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

Six infants with either cavernous hemangiomas or hemangioendotheliomas of the liver are described. Typical clinical features include cardiac failure, hepatomegaly, and cutaneous hamangiomas. Prompt recognition will direct management to prevent lethal complications of cardiac failure, hyperconsumptive coagulopathy, and hepatic rupture. Dynamic and static hepatic scintigraphy will demonstrate the vascularity and size of the liver mass and provide distinction from other tumors, although in certain circumstances angiography is required.
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PMID:Hepatic cavernous hemangiomas and hemangioendotheliomas in infancy. 40 70

Three patients with initial clinical manifestations and biochemical findings suggestive of a diagnosis of Reye's syndrome had acute renal insufficiency develop and had evidence of consumptive coagulopathy, not generally considered features of the syndrome. As a group, they could not be distinguished, either on the basis of their clinical manifestations or liver pathologic findings, from the 17 patients with Reye's syndrome without renal failure seen in our institution during the same period of time. The use of osmotic diuretics in an effort to decrease cerebral edema may be life threatening in these patients with compromised renal function since hypervolemia, cardiac failure, and worsening of cerebral edema may occur.
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PMID:Acute renal failure in Reye's syndrome. 49 89

A very rare case of a myxosarcoma with metastases to the brain is reported. A 33-year-old female was admitted to our hospital because of lassitude, fever, slight left hemiparesis, headache and other signs of intracranial hypertension and cardiac symptoms such as dyspnea and palpitation. She had the cardiac symptoms once 14 years before, which reappeared and rapidly aggravated two months before the admission. Cerebral angiography revealed a mass in the right temporal lobe and physical and laboratory examinations revealed mitral value failure and hyperthyroidism. On the next day, March 19, 1976, a grossly cystic 60 gm tumor was totally removed which was largely imbedded in the subcortex of the right temporal lobe. The symptoms except for the cardiac symptoms and disseminated intravascular coagulopathy rapidly improved, but headache and left hemiparesis returned 13 days postoperatively. She died suddenly 18 days after the operation due to acute cardiac failure. Autopsy revealed two separate hard and solid tumors both attached to the mitral valve and occupied the whole left atrium and another metastasis to the frontal lobe which had not been diagnosed before the death. Microscopic examinations including electronmicroscopic study established the diagnosis of myxosarcoma in all the four tumors.
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PMID:[Brain metastases from primary cardiac myxosarcoma--report of a case (author's transl)]. 71 43

An elderly female with an acute episode of congestive heart failure, unaccompanied by any periods of hypotension, developed fulminant hepatic failure with an accompanying coagulopathy. Attempts to establish an etiology for her acute hepatic insufficiency, other than cardiac failure, proved negative. Fulminant hepatic failure as a consequence of congestive heart failure, without prolonged periods of hypotension preceding alteration in hepatic function, has not heretofore been described. Liver function is adversely effected in congestive heart failure. Hepatic ammonia clearance is impaired in cardiac failure and may be diminished to the point of resulting in hepatic encephalopathy. Coagulopathy is a frequent concomitant of fulminant hepatic failure. Establishing a clear etiology for a coagulopathy in the face of concomitant liver disease is difficult, thus making any therapeutic intervention fraught with peril.
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PMID:Fulminant hepatic failure secondary to congestive heart failure. 101 98

The Kasabach-Merritt syndrome is characterized by thrombocytopenia and localized coagulopathy associated with a hemangioma. Most techniques applied to eradicate the tumor or accelerate its involution (surgery, radiation therapy, embolization) are invasive and require transfusion of large amounts of blood products. In some cases, medical treatment is the only alternative. Efficacy of steroids and antifibronolytic agents has already been described, but even this approach is associated with the administration of blood products. We report two cases of infants with Kasabach-Merritt syndrome associated with cardiac and hepatic hemangiomas. At admission, both had signs of cardiac failure. They were successfully treated with prednisone and epsilon-aminocaproic acid (EACA). Blood products were not required once the diagnosis was made. These observations have important implications for the management of patients with Kasabach-Merritt syndrome because they show that even in severe cases blood transfusions can be avoided by the use of prednisone and EACA.
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PMID:Successful treatment of Kasabach-Merritt syndrome with prednisone and epsilon-aminocaproic acid. 831 77

A survivor of a clinically severe presentation of amniotic fluid embolism during cesarean section performed under epidural anesthesia is presented. Some general pathophysiologic features of amniotic fluid embolism are discussed in the context of presented case: seizures as a first sign of amniotic fluid embolism, heart failure and coagulopathy. In addition we discuss the management of the epidural catheter in coagulopathy in the presented case.
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PMID:Amniotic fluid embolism during epidural anesthesia for cesarean section. 179 32

