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

The clinical syndrome of "shock liver," also known as ischemic hepatitis, is characterized by sudden elevation (to more than 20 times the upper limit of normal) of SGOT and SGPT in response to cellular anoxia, followed by resolution to near normal levels within seven to ten days. In our experience with ten cases, systemic hypotension was documented in only four, but processes characterized by decreased cellular perfusion were identified in all and included cardiac failure or arrhythmia, sepsis, cerebrovascular accidents, renal failure, and chronic obstructive pulmonary disease. We were also able to document the transient rise in serum bilirubin and alkaline phosphatase levels and prolonged prothrombin time that followed the transaminase elevations by 24 to 48 hours in most cases, followed by rapid resolution. In neither of the two cases in which tissue was available by biopsy after resolution of the biochemical abnormalities did we find the classic histologic picture of necrosis in zone 3 ("centrilobular necrosis"). The clinical picture of shock liver is so characteristic and resolves so rapidly that there should be no confusion with other causes of marked elevations of transaminase levels.
 ...
PMID:Shock liver. 407 Nov 67

We report the M-mode and two-dimensional echocardiographic findings in a patient with familial amyloidosis. The diagnosis was made by the clinical picture and histologic evidence of amyloid in peripheral nerve biopsy. Though the patient had no clinical sign of heart failure, extensive involvement of the heart was demonstrated by echocardiography. M-mode echocardiography revealed increased right ventricular wall thickness in conjunction with symmetric increase in left ventricular wall thickness. On two-dimensional echocardiography, the entire interventricular septum and the papillary muscles were more dense than normal. These high density echoes had a "granular and sparkling" pattern. This case shows that cardiac amyloidosis can be diagnosed in the pre-clinical, asymptomatic state by M-mode and two-dimensional echocardiography. When symptomatic, confusion with constrictive pericarditis may be avoided non-invasively.
 ...
PMID:Echocardiographic aspects of cardiac amyloidosis. 697 60

A succession of theories arising from last century has attempted to explain why patients with damaged hearts develop peripheral edema. Opposed to the original simple concepts of backward failure, a number of theories of forward failure have been proposed, the cardiac output being considered inadequate for capillary permeability, renal function, or the metabolic needs of the body. Any theory needs to take account of the neuroendocrine stimulation now known to occur under these conditions. This article presents evidence for the belief that the condition arises when the cardiac output becomes insufficient to maintain the arterial blood pressure without the support of excessive neuroendocrine activity. This explains why the edematous state may be evoked in patients who have a severe reduction in peripheral resistance as well as in those with a reduced cardiac output. While the clinical concept of cardiac failure arose from the consideration of the formation of edema in patients with cardiac disease, the term has also come to be used by laboratory investigators studying the immediate effects of reducing the strength of ventricular contraction. The application of the same name to two different conditions has led to confusion, and this review stresses the importance of definition of terms.
 ...
PMID:The problem of defining heart failure. 794 60

A 50-year-old man was admitted to hospital because of vertigo for 3 weeks. He was found to have severe hyponatraemia (107 mmol/l), which was rectified with sodium chloride infusions. Two weeks later he became agitated with confusion and hallucinations. Within a few hours he went into coma. At that time the serum sodium concentration had again fallen from 132 to 105 mmol/l. Repeated measurement revealed urinary osmolality (558 mosm/l) to be above that of serum (252 mosm/l), pointing to the syndrome of inadequate antidiuretic hormone secretion (SIADH) as the diagnosis. Lung tomography, performed because the patient had two bouts of pneumonia in quick succession, demonstrated enlarged hilar lymph nodes. Bronchoscopy revealed a tumour of about 1.0 cm diameter in the left main bronchus which histologically proved to be a small-cell bronchial carcinoma. Despite chemotherapy the tumour progressed and the SIADH also persisted. The patient died 9 months later of heart failure.
 ...
PMID:[Hyponatremic coma as the first symptom of a small cell bronchial carcinoma]. 807 Mar 40

The histopathology, ultrastructure, and clinicopathologic correlations in six patients with cardiac failure and iron encrustation of lung elastic tissue were examined at autopsy. Transmission electron microscopy (TEM) and energy dispersive x-ray analysis were applied to two cases. Of the group, five patients had cardiac failure due to systemic hypertension (4 patients), valvular disease (4 patients), or coronary atherosclerosis (4 patients). Biventricular failure in one patient was associated with sleep apnea. Both iron and calcium, identified by histochemical stains, impregnated degenerated alveolar and vascular elastic fibers and were associated with a foreign body reaction and focal interstitial fibrosis. Energy dispersive x-ray analysis and TEM demonstrated iron and calcium on the microfibrillar portion of elastin. Morphometry indicated vascular changes of pulmonary venous hypertension. The authors concluded that mineral deposition probably represents nonspecific precipitation of metallic ions on altered elastic fibers in patients with cardiac failure. "Mineralizing elastosis" potentially contributes to lung restriction and, occasionally, can be a source of diagnostic confusion.
 ...
PMID:Mineralizing pulmonary elastosis in chronic cardiac failure. "Endogenous pneumoconiosis" revisited. 827 51

