaluated echographically in 38 normal children and within 24 hours of cardiac catheterization in 53 children with congenital
heart disease
and normal conduction as assessed with the electrocardiogram. In the 53 patients with congenital
heart disease
, isovolumic contraction time was strongly influenced by right ventricular afterload, as defined by pulmonary arterial end-diastolic pressure (r = 0.87). It was possible to utilize isovolumic contraction time to separate patients with normal or elevated values for pulmonary arterial end-diastolic pressure. Similar correlations were demonstrated between isovolumic contraction time and mean pulmonary arterial pressure and calculated pulmonary vascular resistance. Evaluation of 15 children with complete right bundle branch block revealed values for isovolumic contraction time that did not significantly differ from those of patients with similar pulmonary arterial end-diastolic pressure but no conduction abnormalities. These findings indicate that serial echographic evaluation of the interval from tricuspid valve closure to pulmonary valve opening can give an accurate reproducible assessment of right ventricular afterload in many children with congenital
heart disease
and complete right bundle branch block
Am J
Cardiol
1978 Jun
PMID:Echocardiographic assessment of pulmonary arterial pressure in children with complete right bundle branch block. 66 33
A review of cerebral phlebothrombosis using material from the pathology departments of the National Institute of Cardiology and the General Hospital in Mexico City is presented. The most frequent causes found were: post partum. Secondary to congenital
heart disease
and associated with infections. In both institutions the most frequent anatomical find was thrombosis of the superior longitudinal sinus. Isolated venous thrombi in the brain probably takes place more frequently than reported. Hemorrhagic necrosis in brain tissue is the most frequent microscopic finding, associated in variable degrees with edema and anoxic encephalopathy. A description of clinical and angiographic findings is presented.
Arch Inst
Cardiol
Mex
PMID:[Cerebral venous thrombosis]. 66 32
Pulmonary diffusive capacity by the carbon monoxide method was evaluated in 43 patients two years after myocardial infarction, and without evidence of other types of
heart disease
. The patients did not have primary lung disease or clinic bronchitis. Special interest was given to the effects of cigarrette smoking and moderate pulmonary congestion. A significant decrease in diffusion capacity was observed in smokers and former smokers compared to none smokers. In moderate pulmonary congestive the oposite effects was registered. pO2 was decreased in half the patients with old myocardial infarction but there was no significant statistical correlations with D1co values. Mean values for pO2, pCO2, pH, EB did not show statistically valid differences among the subgroups under study. Different factors which may influence the evaluation of diffusion capacity are discussed.
Arch Inst
Cardiol
Mex
PMID:[Pulmonary diffusion capacity in patients with previous myocardial infarct (with respect to the influence of smoking and pulmonary congestion)]. 66 42
We have studied 1148 'isolated" cases of congenital
heart disease
, taken from a general series of 1255 cases. The recurrence risk ranged from 0.9% for relatives of male cases of VSD and for female cases of aortic stenosis to 10.5% for relatives of female cases of atrioventricularis communis; mean value 2.5%. Heritability ranged from 50% to 95%, mean 65%. Full concordance was more frequent in 1st-degree relatives of Fallot's tetralogy patients, while discordance was common in more distant relatives. We propose a hypothesis of several overlapping polygenic systems for the causation of CHD.
Eur J
Cardiol
PMID:The recurrence risk in congenital heart disease. 66 53
Careful histologic studies were performed on the coronary arteries, myocardium and conduction system of the hearts of six men aged 32 to 44 years who died suddenly with no history of
heart disease
. All six hearts demonstrated coronary atherosclerosis without evidence of complete obstruction or myocardial infarction. A nonobstructing mural coronary thrombus was found in all six hearts; in four, the thrombus was located in the left anterior descending coronary artery. Distal microthrombi were found in four hearts. In these six men, the terminal event, often a ventricular arrhythmia, may have been related to the mural coronary thrombus. Small fragments originating from such lesions can obstruct the microcirculation producing sudden lethal arrhythmias. Nonobstructing mural coronary thrombosis may be more prevalent and more significant than previously suspected and should be considered in cases of sudden cardiac death.