The clinical features, radiologic investigation, and treatment of 20 infants with hepatic hemangiomas are presented. Palpable abdominal mass (n = 18) and cardiac failure (n = 11) were the common presenting features. Nine patients had hyperconsumptive coagulopathy. Seven patients had other hemangiomas. Ultrasound (n = 15) showed the number and distribution of the hemangiomas within the liver. Hypoechoic and hyperechoic elements were present in addition to prominent vascular channels and diminished caliber of the distal aorta. Radionuclide sulfur colloid (n = 12) and labeled red blood cell (n = 7) studies showed the distribution and vascularity of the hemangiomas. Computed tomography (n = 8) revealed central hypointensity with marked peripheral enhancement after contrast. Arteriography now performed only as a prelude to therapeutic embolization demonstrated hypervascularity in each patient, contrast pooling in six and early draining veins in five. Magnetic resonance scanning (n = 3) showed decreased signal intensity on T1 images and high intensity signal on T2. In two patients, there was resolution or improvement of the hemangiomas without therapy. Four patients had surgery (lobectomy [2], trisegmentectomy [1], and surgical evacuation of a central hematoma [1]). Steroids and radiation were given to seven patients, and one patient also required therapeutic embolization. Steroids were the initial therapy in five patients, one of whom later required therapeutic embolization and another cyclophosphamide. Two patients were treated initially with radiation therapy, one of whom also needed emergency hepatic artery ligation. Seventeen of the 20 patients are alive and well from 6 months to 14 years after diagnosis.
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PMID:Infantile hepatic hemangiomas. Clinical features, radiologic investigations, and treatment of 20 patients. 266 35

We report a case of brucella endocarditis on a native aortic valve causing severe aortic regurgitation, uncontrolled heart failure and disseminated intravascular coagulopathy. The diagnosis was proven by positive serology, isolation of Brucella melitensis from preoperative blood cultures and excised valve. The patient was successfully treated with valve replacement and specific antibiotic therapy.
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PMID:Brucella endocarditis. Report of one case and review of the literature. 268 Dec 18

During the last 10 years we have inserted a roller pump-driven left heart assist device in 72 patients and a right heart assist device in 7 patients for profound heart failure after a variety of cardiac surgical procedures. In addition a percutaneous left heart assist device (transseptal insertion of left atrial cannula via a femoral vein) was employed in 5 patients with profound cardiogenic shock after acute myocardial infarction. Thirty patients (41.7%) were weaned from the left heart assist device and 21 (29.2%) were discharged from the hospital. Two patients (40.0%) were weaned from the right heart assist device, but both later died during the postoperative period. Of the 5 patients in whom a percutaneous left heart assist device was inserted, 4 underwent successful emergency percutaneous transluminal coronary angioplasty, but all 5 patients died. Causes of death included severe coagulopathy, irreversible extensive myocardial infarction and cardiac failure, refractory arrhythmias, severe "shock" lung, and multisystem failure. In summary, satisfactory results can be achieved with a roller pump-driven left and right heart assist device for severe postoperative heart failure. Further experience should be obtained with the percutaneous technique to assess its efficacy in treating patients with acute myocardial infarction and cardiogenic shock.
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PMID:Technique and results with a roller pump left and right heart assist device. 291 90

As cardiac transplantation becomes more commonplace in the treatment of end-stage heart failure and as suitable donors become less available, an increasing number of patients will require mechanical circulatory assistance to bridge to transplantation. Since 1982, refractory hemodynamic instability requiring placement of pulsatile ventricular assist devices (VADs) has developed in 11 candidates for transplantation aged 24 to 54 years (mean, 39.6 years). A pneumatic Pierce-Donachy pump was used in 9 patients and an electrical Novacor pump in 2. The cause of the cardiomyopathy was ischemic in 6, postpartum in 2, idiopathic in 2, and doxorubicin hydrochloride toxicity in 1. Seven patients required left ventricular support (LVAD); 4 required biventricular mechanical support (BVAD). Duration of support ranged from 8 hours to 91 days with flows ranging from 4.1 to 8.5 L/min (mean, 5.5 L/min). Although hemodynamic stability was achieved in all 11 patients, contraindications to transplantation developed in 5 patients during VAD support (renal failure in 4, sepsis in 3, disseminated intravascular coagulopathy in 1). The remaining 6 patients (4 with an LVAD, 2 with a BVAD) remained good candidates for transplantation despite major complications in 5 (mediastinal bleeding in 3, driveline infection in 3, development of preformed antibodies in 2, small embolic stroke caused by device malfunction in 1). The 3 patients who were supported the longest (24, 75, and 91 days) were ambulatory while awaiting a donor heart. All 6 patients underwent successful transplantation after 8 hours to 91 days (mean, 24 days) of support. Other than one sternal wound infection, there were no major complications after transplantation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Bridging to cardiac transplantation with pulsatile ventricular assist devices. 304 34


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