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

Of 197 patients with heart disease on oral anticoagulant treatment (nicoumalone) 12 were simultaneously taking an estroprogestogenic oral contraceptive. The patients were aged 27-44 years old and anticoagulation control was maintained by measuring prothrombin activity. For 230 months the women took anticoagulant only. The mean prothrombin time ratio was significantly higher when the women were taking both the anticoagulant and the pill than taking only the anticoagulant, but the prothrombin values were in the therapeutic range during both periods. The oral contraceptive seems to potentiate anticoagulation activity not diminish their effect. It is suggested that the estrogen in the pill may produce enzymatic inhibition in microsomes of hepatic cells which potentiate anticoagulant activity through retarded metabolic degradation.
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PMID:Interaction between anticoagulants and contraceptives: an unsuspected finding. 51 2

Five patients with severe heart disease developed cardiogenic shock of more than 24 hours' duration. As a sequela to the shock, severe liver affection was demonstrated. Serum aspartate aminotransferases and serum lactate dehydrogenases showed very high activities. The prothrombin-proconvertin index was reduced to less than 25% of the normal. Four of the patients were jaundiced. The condition gave rise to some differential diagnostic problems. Liver biopsies were available from four of the patients, and histological examination of an autopsy specimen of the liver was performed in each case. The liver histology showed centrilobular necrosis and haemorrhage in all patients. It seems that centrilobular fibrosis develops later in the condition. The pathogenesis of this liver affection is probably hypoxic injury to the centrilobular areas of the liver lobule due to reduced liver blood flow.
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PMID:The shock liver. Clinical and biochemical findings in patients with centrilobular liver necrosis following cardiogenic shock. 71 63

Decreased serum albumin levels are commonly observed in patients with carcinoid tumor, who also show several characteristic clinical and biochemical abnormalities. A large comparative study on a group of 96 carcinoid patients was performed with the purpose of identifying some of the mechanisms leading to hypoalbuminemia in patients with this form of cancer, and thereby to shed light on the cause of hypoalbuminemia of cancer in general. Serum albumin values were compared with a number of clinical parameters (including extent of liver metastases, severity of diarrhea, degree of right heart failure, and extent of gastrointestinal surgery) and of laboratory data (prothrombin time, BSP retention, serum transferrin concentration, hematocrit value, and daily urine excretion of 5-hydroxy-indoleacetic acid). In several patients the gastrointestinal protein loss was assessed by the 51Cr-albumin technique, whereas albumin renewal and distribution were evaluated by the use of 125I-albumin. The data obtained showed that the main factors in determining decreased serum albumin levels in patients with carcinoids are both reduced synthesis and increased loss of the protein. The hepatic synthetic defect appears to be related to a progressive decrease in the number of functioning liver cells; the origin of the gastrointestinal protein loss may be related to the obvious tumor involvement of the gut wall, as well as to the pharmacologically-induced diarrhea. Right heart failure occurring as a result of the carcinoid heart disease may be an additional cause for gastrointestinal protein loss in patients with carcinoid tumor.
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PMID:Pathophysiology of hypoalbuminemia associated with carcinoid tumor. 97 3

Factors involved in the development of coronary atherosclerosis and the possible role of estrogens in its development are discussed. Risk factors in the development of atherosclerosis include hyperlipemia, hypertension, cigarette smoking, and diabetes. However, the incidence of heart disease and presence of risk factors are also related to heredity, geography, and socioeconomic conditions, and to diet, exercise, and emotional stress. Contrary to previous belief, high doses of estrogens aggravate the condition of men and menopausal women at risk of heart attack. Although estrogens do not markedly alter cholesterol levels, they do tend to elevate triglyceride levels and contribute to hyperlipemia. They are also associated with diabotegenic sequelae and hypertension. Pregnancy and estrogens increase blood clotting Factors VII and X, accelerate prothrombin time, shorten clotting time, and incre ase platelef aggregation. Further research into the role of estrogens in the development of atherosclerosis is recommended.
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PMID:Estrogens and atherosclerosis. 99 76

The incidence of abnormal results of coagulation tests and the risks for postoperative hemorrhage were assessed in 235 patients with congenital heart disease. Preoperatively, the prothrombin time, partial thromboplastin time, activated partial thromboplastin time, thrombin time, or platelet count was abnormal in 45 of the 235 patients (19%), a significantly higher incidence than that expected in a normal population (P less than 0.002). Prolonged values for the prothrombin time or the partial thromboplastin time or activated partial thromboplastin time were seen most frequently. Further evaluation in eight of the patients with prolonged prothrombin time or partial thromboplastin or activated partial thromboplastin time showed decreased levels of either factor VII or IX in six of them, suggesting that impaired vitamin K-dependent carboxylation is commonly present. Normal results of preoperative coagulation tests do not exclude the presence of a major bleeding diathesis (von Willebrand's disease was later diagnosed in a patient with such findings). The use of blood products during subsequent cardiac operations was not significantly different in patients with normal or abnormal test results. Two of the three patients who required reoperation and were found to have a nonsurgical cause of bleeding had abnormalities in two or more of the preoperative coagulation tests. This finding suggests that abnormal results of preoperative coagulation tests may be predictive of defective hemostasis in the postoperative period.
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PMID:Preoperative evaluation of hemostasis in patients with congenital heart disease. 357 26

