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)

To evaluate the benefits of operative treatment of congenital heart disease in older age groups, a clinical study on patients over 40 years of age with atrial septal defect was carried out. The series consisted of 125 consecutive patients operated on between 1966 and 1974. There were 8 cases with a primum, 12 cases with a sinus venosus type of secundum and 105 cases with a simple secundum defect. The operative mortality was 2 patients (1.6%). It was due to myocardial infarction in one case and high pulmonary vascular resistance in the other. On re-examination 3-6 months postoperatively, 107 patients were improved, 13 patients unchanged and 3 patients were worse than before operation. On re-evaluation after an average period of 6 years, 88 patients were still improved. 32 patients unchanged and 3 patients were worse compared with their pre-operative status. On the basis of the results and the previous reports on atrial septal defect without operation, the surgical correction of ASD even in older age groups can be recommended. The problem of deterioration of some patients, despite a good immediate postoperative result, is discussed.
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PMID:ASD in patients over 40 years of age. 15 3

A His electrogram was registered with a Castillo tripolar catheter in seven patients with atrio-ventricular discordance and transposition of the great arteries (corrected transposition). They all had ventricular septal defect, six had pulmonary stenosis. two had atrial septal defect, and only one patient presented first degree AV block. The QRS was of normal duration, 4 had RBBB morphology in the left precordials. Two with ASD and VSD had a prolonged P/A interval. In one, the His recording was polyphasic with a prolonged H-V (55 msec) and two others showed a wide polyphasic His potential (25 and 26msec), with a prolonged H-V. These 3 cases with prolonged His had a minor degree of RBBB. The remaining 3 showed normal AV conduction. In all, the Purkinje electrogram was registered. The duration of the Pu potential and the Pu-V were normal. Corrected transposition shows a high incidence of slow AV conduction, frequently not detectable in the usual electrocardiogram in agreement with previous anatomo-pathological studies. The distal block would explain the frequency of complete AV block with low cardiac output and frequent sudden death in this type of heart disease. The distal block would compel us to take e more agressive steps in its treatment. Atrial septal defect with slowing of the intra-arial conduction is not detected in the electrocardiogram.
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PMID:[Study of the heart conduction system in atrioventricular disorders]. 93 45

Three patients with the rare association of secundum ASD and congenital clefts of A-V valves are reported. These three patients illustrate the predictive valve of vectoracardiographic analysis in precisely determining the anatomic location of the valvular pathology. The embryologic origins of the lesion are briefly discussed. A review of the literature supports the use of vector analysis in the evaluation of the patients with this type of heart disease.
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PMID:Congenitally cleft atrioventricular valves associated with secundum atrial septal defects. 99 42

Urine excretion rates of norepinephrine were measured in 15 children with Tetralogy of Fallot and 25 with atrial septal secundum defects anaesthetized with halothane or morphine before, during and for two hours after surgical correction of their cardiac defects. All patients were paralyzed with d-tubocurarine, the tracheae were intubated and respiration was controlled. Urine was obtained for 90 minutes before induction, during induction, before, during and after bypass and postoperative. Patients with TF had significantly higher pre-operative urine norepinephrine excretion rates than patients with ASD. In TF children anaesthetized with halothane norepinephrine excretion was significantly decreased during induction and during operation but increased post-operatively. Children with ASD and anaesthetized with halothane did not have urine norepinephrine excretion rates that were significantly different from post-operative values until the postoperative period. ASD children anaesthetized with morphine had marked elevations in norepinephrine excretion during induction and all subsequent study periods. On the other hand, morphine anaesthetized TF children did not have a significant increase in urine norepinephrine excretion until bypass had been established. Increased norepinephrine excretion was maintained in these patients during all subsequent study periods. These data, when combined with our results in patients with acquired heart disease, demonstrate that disease can alter norepinephrine responses to morphine anaesthesia. In addition our results suggest that dosage of morphine and morphine blood levels might also modify norepinephrine excretion.
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PMID:The effects of morphine and halothane anaesthesia on urine norepinephrine during surgery for congenital heart disease. 124 27

