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

The authors have made a retrospective study of the case notes of 200 patients with valvular disorders seen over the course of 35 months (excluding those due to constrictive endocardial fibrosis). The cases represent the frequency of cardiac failure, especially in the mitral group. The authors found 61% to have mitral valve disease, 28.5% aortic valve disease, and 9.5% disease of more than one valve. Mitral valve lesions were found most frequently in young females (average age 26 years); aortic valve lesions were found more commonly in an older age group of men (average age 47 years). The authors discuss the aetiology. Rheumatic fever was responsible in 60% of cases, and caused particularly mitral valve disease. Atherosclerosis and syphilis were the commonest causes in the aortic group. Indications for surgery were found in 74 cases (37%), and 28% of these were closed heart techniques. The course of the disease is best appreciated during the first hospital admission. The mortality rate was 5.5%, and most of the patients (65%) were stabilised on treatment.
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PMID:[200 valvular disorders seen in Abidjan]. 18 50

Clinical-functional analysis of the efficacy of propranolol was conducted in 32 patients with ischemic heart disease and stable angina pectoris (with angiographically verified stenosing coronary atherosclerosis) depending on the initial myocardial contractility. A marked antianginal effect of propranolol in a dose of up to 160 mg daily was demonstrated irrespective of the initial myocardial contractile function. Treatment with propranolol was not attended with signs of cardiac insufficiency or aggravation of its subclinical symptoms. The results of the study provide convincing data that optimum doses of blocking agents of beta-adrenergic receptors of the myocardium causing a negative inotropic effect even in patients with diminished myocardial function may be used more widely.
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PMID:[Myocardial function and the use of propranolol in ischemic heart disease]. 49 63

Clinical and morphologic features of transmural myocardial infarction (associated with insignificant or absent atherosclerosis of the extramural coronary arteries) are described in seven patients with hypertrophic cardiomyopathy. Marked chronic congestive heart failure associated with supraventricular arrhythmias occurred in six of the seven patients, each of whom had no or mild left ventricular outflow tract obstruction under basal conditions. No patient had typical angina pectoris, and only one patient had clinically evident acute myocardial infarction. Infarction may have caused cardiac arrest in one other patient, but was "silent" in the remaining five patients. At necropsy, six of the seven patients had extensive myocardial scarring involving the ventricular septum, left ventricular free wall and one or both left ventricular papillary muscles; in four patients portions of the right ventricular wall were also scarred. Six patients had dilated ventricular cavities, including two who were known to have nondilated ventricular cavities earlier in their clinical course. It is concluded that transmural myocardial infarction in the absence of significant coronary atherosclerosis is a not uncommon finding (prevalence rate 15 percent) in a population of patients who had died from hypertrophic cardiomyopathy. Although transmural infarction is possibly a secondary event, it more likely contributes causally to the clinical deterioration of some patients with hypertrophic cardiomyopathy, leading to ventricular dilatation and progressive fatal cardiac failure.
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PMID:Hypertrophic cardiomyopathy and transmural myocardial infarction without significant atherosclerosis of the extramural coronary arteries. 57 70

The weight of some organs [brain, heart, lungs, kidneys, liver] was ascertained in a group of 1,598 persons who died a violent death, and a comparison was made with values obtained in a group of persons who died of cardiac insufficiency. The figures found were correlated according to sex with age, obesity, lipomatosis, physical size, the presence and stage of atherosclerosis. --Within the violent death group, a correlation was also made between a subgroup with minimal or no presence of atherosclerosis and one with ascertained atherosclerosis. The average weight of the brain was found to be 1419.6 g in men, 1266 g in women; the heart--394.7 or 343 g; kidney--149.0 g or 124.1 g; lungs 1280.0 or 973.4 g; liver--1770.9 g or 1522.0 g.
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PMID:[Weight parameters of various internal organs]. 61 41

Study of four personal cases and of twelve cases reported in the literature makes it possible to describe the characteristics of coronary embolism in mitral stenosis, a rare complication but indicating the presence of a left intra-atrial thrombosis: -- variable clinical picture, dominated by a syndrome combining simultaneously a picture of myocardial infarction and of peripheral arterial emboli of other localizations; -- diagnosis to be discussed within the framework of coronary syndromes in mitral heart disease: embolism requiring to be distinguished from coronary atherosclerosis combined with mitral stenosis, more rarely a functional coronary insufficiency; -- severe course and prognosis: besides the possibility of rapidly lethal cases, coronary embolism seems liable to result in weakening and diminishing of the adaptation possibilities of the left ventricle, responsible for attacks of heart failure after mitral valvulotomy.
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PMID:[Coronary emboli in mitral stenosis]. 81 66

Discrepancy in coronary stenosis between angiogram and pathological specimen was moderately found. It is of a problem what is meaning by a significant narrowing. Coronary capacity per heart weight markedly reduced in multi-vessel disease and revealed an intimate relationship to sudded death and cardiac failure. Much of sclerosis in the arterial wall was relatively severe in spite of patency in lumen of the terminal artery. Intramuscular arterioles were intact even when severe extramuscular coronary atherosclerosis was seen. Well-developed collaterals were seen in much of multi-vessel disease. Muscle prevervation was relatively good even in the advanced sclerosis. It is reasonable to make an attempt on a newly construction of a vessel to introduce into preserved arteriola with well-developed collateral, and preserved myocardium.
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PMID:Clinicopathological evaluation in the surgical treatment for ischemic heart disease. 88 53