Cefuzonam (L-105, CZON), a new injectable cephalosporin, was used in 12 pediatric patients with infections. The following is a summary of the results: The 12 cases included 3 cases of tonsillitis (pathogen: Haemophilus parainfluenzae in 1 case, Haemophilus influenzae in 2 cases), 4 cases of pneumonia (Staphylococcus aureus in 1 case, pathogen unknown in 3 cases), 2 cases of nephropyelitis (Escherichia coli in 2 cases), 1 case of purulent lymphadenitis (pathogen unknown), 1 case of purulent thyroiditis (mixed infection of Streptococcus milleri, Haemophilus aphrophilus and anaerobes), and 1 case of vulvar abscess (E. coli). Dose levels of CZON were 42.9 approximately 93.3 mg/kg/day divided into 3 or 4 times and the drug was intravenously injected for 6 to 12 days. Clinical efficacies were excellent in 4 cases, good in 5 cases, and poor in 3 cases, with the efficacy rate of 75.0%. The 3 cases with poor efficacy consisted of 1 case each of pneumonia complicated with chronic granulomatosis, purulent thyroiditis associated with piriform recess fistula, and purulent lymphadenitis of armpit developed after surgical operation of congenital heart disease. In the first 2 cases satisfactory efficacy was not obtained by chemotherapy alone, and complete cure was seen after surgical operation. Side effects were not observed clinically. One case each of slight prolongation of prothrombin time and transient elevations of GOT and GPT values were noted but no severe abnormalities were found in laboratory tests.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical evaluation of cefuzonam in pediatrics]. 359 92

Acute hepatic failure (AHF) combined with acute renal failure (ARF) is a well-known complication of open-heart surgery in adults. The occurrence of this complication in two children after open-heart surgery for correction of congenital heart disease is reported. Hypotension occurred during the operation and was treated by catecholamine vasopressors. AHF set in during the postoperative course; it was manifested by impaired consciousness, hypoglycemia, hyperbilirubinemia, hyperammonemia, elevated liver enzymes and prolongation of the prothrombin time with failure of hemostasis. ARF also developed in both children. One of the patients survived the acute episode of hepatic failure. The importance of early diagnosis, routine close monitoring, and appropriate selection of vasopressors is emphasized.
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PMID:Acute hepatic failure after open-heart surgery in children. 362 68

Multiple components of the fibrinolytic mechanism (plasminogen, plasmin, antiplasmin, fibrinogen, fibrin degradation products) and factor II (prothrombin) levels were studied in 40 children with cyanotic congenital heart disease (CCHD) prior to corrective surgery. Seven of these were also studied post-operatively. A further 17 children were studied after corrective surgery only. Pre-operatively, increased fibrinolysis could bedemonstrated in only 7.5-12% of patients, and there was no correlation between the levels of fibrinolytic components and the severity of polycythemia or post-operative blood loss. There was no evidence of fibrinolysis post-operatively. Pre-operatively, low prothrombin levels were common (25%), were correlated with the amount of post-operative bloodloss and were restored to normal by corrective surgery. Hypoprothrombinaemia is one of the most significant haematological abnormalities in CCHD.
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PMID:Pre- and post-operative studies of fibrinolysis and prothrombin in cyanotic congenital heart disease. 428 67

This paper describes a successful cardiac operation in a young boy with hemophilia, congenital heart disease, severe factor VIII deficiency, and an acquired high titer antibody to factor VIII. To our knowledge, there have been no published cases of elective cardiac operations in a person with severe hemophilia and an accompanying complex problem. Utilizing the team approach, we administered a megadose bolus of factor VIII concentrate preoperatively (eight times the calculated dose), followed by a continuous intravenous infusion at 500 units/hr throughout the procedure and at a reduced dose for the first 5 postoperative days. With the anamnestic rise in factor VIII antibody on day 5, activated prothrombin complex concentrates were substituted for factor VIII and provided continued adequate hemostasis during the remaining 9 postoperative days. The rapid infusion of large quantities of factor VIII was effective in neutralizing the low titer inhibitor and providing normal hemostasis during the procedure. In addition, activated prothrombin complex concentrates were substituted for factor VIII coagulant without recurrent bleeding or thromboembolic phenomena.
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PMID:Elective cardiac operation in a patient with severe hemophilia and acquired factor VIII antibodies. 642 12

An avcothanized vinyl sheet consisting of a Pall filter, 2 pressure monitoring lilnes, 2 heparinization lines, and a roller pump was used for transapical left ventricular bypass in 36 calves and 11 patients. Blood was returned to the abdominal or ascending aorta or carotid artery. Prolonged left ventricular flow unloading was carried out. All 31 calves that underwent left ventricular bypass and 5 calves that underwent left ventricular bypass and 5 calves that underwent biventricular bypass survived the scheduled period of bypass of up to 7 weeks except for 2 calves that died of accidental air embolism and 2 that were deliberately sacrificed due to infection. Local heparinization for 6 days followed by oral anticoagulation to maintain the prothrombin time at 150-200% of normal were effective in keeping the animals from bleeding and preventing thromboembolism. Eleven critically ill patients with severe heart disease were supported with left or biventricular bypass for periods of up to 172 hours. Four patients ultimately recovered, and 3 others were successfully weaned from bypass and expired 1-4 months later.
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PMID:Transapical left ventricular bypass with local heparinization for prolonged circulatory support. 740 62


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