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)

An acute ingestion of 6 to 7 mg digoxin as a suicidal gesture in a 76-year-old man with chronic heart disease is presented. The patient arrived in the emergency department approximately 5 hours after ingestion with a normal serum potassium and increasing numbers of multifocal premature ventricular contractions. Digoxin-specific antibody fragments were administered. The patient developed ventricular tachycardia and ventricular fibrillation and was eventually stabilized 35 minutes after the Fab fragments were infused. A review of the pharmacology and indications for use of digoxin-immune Fab fragments is also presented.
 ...
PMID:Acute digoxin overdose: use of digoxin-specific antibody fragments. 341 42

The sodium and potassium concentrations of the red blood cells and plasma were investigated in 93 children with cardiac disease, most of them with congenital heart defect, and in 48 healthy children of the same age. The red blood cell sodium and potassium concentrations were constant within a narrow range in normal subjects, but varied profoundly in pathological conditions. Digitalis treatment caused RBC Na+ and plasma K+ levels to increase and the RBC K+ level to decrease by blocking the Na+-K+ pump. The highest RBC Na+ concentration was observed in critically ill patients with congestive heart failure treated with digoxin. An augmented RBC sodium value was found in heart malformations with left to right shunt and in congestive cardiomyopathy that was not treated, whereas in patients with right to left shunt lower RBC sodium, higher RBC potassium and plasma potassium values were registered without any treatment. In cases of hyperkinetic circulation without any congenital heart defect the value of RBC sodium was definitely low. A low sodium and a high potassium level of the RBC were found after total correcting heart surgery. It is concluded that measurement of changes in sodium and potassium concentrations of the red blood cells is not a reliable method for assessment of the efficacy of digitalis treatment. The results point to the accompanying phenomena at a cellular level in heart disease.
 ...
PMID:Sodium and potassium concentrations in red blood cells and plasma in children with congenital heart defect. 342 57

Low potassium and magnesium concentrations not only cause cardiac arrhythmias, but also interfere with the efficacy or enhance the toxicity of drugs commonly used to treat patients with heart disease. Arrhythmias may develop in hypokalemia due to enhanced normal automaticity, abnormal automaticity, or slowed conduction; moreover, hypokalemia is associated with enhanced digitalis toxicity, quinidine-related Torsades de pointes, and interference with the antiarrhythmic activity of quinidine. Hypomagnesemia, especially in the presence of other electrolyte abnormalities, also affects automaticity and is associated with decreased efficacy of digitalis and with quinidine-related Torsades de pointes. Therefore, treatment that controls hypertension without causing electrolyte abnormalities is preferable for patients who are at risk of arrhythmias, or who are receiving drugs such as digitalis or quinidine.
 ...
PMID:Effects of low potassium or magnesium concentrations on isolated cardiac tissue. 356 23

In the past, potassium depletion in both non-digitalised patients and in patients without cardiac disease was thought to cause no adverse cardiac effects. However, several studies have now demonstrated a significant incidence of ventricular ectopic activity (VEA) with diuretic-induced hypokalaemia, even in hypertensive patients without overt heart disease. Additional evidence suggests that sudden death may occasionally result from this VEA. Potassium repletion with potassium-sparing diuretics or with potassium chloride supplementation has generally demonstrated a beneficial therapeutic effect in reducing VEA. However, after diuretic therapy occasional patients may have persistent VEA which may result from focal myocardial lesions associated with potassium depletion. In contrast, diuretic therapy in which normokalaemia is maintained has only been associated with a very low occurrence of VEA. Thus, with the preservation of normokalaemia, diuretic therapy for hypertension does not appear to be associated with the significant hazards of VEA.
 ...
PMID:Potassium loss, ventricular irritability, and the risk of sudden death in hypertensive patients. 373 99

Sixty-three patients with life-threatening digitalis intoxication were treated with purified fragments of digoxin-specific antibodies (Fab) obtained from sheep. Twenty-eight patients developed toxicity as the result of digitalis ingestion in a suicide attempt, 5 ingested a large amount of digoxin accidentally and 30 developed toxicity in the course of treatment for underlying heart disease. The dosage of digoxin-specific Fab was calculated to be equimolar to the amount of cardiac glycoside in the patient's body. Digitalis toxicity was completely reversed in most cases, with onset of effect usually within 30 minutes of administration of Fab fragments. Unbound and, therefore, active digoxin serum concentrations decreased to undetectable levels within minutes after administration of the fragments. In all patients who had elevated serum potassium concentrations caused by massive digitalis toxicity, treatment with the Fab fragments reversed the hyperkalemia. There were no obvious adverse reactions to treatment. Potentially life-threatening digitalis intoxication can be rapidly and safely reversed by treatment with purified digoxin-specific Fab fragments.
 ...
PMID:Treatment of 63 severely digitalis-toxic patients with digoxin-specific antibody fragments. 388 48