The age distribution of death in all children with congenital heart disease (CHD), who died in a 27-year period in Central Bohemia (population of 1.2 million), and the data on the incidence of CHD in children born in Bohemia (population of 6.3 million) in 1980 were used to calculate the probability of survival of a child born with CHD. Eighty-six percent of these children survived to the first month of life--mostly those with pulmonary stenosis (PS, 99%), aortic stenosis (AS, 95%), ventricular septal defect (VSD, 92%), and atrioventricular septal defect (AVSD, 91%). Seventy-one percent of patients survived the first year of life--mostly those with PS (97%), AS (91%), atrial septal defect (ASD, 89%), VSD (80%), and persistent ductus arteriosus (PDA, 78%). In total, 67% of CHD patients can be expected to survive childhood. The highest survival rates were found in PS (94%), AS and ASD (84%), VSD and PDA (70-80%), and coarctation of the aorta (COA, 68%). The survival rate for the remaining forms of CHD was less than 50%. The highest mortality rate (10% of all children born with CHD) can be expected in the first postnatal week. The lowest survival in the first week was found among those with hypoplastic left heart (HLHS, 39%), double-outlet right ventricle (DORV, 50%), truncus arteriosus (TrA, 57%), pulmonary atresia (PA, 70%), and transposition of the great arteries (TGA, 83%). In addition, total anomalous pulmonary venous connection (TAPVC) and single ventricle had the highest risk of death in the first year of life.
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PMID:Children with congenital heart disease: probability of natural survival. 160 15

Ventricular emptying was evaluated in patients with congenital heart disease (CHD) with left-to-right (L-R) shunt by factor analysis of gated equilibrium radionuclide angiography. In 36 (95%) of 38 ventricular septal defect patients and 20 (95%) of 21 atrial septal defect patients with small L-R shunt (pulmonary to systemic blood flow, Qp/Qs less than or equal to 2.5), as well as all patent ductus arteriosus patients, two significant cardiac factors corresponding to the ventricles (ventricular factor) and the atria plus large vessels (atrial factor) were extracted. However, in all of nine ventricular septal defect patients with large L-R shunt (Qp/Qs greater than 2.5), two different ventricular factors were determined which corresponded to the right and left ventricles (RV and LV). The RV factor showed a delay of ejection phase compared with the LV factor, and the delay was correlated with the value of Qp/Qs (r = 0.82, P less than 0.01). In eight (80%) of 10 ASD patients with large L-R shunt (Qp/Qs greater than 2.5), RV was described by the two different ventricular factors located in the septal and free-wall regions. The LV was extracted in the same factor as that located in the septal region of RV. This study demonstrates the capability of factor analysis in the pathophysiological investigation of CDH with L-R shunt.
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PMID:Factor analysis of gated cardiac blood-pool data: application to patients with congenital heart disease. 179 21

This chapter will review the evolving role of intravascular ultrasound imaging and transesophageal echo in the care of children, infants and adults with congenital heart disease. The technologies relevant to congenital heart disease applications differ from those involving coronary disease since the intravascular structures imaged often involve visualization of large vessels and cardiac chambers. On the other hand, the requirements for transesophageal echo in children with congenital heart disease involve intraoperative (surgical) and imaging procedures in the catheterization laboratory which are performed for monitoring interventional catheterization therapy. As such, whereas the intravascular devices needed for pediatric cases involve lower frequency and sometimes larger catheters, the requirements for transesophageal echocardiography require higher frequency and smaller esophagoscopes. Applications of intravascular imaging including sizing of congenital stenoses, dilation of coarctation and valvular stenoses, imaging of intrapulmonary thrombi and monitoring of placement of ASD 'button' devices in the heart will be reviewed. The intraoperative transesophageal uses for monitoring infant surgery include procedures for tetralogy repair, transposition repair and repair of AV septal defects and other complex congenital heart disorders. Both of these 'invasive' methods of echocardiography have an important and evolving role in the management of congenital heart disease in children and infants.
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PMID:Applications of intravascular scanning and transesophageal echocardiography in congenital heart disease: tradeoffs and the merging of technologies. 191 64

An acyanotic cardiac disease (ASD) was diagnosed in a 9-year-old girl with a very high caries incidence and premature tooth eruption. After the heart operation her caries incidence declined considerably. An epidemiological survey was then conducted to find out if these observations could be generalized. dmf-t, dmfs, DMF-T and DMFS values for each year were counted retrospectively for a group of acyanotic heart diseased children operated on at the age of 5-7 years (mean 6) and another group operated on at the age of 10-13 years (mean 12), from the documents relating to annual examinations conducted by the public health dental services. The results were compared to those of healthy children matched for age and sex living in the same area. Heart disease resulted in DMF-T values above the control level in the group operated on at age 6 years, whereas the values were lower than the controls in the group operated on at age 12 years, the difference being significant after the operation in the latter case. It is concluded that acyanotic congenital heart disease may lead to a higher caries prevalence and sometimes rampant caries. When the caries prevalence of the population is high, however, (DMF-T higher than 4.5 at 12 years), the effect of heart disease remains hidden.
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PMID:Caries incidence in children with acyanotic congenital heart diseases before and after the heart operation. 209 87

