Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

80 patients with acute myocardial infarction were analyzed in our coronary heart unit in whom the use of a transient pacemaker was indicated. The over all mortality was 33.75%, three fold the general myocardial infarction mortality in the CCU of the INCICH which is 12%, and increased to 51.35% in those with complete AV block. The mortality rate was even more significative with the association of RBBB and first degree AV block (80%). Cardiac failure was a fatal complication in 94% of that group of patients, and it increased to 100% in those with cardiogenic shock. Except those who progressed to complete AV block, there was not mortality in the patients with 2nd degree AV block. In the last mentioned group, predominated the posterior infarction with extension to the right ventricle and none had severe heart failure. The mortality rate was low in patients with recent LBBB or in those with RBBB associated to left branch hemiblock, but the majority had the disturbance permanently. In 7.5% of the patients implantation of a permanent pacemaker was necessary. In half of them due to the presence of a 3rd degree AV block of more than one moth duration. We conclude that the insertion of a temporary pacemaker in our cases had no major complications and the 12 accepted indications for this still hold on.
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PMID:[Use of the temporary pacemaker in acute myocardial infarct]. 663 7

Verapamil hydrochloride, a prototype calcium antagonist, is now marketed in the United States for the acute treatment of supraventricular tachyarrhythmias and for chronic management of vasospastic and chronic stable angina. It inhibits the slow inward channel in in the heart and blocks calcium influx in smooth muscle. Its intrinsic negative inotropic action, which is apparent in isolated tissues, is offset in vivo by peripheral vasodilation. It has a mild, noncompetitive sympathetic antagonist effect; its most important electrophysiologic action is a depression of AV nodal conduction, accounting for its effect in supraventricular tachyarrhythmias. Its hemodynamic actions are characterized by a complex interplay of changes in preload, afterload, contractility, heart rate, and coronary blood flow. It does not depress cardiac function, except in severe heart failure. The drug has a mild dilator action on coronary arteries and reverses ergonovine-induced vasoconstriction. Controlled trials have established its role in Prinzmetal's variant angina, unstable angina, and chronic stable angina. It has also been found to be effective in obstructive cardiomyopathies. The potential role of verapamil in such conditions as hypertension, cardioprotection, and Raynaud's phenomenon needs further evaluation; at present these indications have not been approved by the Food and Drug Administration. The most common side effects include constipation, skin rash, and dizziness; AV block, heart failure, and sinus arrest may occasionally be encountered, especially when ventricular function is compromised or conduction system disease is present.
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PMID:Verapamil hydrochloride: pharmacological properties and role in cardiovascular therapeutics. 676 30

The long-term outcome of myocardial infarction (MI) with bundle branch block (BBB) was studied retrospectively by a direct questionnaire and a registry enquiry in order to define the prognostic significance of data obtained during hospitalisation and to discuss the possible indications of permanent pacing in these patients. Out of 2 720 acute MI hospitalised between October 1969 and April 1977, 231 and BBB (unknown before infarction): 58 right, 53 left and 120 bilateral BBB. 113 patients survived the acute phase of MI and 111 patients were followed up for 72 +/- 24 months: 80 patients died, and 30 survive - a global survival rate of only 13% at 6 years. The post-admission mortality rate was not related to the type of BBB or the site of infarction. It was significantly higher in patients with previous myocardial infarction and in a sub group of patients without advanced AV block in the acute phase who had severe cardiac failure (Classes III and IV, Killip). The hospital mortality was higher in patients with advanced AV block in the acute stage (62,5% compared to 45,9%) in patients without advanced AV block, p < 0,025. On the other hand, the post-admission mortality was not significantly different in these two sub groups (77,8% compared to 69,8% : NS). Stokes-Adams syncope was rarely authentified in the post-admission course of the patients. An increased risk of secondary sudden death directly related to a conduction defect has not been proved. The indications for permanent pacing therefore remain uncertain. They should not be widened further than the indications for permanent pacing in chronic degenerative block.
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PMID:[Long-term course of patients with myocardial infarction and bundle branch block]. 677 24

Thirteen fetuses with nonimmune hydrops (22 to 39 weeks of gestation) were evaluated with two-dimensional and M-mode echocardiography. Ten fetuses had cardiovascular abnormalities resulting in heart failure, and three had noncardiac causes of hydrops. In three cases, hydrops was caused by supraventricular tachycardia. One of these fetuses responded to cardioversion at birth, another responded to transplacental digoxin therapy, and the third died with atrial flutter and high-grade atrioventricular block before delivery. There were no cases of "idiopathic" hydrops. Our results show that fetal echocardiography is useful in determining cardiac causes of in utero heart failure resulting in hydrops fetalis. The fetal echocardiogram may also be used in monitoring transplacental therapy of heart failure.
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PMID:Fetal echocardiography for evaluation of in utero congestive heart failure. 703 42

