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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A six-year-old girl presented with clinical signs and symptoms of right-sided heart failure. Cardiac catheterization demonstrated filling defects in both pulmonary arteries felt to represent metastatic lesions or thromboemboli. Intravenous pyelogram revealed bilateral renal masses and intrarenal obstruction. Acute renal failure was unresponsive to standard therapy. An open renal biopsy revealed Wilms tumor with favorable histology. Aggressive chemotherapy and irradiation were undertaken and renal function returned. This case adds to the heterogeneity of presentations described for Wilms tumor, and review of the literature reveals no other cases with similar presenting signs.
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PMID:Bilateral Wilms tumor presenting with acute renal failure and clinical findings mimicking cardiac failure. 22 71

A 58-year-old man had sudden and progressive heart failure after a severe myocardial infarction. Aggressive medical treatment consisting of diuretics, vasopressors, and digitalis failed to improve his condition significantly. Cardiac catheterization disclosed a critical stenosis in the left anterior descending branch of the left coronary artery, a large posterior left ventricul aneurysm, and severe mitral insufficiency. Intermittent third degree heart block developed after admission. Surgical correction resulted in a dramatic recovery, and three years after operation he is fully recovered and asymptomatic.
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PMID:Resection of posterior ventricular aneurysm, replacement of mitral valve, and coronary bypass. 31 60

Out of 769 patients with arterial diseases, reconstructive surgery was performed on 100 limbs of 79 patients for arteriosclerosis. The overall patency rate was 59 per cent over a period of 3 to 8 years. Long-term patency was influenced by the condition of the run-off arteries, the site of the operation, and the method of surgery. No relation was found between patency rate and hypertension, cardiac insufficiency, total serum cholesterol, diabetes mellitus, or age. The survival rate was 62 per cent at 5 years and 48 per cent at 7 years. These rates were significantly poor (p less than 0.001), compared with those in the normal population. Mortality was related to the degree of hypertension, with cardiac and renal failure being responsible for 72 per cent of deaths. Aggressive reconstruction may be indicated in cases with hypertension of stage 2 or below based on the WHO classification. However, especially in patients with associated diabetes mellitus close long-term observation of the cardiovascular system is necessary.
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PMID:Long-term prognosis for reconstruction of arterial lesions due to arteriosclerosis. 47 Feb 53

AVMs are congenital malformations of central nervous system blood vessels. The majority of lesions become symptomatic prior to age 40. Hemorrhage and epilepsy are the most frequent presenting symptoms. Disabling headache, transient, progressive, and permanent neurological deficit, heart failure, hydrocephalus, macrocephaly, and intellectual impairment may also occur. Long-term mortality is approximately 18%, and morbidity leading to disability occurs in 30% of patients. Aggressive management when possible is indicated.
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PMID:Natural history and pathophysiology of arteriovenous malformations. 54 27

Fulminating active rheumatic carditis has been observed for over 3 decades in this environment with no recent alteration in either the incidence or the pattern of presentation. Patients are black, seldom older than 20 years and are usually in their early teens but may occasionally be as young as five years. Heart failure is prevalent but occurs only when a haemodynamically important left-sided valve lesion supervenes. Regurgitation is the predominant valve lesion and involves principally the mitral valve. Mitral annular dilatation is the initial pathology and predisposes to lengthening--or rupture--of chordae tendineae and prolapse of the anterior leaflet. The resultant cardiac work-overload apparently perpetuates the rheumatic activity. Heart failure, whether caused by or associated with active rheumatic carditis, makes surgical management of the valve lesion mandatory as a life-saving measure. Mitral valve repair, rather than replacement, is the surgical procedure of choice but is not always practicable when the rheumatic activity is fulminant, significant aortic regurgitation associated or the surgeon relatively inexperienced. Aggressive medical therapy for heart failure, which should include vasodilator drugs, provides temporary improvement only. Contrary to ongoing doctrine, treatment with steroid drugs is neither life-saving nor beneficial. Varying degrees of left ventricular dysfunction are encountered pre-operatively and may be a sequel of the severe regurgitant valve lesion rather than of a rheumatic 'myocardial factor'.
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PMID:Aspects of active rheumatic carditis. 144 46