Most diagnoses of cardiovascular disease are made in the office or at the bedside. For example, in pulsus alternans of the radial pulse, observed when first greeting a patient, alteration of intensity of the second sound and systolic murmur and a ventricular (S3) gallop are clinical pearls--often subtle--that diagnose cardiac decompensation. A faint gallop, ventricular (S3) or atrial (S4), might be overlooked in a patient who has an emphysematous chest and an increase in anteroposterior diameter if one listens over the usual areas of the precordium. However, the gallop might be detected easily by listening over the xiphoid or epigastric area. How do you tell the difference between an S4, a split first sound, and an ejection sound? The S4 is eliminated with pressure on the stethoscope, but pressure does not eliminate the ejection sound or the splitting of S1. The atrial sound (S4) is most frequently found in patients who have coronary heart disease, and it is a constant finding in patients who have hypertension. It does not denote heart failure, as does the S3 (ventricular) gallop. In some patients, both atrial (S4) and ventricular (S3) diastolic gallops may be present. This occurrence is common in patients with cardiac decompensation associated with coronary heart disease, hypertensive heart disease, and dilated cardiomyopathy. When these diastolic filling sounds occur in close proximity, a short rumbling murmur may be heard, which causes confusion of this sound with that of a valvular or congenital lesion. When both sounds occur exactly simultaneously, a single sound results. Often, this sound is louder than either the first or second sound and can be misinterpreted as either a valvular or congenital lesion. This, however, is a summation gallop, which is rare. For the most accurate timing of heart sounds and murmurs, the simple technique called "inching" is the best. Keeping the second sound in mind as a reference, the physician moves (inches) the stethoscope from the aortic area to the apex. An extra sound may be noted to occur in systole before the second sound, thereby diagnosing a systolic click. If the sound occurs after the second sound, however, it is an S3 or ventricular diastolic gallop. If a murmur appears before S2, it is a systolic murmur; if it appears after S2, it is a diastolic murmur. When the Austin-Flint murmur is heard, significant aortic regurgitation exists.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:Cardiac pearls. 830 47

Unlike hypertension, heart failure is not readily identified, defined and evaluated. Research and clinical management of heart failure has been handicapped by the absence of a clear definition. In other branches of medicine, e.g. renal or pulmonary failure can be clearly defined with the help of direct measures of organ function. Unfortunately such a parameter does not exist in cardiology to help us with defining cardiac function or failure. Representative definitions of heart failure hitherto proposed are reviewed. A common error in these 'definitions' is the confusion between formulating a definition and giving instructions on how to identify or diagnose heart failure. Other short-comings are also recognised. From these it is possible to compile criteria which a definition of heart failure should possess. When formulating any definition, in order to avoid unnecessary detail, the importance of including only the essence and not the contingents is recognised. To find a new definition which complies best with these criteria is an important challenge facing cardiologists.
 ...
PMID:Heart failure: can it be defined? 883 27

The proportion of patients reported to die suddenly or from progressive circulatory failure is not consistent among studies of heart failure. Lack of an adequate or consistent classification of how patients die contributes to the current confusion over the mode of death in heart failure. Defining how patients with heart failure die could be important in developing strategies to reduce the continuing high mortality associated with this condition. We identified 27 studies that reported 50 or more deaths among patients with heart failure to ascertain how death was classified. Definitions of sudden death appeared heterogeneous and the majority of studies failed to publish or make reference to how circulatory failure was defined. A framework for the classification of the mode of death has been developed in which clear separation of the activity and place at the time of death, cause of death, mode of death, and events prior to death is made (ACME: Activity, Cause, Mode and Event). This mode of classifying death has been successfully piloted in two mortality studies; AIRE and NETWORK. Classifying mortality in this way will help identify pathways leading to death and hence suggest therapies and strategies to reduce mortality in patients with heart failure, a group of patients whose prognosis remains poor.
 ...
PMID:Mode of death in chronic heart failure. A request and proposition for more accurate classification. 888 25

Abnormalities of diastolic function have a major role in producing the signs and symptoms of heart failure. However, diastolic function of the heart is a complex sequence of multiple interrelated events, and it has been difficult to understand, diagnose and treat the various abnormalities of diastolic filling that occur in patients with heart disease. Recently, Doppler echocardiography has been used to examine the different diastolic filling patterns of the left ventricle in health and disease, but confusion about diagnosis and treatment options has arisen because of the misinterpretation of these flow velocity curves. This review presents a simplified approach to understanding the process of diastolic filling of the left ventricle and interpreting the Doppler flow velocity curves as they relate to this process. It has been hypothesized that transmitral flow velocity curves show a progression over time with diseases involving the myocardium. This concept can be applied clinically to estimate left ventricular filling pressures and to predict prognosis in selected groups of patients. Specific therapy for diastolic dysfunction based on Doppler flow velocity curves is discussed.
 ...
PMID:Evaluation of diastolic filling of left ventricle in health and disease: Doppler echocardiography is the clinician's Rosetta Stone. 920 15

The differential diagnosis of ascites often leads to confusion and an inability to exclude its multitude of causes in many patients. In this review, we outline the clinical features and laboratory investigations that usually elucidate the cause of ascites for the clinician in a simple and logical manner. Roughly 80-85% of cases of ascites are related to underlying chronic liver disease, but cardiac failure, tuberculosis, malignancy-related ascites and other less common causes should always be considered. Careful evaluation of the patient, including a clinical history, physical examination and diagnostic paracentesis should routinely be performed to determine the cause of ascites. Fluid should be sent for cell count and albumin along with simultaneous determination of serum albumin to determine the serum: ascites albumin gradient. This gradient allows classification of the cause of ascites into portal hypertension-related and nonrelated with a diagnostic accuracy of > or = 97%. The causes of ascites are individually discussed in relationship to their clinical features and to the laboratory investigations that are relevant in each situation.
 ...
PMID:Differential diagnosis of ascites. 930 24


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>