Five patients with severe left ventricular failure, renal insufficiency, and recurrent ventricular tachycardia had cardiovascular collapse and died eight hours to 23 days after initiation of the usual doses of disopyramide. Three patients had recent myocardial infarction (12 to 33 days), and one had severe congestive cardiomyopathy. ECG changes antedated appearance of cardiovascular collapse and consisted of lengthening of the QRS (0.10 plus or minus 0.02 to 0.22 plus or minus 0.09; P less than 0.025) and the QTc duration (0.44 plus or minus 0.04 to 0.56 plus or minus 0.09; P less than 0.05). Sinus bradycardia or varying degrees of atrioventricular block or both occurred in all patients. Terminal disopyramide blood concentration (4.9 and 8.1 micrograms/ml) were available in two patients. A syndrome of progressive lengthening of ventricular depolarization and repolarization terminating in cardiovascular collapse and death associated with disopyramide is described. In addition, a high incidence of sinus bradycardia, atrioventricular conduction disturbances, or both was also noted. Disopyramide is contraindicated in patients with severe heart failure and renal insufficiency. Progressive widening of the QRS complex or the QT interval may presage appearance of severe myocardial dysfunction.
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PMID:Cardiovascular collapse associated with disopyramide therapy. 722 32

A case of metastatic myocardial calcification is reported in a patient with chronic renal failure. The characteristic features are failure to take phosphate-binding antacids on a regular basis, intractable congestive heart failure, atrioventricular block, a calcium phosphate product consistently greater than 60, and sudden irreversible cardia arrest. Arteriovenous fistulae created for haemodialysis appear to be an unlikely cause of cardiac failure.
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PMID:Metastatic myocardial calcification. 724 27

The results of haemodynamic, echocardiographic and bicycle exercise investigations in a 72-year-old man with a permanent complete atrioventricular block and heart failure following infarction are presented. Comparative measurements were obtained under the conditions of a ventricular and an av-sequential pacemaker (PM). The ventricular demand pacemaker (VVI) was implanted three years ago and because of further impairment of cardiac performance an av-sequential pacemaker (DDD) was used to restore atrio-ventricular synchronisation. The treatment with bifocal PM improved dramatically cardiac output and exercise capacity. The echocardiographic findings demonstrate the significance of Frank-Starling mechanism in this case due to better filling of the ventricles. As noninvasive methods, echocardiography and bicycle-exercise test allow long-term analysis of cardiac function.
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PMID:[Hemodynamic and exercise capacity in a 72 years old patient under a ventricular and bifocal pacemaker (author's transl)]. 725 4

Examination of 900 patients with acute myocardial infarction was carried out, in 110 of them disorders of intraventricular conduction were revealed. Atrioventricular block of grade III-IV developed in 13 patients within the first 3 days of the disease. Nine patients died: asystolia developed in 4 of them, progressive cardiac insufficiency in 3, cardiogenic shock in 1, paroxysm of ventricular tachycardia followed by ventricular fibrillation in 1 patient.
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PMID:[Sudden death in patients with intraventricular conduction disorders in myocardial infarct]. 726 29

An ajmaline test was conducted in 120 patients with a history of disorders of consciousness : Adams-Stokes syndrome (n = 49), loss of consciousness (n = 42), or lipothymia (n = 29). Four types of response were observed after ajmaline : VH less than 80 ms (n = 63); VH between 80 and 100 ms (n = 19); VH greater than 100 ms (n = 17); distal block (n = 21). One hundred and fifteen of these patients were followed-up for from three to six years (mean 56 months). Pacemakers had been fitted in 46 of them. Atrioventricular block was eventually detected in 37 patients but was excluded in the other 78 cases, either because the syncope attacks did not recur or because another cause was demonstrated. The predictive value of the ajmaline test was confirmed by the subsequent course of the disorders. Based on only clinical findings, diagnosis was confirmed in 42 p. cent, excluded in 12 p. cent, and impossible to define in 46 p.cent of cases. After the ajmaline test, diagnosis was confirmed in 79 p.cent, excluded in 6 p.cent, and impossible to define in 15 p.cent. The risk of atrioventricular block can be evaluated as 1-6 p.cent when the increase in VH is less than 80 ms, 35.3 p.cent when the increase is between 80 and 100 ms, 62.5 p.cent when it is greater than 100 ms, and 100 p.cent when there is a distal block. The indications for fitting a pacemaker depend upon the results of this test. If contra-indications are respected (recent history of an infarct, cardiac failure, marked enlargement of the heart), complications are rare, being observed in less than 3 p.cent of cases.
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PMID:[Predictive value of the ajmaline test for the diagnosis of distal paroxysmal atrioventricular block (author's transl)]. 730 73

Certain rhythm and conduction disorders in 252 patients with myocardial infarction were studied. Twenty one of them had auricular fibrillation, influenced by medicaments, with the exception of one, six had relapses and 4 of the patients died. Ventricular extrasystoles (frequent, polytopic, more than three one after the other, R of T) were found in 48 patients. Regardless of the reported good result from the treatment of ventricular extrasystoles, ventricular tachycardia originated in 10 and ventricular fibrillation--in 9 patients. Ventricular fibrillation (a total of 29 patients) was more frequent in patients with cardiac insufficiency (25%) as compared with those (6.1%). With the combination of cardiac insufficiency and ventricular extrasystole, a very high risk group is formed--every third patient develops ventricular fibrillation. Four patient out of 22 patients, were discharged with timely initiated treatment of the ventricular fibrillation. Complete atrioventricular block was recorded in 12 of the patients with a lethality of 50%. Conclusions are drawn as regards the duration of prophylaxis and treatment of rhythm and conduction disorders and in-patient days of the patients in the intensive care unit.
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PMID:[Clinical characteristics, immediate therapeutic results and the outcome in rhythm and conductivity disturbances in myocardial infarct]. 738 1


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