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)

The cardiac effects of chemotherapeutic regimens using high doses of cyclophosphamide (180 mg/kg over four days) were assessed in 32 patients with hematologic malignant neoplasms. Left ventricular systolic function, determined by the fractional shortening on echocardiogram, declined substantially five to 16 days after the initiation of cyclophosphamide therapy. Although pericardial effusion on echocardiogram occurred in 33% of the patients studied, ECG voltage decreased five to 14 days after beginning cyclophosphamide therapy even in those patients without pericardial effusion. Congestive heart failure was noted in nine patients (28%) within three weeks of cyclophosphamide administration. Six of these patients (19%) died of myocardial failure. Pericardial tamponade occurred in six patients (19%), including five who died of myocardial failure. Histopathologic and electron microscopic findings showed endothelial injury and a hemorrhagic myopericarditis. Cyclophosphamide in this high dose is associated with a toxic, often fatal, pericardiomyopathy. Depression of ECG voltage and systolic left ventricular function, though common, do not necessarily predict clinical cardiac deterioration.
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PMID:Cardiotoxicity associated with high-dose cyclophosphamide therapy. 723 84

Acute idopathic pericarditis can be accompanied by myocarditis, and in all types of acute pericarditis there are electrocardiographic signs of myocardial lesions. In order to determine the severity of the myocardial disease in acute idiopathic pericarditis, a prospective study has been carried out in a group of 25 patients with this diagnosis. The clinical evaluation included phonomecardiographic measurements of the systolic intervals, Weissler index in 24 cases, and echocardiographic study of the left ventricle in eight cases. Besides that, the serum levels of the myocardial enzymes (GOT, GPT, CPK, and LDH and its isoenzymes) were determined in all cases. The results showed a gallop rhythm in 8 percent of the cases, supraventricular arrhythmias in 4 percent, dysfunction of the left ventricle by systolic intervals and/or echocardiography in 32 percent, and increase of the myocardial enzymes in 24 percent, which represents a global incidence of myocardial disease of 44 percent. However, only three patients presented clinical manifestations of myocardial disease, although the congestive cardiac failure was always secondary to cardiac tamponade and not to myocardial failure. The increase of myocardial enzymes can determine important problems of differential diagnosis with an acute myocardial infarction. The clinical course was favourable in all of the cases, including the ones which showed myocardial disease.
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PMID:[Myocardial disease in acute idiopathic pericarditis (author's transl)]. 736 77

Cardiac tamponade (CT) and Carcinomatous lymphangitis (CL) association as an initial clinical presentation of a neoplasm is very uncommon, creating diagnosis difficulties in the patient first evaluation. This paper reports one case of a male who was admitted in Emergency Department with clinical and radiological findings of heart failure. Following studies showed CT and CL secondary to a bronchial adenocarcinoma. Differential diagnosis is really important for its associated therapeutic implications because of the CT hemodynamic worsening situation due to the diuretic and vasodilators used in the treatment of heart failure. An echocardiography should be done because it is very useful for the initial evaluation of a heart failure of obscure origin.
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PMID:[Pericardial tamponade and carcinomatous lymphangitis as primary manifestation of lung neoplasm]. 754 46

Percutaneous cardiopulmonary support (PCPS) was used in 5 patients (4 males and 1 female); 70.2 +/- 10.8 years old) who underwent open heart surgery and failed to wean from the extracorporeal circuit because of profound heart failure unresponsive to maximal doses of catecholamines and intra-aortic balloon pump support. Duration of PCPS was 6975 +/- 5516 min, and the average flow was 1.51 +/- 0.26 l/min/m2. Heparin-coated circuit including the oxygenator was used to minimize the necessary dose of heparin, and activated clotting time (Celite ACT) was maintained between the range of 130 and 200 seconds. Despite this low-dose heparinization, mediastinal hematoma formation and subsequent cardiac tamponade occurred in 4 patients. Weaning from PCPS was successful in 3 patients for whom reexploration to remove hematoma was performed, and 2 of these 3 achieved long-term survival. During the use of PCPS, ipsilateral femoral artery, through which part of the pump flow was actively perfused. Owing to this maneuvering, limb ischemia did not occur in any case. From these findings, we could conclude that reexploration for mediastinal hematoma should be performed in weaning from PCPS for postoperative patients, even when low-dose heparinization was employed, and that active perfusion through the 18g catheter downstream to the ipsilateral lower limb is effective in preventing limb ischemia during relatively long time PCPS.
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PMID:[Relatively long time use of percutaneous cardiopulmonary support after unsuccessful weaning from intra-operative extracorporeal circulation--clinical considerations from an experience of 5 patients]. 759 40