Heart disease is a major cause of morbidity and mortality in the Churg-Strauss syndrome. However, few clinical follow-ups have been published. In this case report, in which the diagnosis of Churg-Strauss syndrome was made based on histologic criteria and clinical features, heart failure with globally depressed left ventricular function was present. Aggressive therapy (prednisone and cyclophosphamide) was instituted. In the follow-up a prompt clinical response and eventual recovery of the indices of cardiac function as evaluated by echocardiography and radionuclide ventriculography were observed.
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PMID:Reversible myocardial impairment in the Churg-Strauss syndrome: report of a case. 155 Dec 83

A multidisciplinary team approach using a staged transcatheter embolization and neurosurgical protocol was applied to 22 patients with neonatal presentation of vein of Galen malformations over a 12 year period. Aggressive medical therapy was combined with interventions including: ventricular shunting, transcatheter embolization, retrograde transtorcular embolization, and neurosurgical obliteration. There was a high frequency of high output cardiac failure, multiple organ system dysfunction, seizures, hydrocephalus, visual, developmental and neurological disability. Of the first 11 patients, five survived; four with seizures and three with marked retardation. Of the last 11 patients, six survived; five with seizures but only one with retardation. Despite persistently high morbidity and mortality, our continuously evolving protocol offers these otherwise hopeless patients some chance of survival.
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PMID:Neonatal vein of Galen malformations: experience in developing a multidisciplinary approach using an embolization treatment protocol. 174 76

Fulminating active rheumatic carditis has been observed for over three decades in this environment with no recent alteration in either the incidence or the pattern of presentation. Heart failure (in this context defined as 'an inadequate circulation at rest together with a raised pulmonary venous pressure, with or without an associated high systemic venous pressure in the absence of haemodynamically significant tricuspid valve disease or pericardial effusion') is prevalent but occurs only when a haemodynamically important left-sided valve lesion supervenes. Regurgitation is the predominant valve lesion and involves principally the mitral valve. Mitral annular dilatation is marked and predisposes to lengthening--or rupture--of chordae tendineae and prolapse of the anterior leaflet. The resultant cardiac work-overload apparently perpetuates or aggravates the rheumatic activity. Heart failure, as defined, whether caused by or associated with active rheumatic carditis, makes surgical management of the valve lesion mandatory as a life-saving measure. Aggressive medical therapy for heart failure, which should include vasodilator drugs and especially angiotensin-converting enzyme inhibitors, provides temporary improvement only. Contrary to ongoing doctrine, treatment with steroid drugs in this context is neither life-saving nor beneficial.
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PMID:Mechanisms and management of heart failure in active rheumatic carditis. 220 Jan 47

The biology of the myocardium was studied in chronic heart failure, especially in the course of compensatory hypertrophy induced experimentally by partial stenosis of the aorta for 10 months and the administration of large isoproterenol doses for 7 months. In the stage of acute aggression, varied disseminated ultrastructural lesions are predominant, with the decrease of energy reserves, hydroelectrolytic and ECG perturbations. In the stage of ultrastructural compensatory hypertrophy, there is a prevalence of normal myocytes or others presenting regenerative aspects next to progressive fibrosis reflected biochemically by return to almost normal values, with certain oscillations due to the presence of some lesional foci, also recorded on the ECG tracings. The question of the pathogenesis and prognosis of these lesions is discussed.
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PMID:The biology of the myocardium in chronic hypoxia. Note I. Myocardial lesions in experimental chronic heart failure. 293 27

Two infants with thrombosis of the abdominal aorta are discussed. In each case the presentation was indistinguishable from that in coarctation of the aorta, with heart failure and absent femoral pulses. Surgery in one infant successfully relieved the obstruction. The diagnosis may not be suspected from the history. Aggressive management is indicated.
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PMID:Congestive heart failure and absent femoral pulses in newborns without coarctation of the aorta. 683 58


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