Am J
Cardiol
1978 Jul
PMID:Nonobstructive coronary thrombosis in sudden cardiac death. 67 36
Apexcardiograms were performed in 68 consecutive patients who had either normal findings or coronary artery disease on cardiac catheterization. The height of the a wave in relation to the total apexcardiographic deflection (a/H) and the duration of both the rapid (RFW) and the slow (SFW) filling periods were determined in each case. The patients were classified into three gorups: I, no evidence of
heart disease
on catheterization; II, significant coronary artery disease with elevated left ventricular end-diastolic pressure; and III, coronary artery disease with normal filling pressure. There was a significant difference (P less than 0.001) between the SFW/RFW values (mean +/- 1 standard deviation) in control subject (group I, 2.3 +/- 0.5) and in subjects with coronary artery disease (group II, 4.7 +/- 1.6 and group III, 4 +/- 1.7). Setting the upper limit of normal for SFW/RFW at 2.8 (mean + 1 standard deviation) identified 94 percent of patients, in group II, 71 percent of patients in group III and 86 percent of all patients with coronary disease (group II plus group III). This sensitivity appeared greater than that of the a/H ratio. Only 2 of 17 patients (12 percent) without coronary atherosclerosis had an SFW/RFW ratio greater than 2.8. It is concluded that (1) the slow/rapid filling period ratio is a useful noninvasive measurement for identifying subjects with ischemic heart disease; (2) the increased values for slow/rapid filling period ratio associated with obstructive coronary lesions may be caused by impairment of early left ventricular distensibility; and (3) this ratio should be determined in patients with other forms of
heart disease
to determine its specificity.
Am J
Cardiol
1978 Sep
PMID:Slow filling period/rapid filling period ratio in the apexcardiogram: relation to the diagnosis of coronary artery disease. 68 50
Forty-nine patients with chronic left bundle branch block and a normal frontal axis were compared with 53 patients with left bundle branch block and left axis deviation. The following clinical variables were more frequent (P less than 0.05) in patients with left axis deviation: greater age, exertional angina, congestive heart failure, cardiomegaly, cardiac functional class II to IV, coronary artery disease and presence of organic
heart disease
. Absence of organic
heart disease
(primary conduction disease) was seen only in patients with a normal axis. Patients with left axis deviation had longer (P less than 0.05) mean P-R, A-H and H-V intervals and atrial and atrioventricular (A-V) nodal effective refractory periods. All patients were prospectifely followed up for 30 to 2,271 days with a mean +/- standard error of the mean follo-up period of 538 +/- 72 for the group with a normal axis and 604 +/- 72 days for the group with left axis deviation (difference not significant). A-V block developed in three patients (6 percent) with left axis deviation and in none of those with a normal axis. The cumulative 4 year mortality rate for the entire group approached 75 percent. The patients with left axis deviation had greater cardiovascular mortality (P less than 0.05). In conclusion, among patients with left bundle branch block, those with left axis deviation have a greater incidence of myocardial dysfunction, more advanced conduction desease and greater cardiovascular mortality than those with a normal axis.
Am J
Cardiol
1978 Oct
PMID:Significance of left axis deviation in patients with chronic left bundle branch block. 69 36
Maximal treadmill tests following the Bruce protocol were performed by 830 children with heart defects and the endurance times compared with normal values from 327 children seen in the same clinic because of normal murmurs and from 388 normal children randomly selected and tested in the schools. When values in the normal clinic children were used as the reference, only 21 percent of the patients with heart defects had endurance times below the 10th percentile line. This line was 14 percent higher in the normal school children, and 47 percent of the patient group had values below the 10th percentile when values in the school children were used as the reference. Maximal heart rate in children with heart defects was almost always in the normal range (180 to 210 beats/min) except in patients with cyanosis or severe valve disease and, when encouraged to continue exercising, even these children had a mean maximal heart rate of 175 beats/min. When comparing the exercise capacity of children with heart defects with that of normal children, the source of the normal children is important; body build needs to be considered, as well as physical activity habits. Clinic patients without heart defects probably serve as a better normal control group than children obtained from the school system. Maximal exercise tests do not necessarily distinguish between children with mild or severe
heart disease
. Only children with lesions causing cyanosis or children with obviously severe disease have consistent reductions in exercise capacity.
Am J
Cardiol
1978 Oct
PMID:Maximal exercise capacity of children with heart defects. 69 44
The angiocardiographic features of 11 patients with superoinferior and criss-cross type of atrioventricular (A-V) connections are presented. These unusual ventricular relations are thought to result from postseptation disturbances of ventricular looping. The angiocardiographic appearance of criss-cross is really an illusion, and the A-V connections among these patients are either concordant, discordant or straddling. The often small right A-V valve inflow and sinus portion of the ventricle, combind with the ventricular rotational anomaly, combine to give the angiocardiographic perception of criss-cross. A review of the 11 patients from this institution and those previously reported on suggests that most patients have a transposition of malposition of the great arteries; many have a small right ventricle, and about half have pulmonary outflow tract obstruction. In addition to the obvious embryologic, morphologic and clinical implications of these distorted ventricular loops, the criss-cross A-V hearts raise questions about the various segmental nomenclatures applied to these types of congenital
heart disease
.
Am J
Cardiol
1978 Oct
PMID:The criss-cross and superoinferior ventricular heart: an angiocardiographic study. 69 45
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