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

The pattern of heart disease in 404 patients seen prospectively from the guinea savanna region of Africa is presented. Over 90% presented with cardiac failure. Hypertension, Peripartal Cardiac Failure (PPCF), Congestive Cardiomyopathy and Rheumatic Heart Disease are major problems. The highest incidence of PPCF in the world probably occurs in this area but the prognosis is good. The reasons for this and the possible interrelationship of hypertension with cardiomyopathy and PPCF are discussed. In contrast to the tropical rainforests, no case of endomyocardial fibrosis was seen. During the period of study, vascular thrombosis is uncommon and coronary heart disease is non-existent in Zaria.
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PMID:Pattern of heart disease in adults of the Nigerian Savanna: a prospective clinical study. 9 46

In acute and chronic left heart failure peripheral resistance is elevated due to increased sympathetic tone. This should compensate the decrease in stroke volume. In the diseased left ventricle however the augmentation of afterload leads to further reduction of stroke volume and to increase of heart size and myocardial oxygen consumption. This vitious cycle may be interrupted by vasodilators. Drugs like nitroglycerin, mainly acting on the venous system, reduce preload and thereby relieve symptoms of pulmonary congestion (backward failure). Phentholamin on the other hand primarily reduces afterload by an action on the resistance vessels and thereby increases cardiac output (forward failure). Nitroprusside has effects on both, the capacity and resistance vessels. So nigroglycerin is the remedy of choice in acute pulmonary edema. Nitroprusside in leftf heart failure in acute myocardial infarction and Phentolamin in acute left ventricular failure due to critical rise in blood pressure. For long term treatment of chronic left heart failure (coronary heart disease, cardiomyopathy, rheumatic heart disease) hydralazin or prazosin may be used as well as long acting nitrates.
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PMID:[Progress in the therapy of acute and chronic cardiac insufficiency by means of systemic vasodilators. Studies with prazosin and nitroglycerin]. 12 80

Heart insufficiency, cardiomegaly and pathological changes of the ECG after exclusion of coronary heart disease, congenital or acquired vitia cordis and hypertension of the greater or lesser circulatory system result in the diagnosis cardiomyopathy with the liability of further differential-diagnostic demarcation. If causes of a secondary cardiomyopathy can be detected, a causal therapy is often possible, as to the remaining group of the idiopathic cardiomyopathies one must for the time being limit to an exclusively symptomatic treatment (protective therapy, limitation of the fluid supply, glycosides, diuretics, medicamentous and electric therapy of disturbances of the rhythm).
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PMID:[Cardiomypathies]. 12 20

Alcoholic cardiomyopathy is a consequence of toxic effects of ethyl alcohol. Acute effects must be distinguished from chronic effects over many years. Chronic abuse of alcohol of 1.5-2 g ethyl alcohol per kg body weight (i.e. about 100-150 g/70 kg) per day for years can cause congestive cardiomyopathy in predisposed persons, usually between 30 and 50 years of age. The diagnosis is associated with some criteria for exclusion, i.e. coronary heart disease, hypertension, valvular heart disease, in addition all obstructive and restrictive cardiomyopathy must be excluded. On the other hand, a specific constellation of findings can be considered characteristic of alcoholic cardiomyopathy, namely the coincidence of a radiologically established cardiomegaly in the form of a congestive cardiomyopathy with a raised serum concentration of immunoglobulin A and a negative myocardial immunofluorescence test. Therapeutically, in addition to the classical principles of the treatment of heart failure, absolute abstention from alcohol and physical stress seemed to be effective.
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PMID:[Alcoholic Cardiomyopathy (author's transl)]. 13 Dec 48

A 45-year-old woman with congestive heart failure, in whom there was no evidence of coronary heart disease, valve disease, or other demonstrable cause of heart failure, was found to have taken high doses of dextroamphetamine over a long period. Withdrawal of amphetamine resulted in deterioration, suggesting a physical cardiac dependence on the drug. The clinical and autopsy findings are presented and the similarities to the myocarditis associated with pheochromocytoma are discussed. The evidence presented suggests a causal relationship between administration of dextroamphetamine and the cardiomyopathy.
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PMID:Cardiomyopathy associated with amphetamine administration. 13 14

Twenty-one chronic haemodialysis patients with cardiomegaly and repeated episodes of heart failure were selected for left ventricular cineangiography and haemodynamic studies. Left ventricular end-diastolic (LVED) volume was augmented in eleven, LVED pressure increased in fourteen, and ejection fraction decreased in nine patients. A decrease of maximum velocity of myocardial fibre shortening was observed in fifteen, and of normalised ventricular rigidity index in eleven. Many patients had diminished cardiac performance in the absence of demonstrable coronary heart disease, hypertension, or chronic volume overload. The diagnosis of congestive cardiomyopathy of unknown aetiology, possibly related to uraemia, was reached in ten patients.
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PMID:Angiocardiographic and haemodynamic studies in chronic haemodialysis patients with cardiomegaly. 16 2