An estimate of the mass of fat-free tissue in the body can be calculated from body weight and skinfold thickness; this estimate is called the 'fat-free mass'. Total body potassium and nitrogen are alternative estimates. Factor analysis of data for healthy subjects has defined relationships between the true values of these three quantities and estimated the random component of the variance of each, i.e. the component independent of variations in the mass of fat-free tissue. The results indicated that all three were reliable measures of the mass of fat-free tissue. However, it is not known whether these findings are valid for patients who have lost weight. We have measured the same three quantities in 104 wasted patients with heart disease or disorders of the gastrointestinal tract. The patients' mean values were significantly less than corresponding values for healthy volunteers. The patients had a mean ratio of total body nitrogen to fat-free mass similar to that of healthy subjects, but lower mean ratios of potassium to fat-free mass and nitrogen. These findings suggest that the potassium content of the patients' fat-free tissues was abnormally low. Factor analysis of the patients' data gave relationships between the true values of the three quantities similar to those for healthy subjects; however, total body potassium was 100-300 mmol lower in patients than in healthy subjects with the same fat-free mass or total body nitrogen.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Mass and composition of the fat-free tissues of patients with weight-loss. 397 73

Chronic cigarette use is common in persons who habitually use other cardioactive agents that have been causally associated with heart disease. This study was undertaken to determine if cigarette use intensifies the abnormalities of myocardial function and composition observed in experimental alcoholism over an 18-month period. Young adult male beagles with tracheostomy were divided into four groups. There were 10 controls (group 1); 9 smoked seven cigarettes per day (group 2); 7 were fed ethanol as 20% of calories (group 3), and 6 received both ethanol and cigarettes (group 4). After a period of 18 months, left ventricular function was assessed under anesthesia. Heart rate, left ventricular end-diastolic pressures, and volumes (indicator dilution) did not differ in the four groups. An index of contractility derived by normalizing peak dP/dt for pre- and afterload was reduced significantly below the level of 2.41 +/- 0.7 cm/s in controls to 1.41 +/- 0.35 in group 2, 1.19 +/- 0.38 in group 3, and 1.28 +/- 0.17 in the ethanol cigarette group (each p less than 0.002). Arterial pressures were moderately elevated above group 1 in all three experimental groups without evidence of left ventricular hypertrophy. In contrast to smoking, which elicited no abnormalities of myocardial cation composition, ethanol reduced myocardial potassium and sodium in group 3 without a gain of water content. In group 4, no further decline of tissue cations was observed. Thus, cigarette use when combined with ethanol over a relatively long period produced no greater myocardial abnormalities than ethanol alone and may not be essential to the genesis of cardiomyopathy in alcoholics.
 ...
PMID:Interaction of chronic cigarette and ethanol use on myocardium. 397 84

Exchangeable sodium and potassium, total body water, and sulphate space were measured in 42 patients with severe valvular heart disease who were free of oedema. Compared with normal subjects of the same height, no increase in exchangeable sodium was found but a mean potassium depletion of 27% was shown. This depletion was not related to diuretic therapy, and no relationship between the degree of depletion and postoperative arrhythmias was found. It is concluded that the major cause of the low exchangeable potassium is the reduction in cell mass that occurs in chronic heart disease, and that there is no significant fall in the intracellular potassium concentration.
 ...
PMID:Potassium depletion in severe heart disease. 579 71

We have examined the electrocardiograms of 516 patients hospitalized for acute abdomen. We have excluded from this research the younger patients than 14 years, those with shock, those with clinical signs of cardiopathy, those with electrolytic alterations and those executing anti-arythmic or anti-depressing therapy. We have found changes of repolarization and of rhythm. The changes of regularization consisted in flottening-inversion of T wave in the precordial and/or limb leads associated sometimes at negative deflection of the ST tract in the same leads. The changes of rhythm consisted in atrial or ventricular extrasystoles, paroxismal atrial tachycardia, paroxysmal atrial fibrillation. Sometimes the changes of repolarization and rhythm were associated. We have discussed the possible pathogenetic mechanisms answerable for these changes; sympathetic adrenergic activation mediate or no from a parasympathetic reflex, reduction of intra-cellular potassium, activation of enzymatic systems, reabsorption of toxic substaces. The Authors have underlined the benignity of these ECG changes, disappearing after resolution of abdominal disease, and the necessity of a correct interpretation of those, to avoid the arising of a iatrogenic disease.
 ...
PMID:[Electrocardiographic changes in acute abdomen]. 616 3

Electrophysiologic studies support significant hypokalemia as a cause of atrial flutter in a patient without manifest heart disease. Atrial flutter, reproducibly initiated and terminated by rapid atrial pacing during hypokalemia, was not inducible after potassium correction. In an individual with existing atrial conduction disease, hypokalemia may generate both non-uniform atrial refractoriness and atrial premature beats, and it may facilitate the development of atrial flutter as a re-entrant arrhythmia.
 ...
PMID:Atrial flutter secondary to hypokalemia. 618 28


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