To compare the costs and effectivenesses of 2-dimensional/Doppler echocardiography (2D/DE), cardiac catheterization (CC) and angiography (CA) in the evaluation of cardiac anatomy in patients with congenital heart disease, these three kinds of examinations were performed in 100 patients before operation. The 100 patients had 120 separate cardiovascular abnormalities, of which 100 (83.3%) were prospectively identified by 2D/DE. The sensitivity and specificity of 2D/DE were: ASD, 87.9% and 100%; VSD, 97.9% and 96.1%; PDA, 86.7% and 98.2%, Tetralogy of Fallot, 6 of 6 patients; the overall sensitivity and specificity of the less common defects, 31.6% and 95.8%. Ninety-seven (80.8%) were prospectively identified by catheterization. The sensitivity and specificity of catheterization were: ASD, 87.9% and 100.0%; VSD, 80.9% and 94.6%; PDA 93.3% and 96.6%; Tetralogy of Fallot, 6 of 6 patients, the less common defects, 52.6% and 95.5%. Forty-five (81.8%) were prospectively identified by angiography in 55 patients. The sensitivity and specificity of angiography: ASD, 5 of 7 patients, VSD, 88.0% and 94.3%; PDA, 2 of 2 patients; Tetralogy of Fallot, 5 of 5 patients; the less common defects, 68.8% and 100.0%. The economic evaluations were performed. The costs of the depreciation (including equipments and houses), hospital bed, water and electricity, management and staffs' wage were: 2D/DE, RMB 46.09 per patient; catheterization, RMB 314.17 per patient; angiography, RMB 314.17. The ratios of cost to outcome (cost per correct diagnosis) of 2D/DE, CC and CA were: 55.33, 388.82 and 384.07 respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Cost-effectiveness analysis of two-dimensional/Doppler echocardiography, cardiac catheterization and angiography in the diagnosis of congenital heart disease]. 251 46

A two-dimensional echocardiographic method was applied to determine the axis of interventricular septum (IVS) in the horizontal plane. This study comprised 19 subjects with ASD, 15 subjects with VSD(I), 20 subjects with VSD(II), 13 subjects with PDA, 16 subjects with PS, 15 subjects with TOF and 99 normal children. Parasternal left ventricular short axis view was taken, and the IVS was recorded by using the polaroid prints. The axis of the IVS in the horizontal plane was measured from the recorded polaroid prints. The value of the angularity of IVS (IVS-A) expressed as means +/- one standard deviation (mean +/- 1S.D.) is 52.0 +/- 13.7 degrees in ASD, 42.2 +/- 9.7 degrees in VSD(I), 43.7 +/- 9.1 degrees in VSD(II), 41.6 +/- 11.4 degrees in PDA, 38.6 +/- 10.9 degrees in PS, 61.0 +/- 8.5 degrees in TOF and 40.1 +/- 8.2 degrees in normal controls. There was no significant difference among VSD(I), VSD(II), PDA, PS and normal controls but a highly significant difference was noted in ASD and TOF as compared to other groups. The correlation coefficient of the IVS-A with (1) the Qp/Qs ratio, (2) the magnitude of shunt (%), (3) the right ventricular pressure and (4) the hematocrits were evaluated among the patient groups. The IVS-A of ASD and VSD(II) had a good correlation with the shunt flow (r = 0.921 and 0.88 respectively) and/or the Qp/Qs ratio (r = 0.782 and 0.955 respectively); while that of VSD(I), PDA, and PS had a good correlation with the right ventricular pressure (r = 0.956, 0.953, 0.842 respectively) and that of TOF was mostly concerned with the hematocrits (r = 0.911). Besides, the IVS-A in each severe CHD subgroup was significantly (p less than 0.005 or a better value) higher than the normal control group. Thus an alternative method was validated for evaluating the severity of congenital heart disease by using a noninvasive two-dimensional echocardiographic technique.
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PMID:Evaluation and comparison of the axis of the interventricular septum by two-dimensional echocardiography among the patients with congenital heart disease (ASD, VSD, PDA, PS, TOF) and the normal subjects. 251 99


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