The authors report 25 cases of patients, average age 67 years with severe coronary or valvular heart disease, with conduction disorders. The conduction disorder occurred alone in 8 cases and was associated with a disorder of excitability in 17 cases. It was either obvious, as in 14 cases, or latent, as in 11 cases, and precipitated by various forms of treatment, the disadvantage of which was the negative dromotrope effect. This treatment was prescribed for permanent resting angina (amiodarone and prenylamine), heart failure (digitoxin) or excitability disorder (beta-blockaders or procainamide). 11 patients had one or several fainting attacks. Permanent electro-systolic pacing with stimulation on demand, is necessary in all patients to palliate the consequences of treatment. In 11 cases out of 25, prior temporary pacing permitted the authors to assess the efficacy of treatment. The high post-operative mortality (40%) is not due to the apparatus but depends on the severity of the coronary heart disease or heart failure in these patients, In 60% of cases, the result of stimulation was excellent and was maintained permanently.
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PMID:[Indications for permanent electrosystolic pacing in arrhythmia revealed or aggravated by treatment]. 17 99

In the course of coronary heart disease an aneurysmal dilatation of the left ventricle may occur. This may be an additional risk for the patient by changed haemodynamics. Depending on the extent of the aneurysm and the contractile potency of the remaining myocard the cardiac compensation may be sufficient. A reduction of the pump efficiency is not necessarily the consequence. In case there is an increasing cardiac insufficiency by means of a pathologic ventricular filling pressure pulse, the best therapy is digitalis in combination with a reduction of volume by sodium-selective diuretics. Under same haemodynamic conditions the treatment of angina pectoris consists of long acting nitrites in combination with a betablocking agent having some intrinsic activity. Special care for the choic of medicaments has to be taken in relation to the sufficiency of the remaining myocard, if an antiarrhythmic therapy is necessary. If there is no stabilisation of the haemodynamic parameters by conservative therapy, the left ventricular function is meliorated by surgical aneurysmectomy. The data demonstrate, that under resting condition a normalisation and under exercise condition at least a melioration of pulse pressure and circulation is achieved after resection of the aneurysma. A small but measurable decrease in cardiac output under exercise condition is the consequence of a persisting cardiodepressive effect due to the operation.
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PMID:[Ventricular aneurysm and coronary heart disease. Pathophysiology, differential therapy, and postoperative haemodynamics (author's transl)]. 24 99

The case files of 4,456 medical admissions in 1975--1976 at Ahmadu Bello University Teaching Hospital, Kaduna, Nigeria, included 354 cardiovascular patients. The most common causes were hypertension (45.5%), cardiomyopathy (20.6%) and chronic rheumatic heart disease (14.4%). The mean age of hypertensive and cardiovascular patients was lower than in Europe. The majority of hypertensive patients suffer from essential hypertension. Congestive cardiac failure is the commonest complication of hypertension and cardiomyopathy. Rheumatic valvular disease with mitral incompetence is frequent and sometimes severe in young people. Other cardiovascular diseases included pericardial disease, bacterial endocarditis, cor pulmonale, anaemic heart failure, congenital and syphilitic heart disease. Coronary heart disease was only encountered in non-Africans. Cardiovascular mortality in hospital was high (20%).
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PMID:Cardiovascular disease in Northern Nigeria. 31 94

The method of radionuclide cardangiography (RNCA) has become a well-established method amongst non-invasive assessments in coronary heart disease (CHD). By means of RNCA the most important parameters of left ventricular function, viz. ejection fraction (EF) and wall motion (WM), can be determined very exactly. The first bolus pass method (FBP), which allows satisfactory separation between right and left heart, enables the additional determination of EF distribution, stroke volume (SV) and SV distribution. This method requires the technical necessity of a multicrystal gamma camera. Special nuclear medicine characteristics have been worked out for different groups of CHD. EF and WM show typical signs of angina pectoris, caused by exercise correlating with reduced perfusion in the referring section of WM. While these changes may be reversible after nitrate administration, pathological myocardial function caused by acute myocardial infarction (AMI) or manifest heart failure is not reversed by nitroglycerine. Typical findings were seen in the course of AMI: initial decrease in global EF and diffuse (multilocated) asynergies in the left ventricular wall; in the second week possible start of recovery, including regression of dyskinesia to akinesia at the end of hospitalization. Especially in the early phase of AMI it was demonstrated that FBP--as a non-invasive technique--gives high information quality which is unequalled by other comparable methods. Therefore, the described method of FBP should be classified as very useful and effective in clinical cardiology.
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PMID:[Radionuclide cardangiography as non-invasive assessment in coronary heart disease (author's transl)]. 39 49


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