Based on a series of four cases and a review of the literature, the authors describe the lesions of the various cardiac tissues in the course of systemic scleroderma. Pericardial involvement presents in the form of either acute pericarditis or chronic pericarditis. Pericardial tamponade is exceptional. Sclerodermal cardiomyopathy is frequent and serious and can be responsible for heart failure. Arrhythmias are frequent and may be either ventricular or supraventricular. Involvement of the conduction tissue often requires implantation of a pacemaker. Endocardial and valvular involvement is very rare. Lastly, coronary involvement appears to be fairly rare and responsible for vasospastic episodes in the coronary artery territory.
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PMID:[Cardiac manifestations of diffuse systemic scleroderma. Apropos of 4 cases]. 779 49

Advanced malignant disease frequently involves the heart and pericardium, and pericardial effusion is a common postmortem finding in such patients. Identification of pericardial effusions in life is uncommon, however, even when symptomatic. Cardiac tamponade occurring as the first presentation of malignancy appears to be uncommon. We present five cases of cardiac tamponade due to undiagnosed malignancy which presented to a general medical unit over 18 months. The availability of echocardiography was an important factor in correct diagnosis, since clinical features were non-specific. Bronchial adenocarcinoma was the cause in three of the five cases. Review of the literature confirms adenocarcinomas of the bronchus as the most common cause of this complication. The majority of cases have presented with large volume, haemorrhagic effusions, and cytology (with or without carcinoembryonic antigen measurement) was diagnostic in most patients. Immediate treatment with subxiphoid pericardiotomy is recommended; the role of balloon catheter pericardiotomy remains to be established. Combined chemotherapy and radiotherapy appears to extend survival, which in some cases may be prolonged. We recommend that early echocardiography should be obtained in all patients presenting with apparent cardiac failure, since early treatment of malignant effusions provides symptomatic relief.
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PMID:Cardiac tamponade as the initial presentation of malignancy: is it as rare as previously supposed? 783 Nov 64

Endomyocardial biopsy remains the primary method for diagnosis of cardiac allograft rejection. Generally, endomyocardial biopsy is considered a relatively safe procedure in heart transplant recipients. Complications that have been reported are related to catheter insertion and include carotid arterial puncture, prolonged bleeding, vasovagal reaction, ventricular tachyarrhythmias, and transient conduction abnormalities. Serious complications such as right ventricular perforation with cardiac tamponade may also occur. Most complications are usually without significant long-term sequelae. This report describes an unusual case of atrioventricular fistula between the right atrium and left ventricle that occurred during a routine endomyocardial biopsy in a heart transplant recipient. Sudden hemodynamic compromise developed in this patient soon after heart biopsy associated with hemodynamic picture of high-output heart failure. Right heart catheterization, including oximetry, peripheral venous contrast echocardiography, color flow Doppler studies, and transesophageal echocardiography confirmed the diagnosis of fistulous communication between the right atrium and left ventricle, most likely through the membranous interventricular septum. Conservative medical management resulted in striking clinical improvement within 48 hours commensurate with spontaneous closure of the right atrium-to-left ventricle fistula documented by hemodynamic and echocardiographic studies.
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PMID:Atrioventricular fistula: an unusual complication of endomyocardial biopsy in a heart transplant recipient. 791 50

We report a case of angiosarcoma of the right atrium, manifested as a cardiac tamponade. The patient was a 57-year-old man. Transesophageal echocardiographic examination revealed a pericardial effusion and an abnormal structure arising in the right atrium. Emergency operation was performed and the tumor in the right atrium was resected under cardiopulmonary bypass. The resected tumor measured 5.0 x 3.5 x 2.0 cm, and microscopic examination revealed an angiosarcoma. The patient was initially recovered, but he died of heart failure caused by the recurrence in the left ventricle on the 5th postoperative month.
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PMID:[A case of primary angiosarcoma of the heart]. 808 76

59 cases of late cardiac tamponade following open heart surgery were studied. The incidence was 2.1%. Postoperative prolonged heart failure, anticoagulants, and blood in the pericardium left undrained may play a role in its pathogenesis. Echocardiography was the sure method of diagnosis. Insertion of a drainage tube into the pericardium through the subxiphoid approach was effective with minimal invasion and a treatment of choice.
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PMID:[Late cardiac tamponade after open heart surgery]. 830 2

The clinical condition of heart failure induced by pericarditis is expressed as cardiac tamponade or constrictive pericarditis. In both conditions, cardiac filling is impaired either by pericardial fluid or nonelastic pericardial sac under increased diastolic pressure and cardiac output is reduced. Patients show signs of right side heart failure. Immediate pericardiocentesis or pericardiotomy is required for cardiac tamponade, and pericardiectomy is essential for constrictive pericarditis. The clinical expression of myocarditis ranges from asymptomatic state to fulminant fatal congestive heart failure. Recently, identification of viral infection, using polymerase chain reaction (PCR), has contributed to the diagnosis of myocarditis, involving cases of idiopathic congestive cardiomyopathy.
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PMID:[Clinical features of heart failure induced by pericarditis and myocarditis]. 833 3


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