Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Complete and unselected data concerning the postoperative pathology of congenital heart disease are presented for the first time. This study was based on 2,365 autopsies performed at the Children's Hospital Medical Center, Boston, in the 9 years from 1966 through 1974. Of these, 586 autopsies (25 percent) revealed congenital heart disease--238 performed in medically treated patients (41 percent) and 348 in surgically treated patients (59 percent). Tetralogy of Fallot, including cases with pulmonary outflow tract atresia and other associated malformations, was the congenital heart disease most often encountered in the postoperative autopsy series (88 cases, 25 percent of that series). D-transposition of the great arteries, including cases with other associated anomalies, was second (54 cases, 15.5 percent). Early death (hospital mortality) accounted for 320 (92 percent) of the 348 surgical cases; late death occurred in 28 patients (8 percent). Causes of late postoperative death included arrhythmias, excessively small ventricular septal defect with tricuspid atresia, massive hemoptysis, rupture of the pulmonary artery, cyanotic spell, congestive heart failure and infection. Prophylactic penicillin is recommended for patients with the asplenia syndrome because of their probably enhanced vulnerability to fulmfulminating septicemia by encapsulated bacteria such as the pneumococcus. Completeness and lack of selection in reporting data are essential in the interests of perspective and comparability of findings.
Am J Cardiol 1976 Aug
PMID:Postoperative pathology of congenital heart disease. 95 66

Ultrasonic studies were performed in 19 neonates with the hypoplastic left heart syndrome whose diagnosis was confirmed at angiography or autopsy, or both. The patients were classified in two echocardiographic groups: Group I, 10 infants whose ventricular septum could be recorded, and Group II, 9 infants whose septum could not be recorded. The findings in these groups were compared with those in 60 neonates without congenital heart disease also studied with ultrasound. Two additional neonates who presented with signs of shock were also studied. The diagnostic echocardiographic features of hypoplastic left heart syndrome were: (1)a left ventricular end-diastolic dimension of less than 9 mm; (2)an aortic root diameter of less than 6 mm; (3)a ratio of left ventricular end-diastolic to right ventricular end-diastolic dimension of less than 0.6; and (4)a mitral valve echo that is absent or greatly distorted and of small amplitude. These echocardiographic criteria differed significantly from findings in the normal group (P less than 0.01). Echocardiography proved valuable in neonates with shock. It is a safe, reliable technique that can be used to delineate the intracardiac anatomy in sick neonates with the hypoplastic left heart syndrome.
Am J Cardiol 1976 Sep
PMID:Echocardiographic sepctrum of the hypoplastic left heart syndrome: a clinicopathologic correlation in 19 newborns. 96 8

37 patients with mixed cardiac pathologies were subjected to isometric exercise (hand grip) during routine cardiac catheterization. On the basis of a simple and safe grip test it was possible to distinguish three groups of patients according to the left ventricular pressure at rest and its response to this test. Group 1 consisted of 14 patients with left ventricular end diastolic pressures remaining below 12 mm Hg both at rest and on exercise. These patients were considered to have normal left ventricular function some, even in the presence of organic heart disease. No deaths occurred in this group during the follow-up period which averaged 33.8 months. At the other extreme (Group 3) there were 12 obviously disabled patients with resting left ventricular filling pressures above 12 mm Hg rising further under isometric stress. Six of these patients (50%) died during the period of the study. (Average follow-up 21.4 months). By the application of the hand grip test, an intermediate population (Group 2) of 11 patients was discernible. These patients were able to maintain a normal cardiac reserve at rest (LVEDP less than 12 mm Hg) but not during isometric effort (LVEDP greater than 12 mm Hg). Two of these patients (18%) died during the follow up period (average 22.1 months). Assuming a pathological progression with time from groups 1-3 and in view of the different prognoses observed in the course of the long-term follow-up it would appear that the Group 2 patients should be considered more critically and offered more active management.
Eur J Cardiol 1976 Sep
PMID:The grip test: a simple method for the assessment of left ventricular performance. 96 82