Coagulability of arterial and venous blood was studied in 50 healthy subjects and in 179 patients with circulation disturbances caused by coronary atherosclerosis and rheumatic cardiopathies. All indicators characterizing the individual haemocoagulation phases were respected. In the healthy subjects the coagulative and fibrinolytic activities of venous blood were higher than those of arterial blood. In the patients with heart failure the coagulability of venous blood decreased and that of arterial blood increased. These phenomena were accompanied by fibrinogenaemia, appearance of fibrinogen B in the blood, elevation of free heparin, and inhibition, but occasional activation, of fibrinolysis in both vascular systems. The findings seem to signalize enhanced intravascular blood coagulability in patients with circulation disturbances, which phenomenon has to be taken into account in the treatment of such patients.
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PMID:Coagulability of arterial and venous blood in healthy subjects, patients with coronary atherosclerosis, and patients with rheumatic cardiopathies. 102 2

49 cases of myocardial infarction during pregnancy are reviewed from the literature, considering the frequency, pathogenesis, clinical findings, prognosis, treatment, obstetrical conduct including whether abortion is indicated, and finally 17 cases of pregnancy in women with previous heart attacks are summarized. A myocardial infarction is rare, about .01-.075%, more frequent in late pregnancy or the postpartum, and in older women. This series averaged 32.9 years. 88% were due to atherosclerosis. Other risk factors were usually not reported systematically. 56% of the incidents were the 1st heart attack; 44% were preceded by angina; 68% were anterior. Pregnancy affects the EKG and white blood count, but serum enzymes are the same as in nonpregnant women. 29% of these women died, 23 went to term, and 7 gave birth prematurely. 13 labors were spontaneous, 7 required forceps, and 10 were Caesarean births. Fetal loss was 27%. Treatment is the same as that in any heart attack patient, except for lignocaine and use of anticoagulants. Abortion is only necessary in cardiac insufficiency. Delivery should probably involve forceps, epidural anesthesia, and anticoagulatns immediately after delivery, but oxytocin should be avoided. The 17 cases of pregnancy after a heart attack resulted in 1 abortion, 15 term deliveries, 3 new infarctions, and 1 death due to antoher heart attack at term.
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PMID:[Myocardial infarct and pregnancy]. 103 53

The following effects in treatment of coronary artery disease are desired: 1. Elimination or improvement of angina. 2. Improvement of physical capacity. 3. Prevention of imminent complications (myocardial infarct, cardiac arrhythmias, heart failure, embolism). 4. Elimination or diminuation of risk factors. 5. Prolongation of life. - In a critical survey concerning long-term studies of patients with aorto-coronary bypass or medical treatment in the literature subtile lists of indications for surgical and conservative treatment are put up (Table II and III), illustrated by case reports. - Useful criteria for diagnosis, follow-up, and prognosis are selective coronary angiography, ventriculography as well as determination of the coronary reserve (Argon Method). Indication for aorto-coronary bypass and resection of myocardial aneurysms are presented. Principles of medical treatment are: 1. Diminuation of myocardial oxygen requirement (release of pressure, economisation of work load, recompensation, regulation of arrhythmias) and 2. improvement of myocardial oxygen supply (Diminuation of coronary perfusion resistance including prevention and treatment of atherosclerosis). Indication for various medications are discussed (nitrites, beta-adrenergic blocking agents and antihypertensive drugs, glycosides, medication for arrhythmias, coronary dilatators, anticoagulants, and lipotropic substances). Their mode of action is debated and documented by own results. Present possibilities and limits in treatment of coronary artery disease are presented.
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PMID:[Indications for surgical and medical treatment of coronary artery disease (author's transl)]. 108 41

Atherosclerosis and insufficiency of the coronary arteries and their sequelae are summarized in the term "coronary heart disease". For the evaluation of the coronary arteries the knowledge of malformations, variants and supply areas is of importance. Extension and severity of atherosclerosis of the coronary arteries and their insufficiency is being influenced by hyperlipidemia, hypertension and diabetes mellitus. The process of atherosclerosis as a cause of the proliferation of vascular smooth muscle cells in complicated by ulceration, parietal and obliterative thrombosis as well by intramural hemorrhages. Relative ischemia leeds to disseminated cell necrosis; total ischemia causes large myocardial tissue necrosis, called infarction. Localization and extension of infarction and the later scars correspond to the caliber of the obliterated coronary artery and to the significance of the collaterals. Postmortem coronary angiography can detect cause and extension of the damaged cardiac area. Functional significance of chronic coronary heart disease is related to the "critical connective tissue content" of the heart. After surgical treatment qualitative and quantitative morphology may help to explain postoperative cardiac failure.
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PMID:[Morphology of coronary heart disease (author's transl)]. 126 48


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