Noninvasive myocardial imaging with potassium-43 and rubidium-81 has been used successfully to identify areas of infarction and exercise-induced ischemia as regions of decreased radioactivity. The image defects observed are believed to be due to a decreased radionuclide uptake in regions of myocardial scar or to heterogeneous myocardial accumulation of tracer as a result of regional ischemia. Of 27 patients with left bundle branch block studied with noninvasive imaging at rest and during exercise, 25 manifested at rest reduced radioactivity in the region of the interventricular septum. This pattern is similar to that seen in patients with anteroseptal myocardial infarction. Sixteen of the 27 patients underwent diagnostic coronary arteriography and left ventriculography. Only five of these patients had evidence of either previous infarction or significant obstructive coronary artery disease as assessed with clinical or angiographic criteria, or both. Although the image defect was routinely demonstrated at rest in patients with left bundle branch block, this defect was generally normalized or less distinct with exercise in patients with no anatomic heart disease. In contrast, a larger, more distinct or new image defect with exercise correctly identified the presence of significant obstructive coronary artery disease in patients with left bundle branch block. In the clinical application of noninvasive myocardial imaging, these image defects observed at rest can lead to the false pasitive radionuclide interpretation of anteroseptal myocardial infarction.
Am J Cardiol 1976 Oct
PMID:Noninvasive myocardial imaging with potassium-43 and rubidium-81 in patients with left bundle branch block. 97 Mar 29

The purpose of this study was to clarify certain electrovectorcardiographic aspects suggestive of heart disease associated with W-P-W syndrome. Seventy-six vectorcardiograms with W-P-W features were analyzed. The curves were obtained by Grishman's cube system and in 8 cases by Frank's method, as well. In addition, the conventional electrocardiograms corresponding to 55 vectorcardiograms, were studied. Not all the electrocardiographic and vectorcardiographic tracings were recorded simultaneously. The W-P-W syndrome was classified as type A when the electrical records suggested a pre-excitation phenomenon in the left postero-superior septal mass, probably with a partial "wave jumping" toward the right anterior septal mass. The W-P-W syndrome was judged to be of type B when the electrical tracings showed a pre-excitation in the right anterior septal mass, probably with a partial "wave jumping" toward the left posterior septal mass. The results of this study permit the following conclusions: 1. It seems justified to assert that the calssification of the W-P-W syndrome must be realized deductively on the basis of the sequence of the ventricular activation and of the heart position. 2. An interval of 30 msec. or more between the end of initial slurring and the vertex or middle point of the R loop permits inferring the coexistence of left ventricle hypertrophy. 3. The presence of an inactivable zone due to myocardial infarction should be suspected on the basis of segmentary irregularities or distortions of the electrical curves, while extensive deformations are more suggestive of myocardiopathy. 4. The duration of terminal slurrings does not depend on that of the initial ones. However, when the initial slurrings are very prolonged, the terminal ones are relatively short. 5. In the presence of W-P-W syndrome, the primary ventricular repolarization changes cannot be considered as pathognomonic of any associated cardiopathy because they are often provoked by drugs.
Arch Inst Cardiol Mex
PMID:[Observations on varions electrovectocardiographic aspects of the W-P-W syndrome]. 98 54

To assess the effect of long-term lithium therapy on cardiac arrhythmias and cardiovascular performance, extended ambulatory electrocardiographic monitoring was performed in 12 patients, and rest and exercise electrocardiograms in 10 of 12, before and during lithium therapy. Lithium increased the frequency of premature ventricular contractions in three patients, decreased it in one, and produced no change in eight. Three of four patients with atrial arrhythmias showed improvement during lithium therapy. Exercise performance was unchanged. Although 7 of the 12 patients manifested T wave flattening in the resting electrocardiogram, none had S-T segment displacement at rest or on treadmill exercise. Before lithium therapy, arrhythmias on exercise included premature atrial contractions in four patients, ventricular arrhythmias in four (premature ventricular contractions in four, with couplets in two and with ventricular tachycardia in one). During lithium therapy, exercise did not provoke premature atrial contractions or ventricular tachycardia in any of the patients, but three patients had premature ventricular contractions (with couplets in one case). We conclude that lithium at therapeutic levels may precipitate or aggravate ventricular arrhythmias. When administered to patients with heart disease, factors that interfere with renal clearance of lithium (heart failure, salt restriction, long-term diuretic therapy) must be recognized and doses must be adjusted accordingly. Careful follow-up and electrocardiographic monitoring are advisable if lithium is to be used in the presence of ventricular arrhythmias. Cardiovascular performance as assessed by treadmill exercise testing was not affected by long-term lithium therapy.
Am J Cardiol 1976 Nov 23
PMID:Effect of lithium on cardiovascular performance: report on extended ambulatory monitoring and exercise testing before and during lithium therapy. 99 8

Radionuclide angiocardiography is a useful method in the evaluation of patients with congenital heart disease, safely and nontraumatically. Physiologic variables such as transit times, cardiac output, left ventricular ejection fraction, stroke volume, end-diastolic volume can be measured accurately with this technique. An important application of radionuclide angiocardiography in children with congenital heart disease is in the detection, localization and quantification (pulmonary to systemic flow ratio) of intracardiac shunts and shunts between the great vessels. This technique has been found useful in the evaluation of the newborn infant with cyanosis, the patient with a cardiac murmur and the patient who has had cardiovascular surgery. Newer mobile gamma camera-computer systems permit the performance of radionuclide angiocardiography in several ill premature and newborn infants and patients during the early postoperative period. Specially designed magnifying collimators and the development of ultrashort-lived radionuclides should result in an overall improvement in the diagnostic capabilities of this technique and in a further reduction in the radiation dose.
Am J Cardiol 1976 Nov 23
PMID:Radioactive tracers in congenital heart disease. 99 10

Thirty-one patients with systemic candidiasis at postmortem examination were found to have Candida involvement of the myocardium without valvulitis. Retrospective examination of their clinical course demonstrated that a new conduction disturbance was seen in 10, supraventricular arrhythmias in 5,QRS changes mimicking myocardial infarction in 3, and pronounced T wave changes in 13. Hypotension or shock was seen in 13 patients and could not be explained by coexistent bacteremia or blood loss in 8. One patient died suddenly. Of 19 patients with systemic candidiasis without myocardial invasion, 4 had minor T wave changes and one had a supraventricular arrhythmia. Candida invasion of the heart significantly complicates the clinical course in systemic candidiasis and should be suspected when a young person without preexistent heart disease has cultures positive for a Candida organism, a significant arrhythmia, conduction distrubance or other dramatic QRS change. The effect of therapy on Candida invasion of the heart is unknown.
Am J Cardiol 1976 Dec
PMID:Candida myocarditis without valvulitis. 99 27

157 cases affected with "unstable angina" and hospitalized were observed over a period of from 8 to 24 months (average observation time: 16 1/2 months). The patients were treated with: nitroderivates, beta blocking drugs (when not contra-indicated); treatment of side affects (hypertension; arrhythmias, decompensation, associated pathology, correction of risk factors of coronary heart disease). 9 cases were lost and 148 were studied for the course of the illness. 10.6% died from cardiopathy (2.8% through sudden death; 7.4% from myocardial infarction); there was a 12.1% total incidence of myocardial infarction; 50% of the cases were alive but with sumptoms of stabilized angina, whilst 32.4% were completely asymptomatic. Coronographic alterations and myocardial contractility negatively affect the course of the illness. Negative effects (disease or infarction) were not checked in the cases of stenosis of only one coronary branch. In the casuistry, there were no negative effects in patients with stenosis of one coronary branch, and in cases of two or more branches, negative effects were 28%. 41% of patients with alterations of ventrical contractility gave negative results. An asymptomatic course of the illness was checked more frequently in the intermediate stages than in angina cases.
G Ital Cardiol 1976
PMID:[Natural history of unstable angina. Observations on 157 cases (author's transl)]. 101 Jan 71

The onset of serious arrhythmias during potassium depletion occurs rather frequently in female subjects who have undergone hypotensive-diuretic treatment, independently from the duration and doses of drugs. These arrhythmias which produce a cardiac arrest, can also occur in subjects not affected with heart disease. They are not necessarily preceeded by clinical prodrumus or other types of minor arrhythmias not accompanied by other important electrocardiographic or serum-logical alterations of hypokaliemia. The most commonly observed type is the "torsades de pointe", though cases of ventricular tachycardia or ventricular fibrillation are also documented. The ethiopathogenesis is discussed with regard to the alterations of the basic electrocardiogram as well as to the kind of major arrhythmia. In most cases , lidocaine has given the most satisfactory thmias, results in the treatment of these arrhythmias, probably because of the modality of the action which is substantially different from the other antiarrhythmic drugs.
G Ital Cardiol 1976
PMID:[Syncope during potassium depletion (author's transl)]. 101 Jan 79


<< Previous 1 2 3 4 5 6 7 8 9 10