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)

While psychotherapy is the treatment of choice in neurotic situational depressions of older patients, it is not effective enough in endogenous bipolar or monopolar depression of elderly. These respond better to somatic therapy, mainly pharmacotherapy, or, if necessary, ECT. Experience shows the aged endogenous depressions respond favorably to tricyclic antidepressants as well as to mono-amino oxidase inhibitors, although the dosage may have to be kept lower than with younger patients. ECT, if necessary, is well tolerated and effective in aged patients. However, proper precautions have to be taken before this treatment is commenced. Patients with a history or signs of recent coronary thrombosis or decompensated heart failure should be excluded. Also, the number of treatments should be kept at a minimum. The individual treatments should be spaced farther apart and so-called "intensive treatment" avoided. If an endogenous depression lasts for more than 2 years and does not respond to any other kind of treatment, psychosurgery may have to be considered. Experience has shown that long-lasting, deep depressions of the aged can be helped by this method without any important personality change.
 ...
PMID:Somatic therapies in older depressed patients. 127 Jul 65

Thirteen clinical charts belonging to children with Kawasaki disease admitted to different hospitals were analyzed. The average age among the children was three years (from nine months to nine years), with a predominance of this disease in males with a ratio of 3.3:1. Echocardiograms were obtained from 10 of the patients; seven showed coronary aneurysms (70%). Other complications seen were myocarditis in six children, and one case in each of the following: arthritis, pericarditis, cardiac failure, coronary thrombosis, hydropic gall bladder and aseptic meningitis. All of the patients recovered successfully; only four of the patients with aneurysms were followed-up with an echocardiogram. The echocardiogram showed the aneurysms to have disappeared in three of the children one to five months later, and the other showed a persistent aneurysm plus dilated myocardiopathy 2.5 years later in the remaining patient. It is worth noting the high incidence of aneurysms (70%) compared to other series (20-65%) which may be due to the suspicion of this diagnosis in only typical cases.
 ...
PMID:[Kawasaki disease in Mexico: an analysis of 13 cases]. 191 May 55

To define the mechanisms of unexpected cardiac arrest in advanced heart failure, we reviewed the causes of cardiac arrest as established from electrocardiographic monitoring and from clinical and autopsy data in patients hospitalized for cardiac transplantation evaluation and management of advanced heart failure (mean left ventricular ejection fraction, 0.18 +/- 0.08) who were stable while on vasodilator and diuretic therapy such that hospital discharge to home was anticipated. Twenty-one cardiac arrests occurred in 20 of 216 (9%) such patients during a 4-year period. Heart failure was due to coronary artery disease with prior myocardial infarction in 13 patients and nonischemic cardiomyopathy in seven patients. The rhythm at the time of arrest was severe bradycardia or electromechanical dissociation (BA/EMD) in 13 (62%) patients. The precipitating cause of the BA/EMD arrest was coronary artery thrombosis or embolism in two patients, pulmonary embolism in one patient, hyperkalemia in two patients, and unexplained hypoglycemia in one patient. In seven of 13 (54%) patients, a precipitating cause of the bradycardia arrest could not be established. Only eight of 21 (38%) arrests were due to ventricular tachycardia or fibrillation (VT/VF), and all occurred in patients with prior myocardial infarction (p = 0.02 vs. BA/EMD arrests). Two VT/VF arrests were due to acute or recent infarction, and one patient had hyperkalemia. The patients who suffered a BA/EMD arrest were similar to those who had a VT/VF arrest in age, ventricular arrhythmia history, ventricular function, and serum potassium levels. Serum sodium levels were lower in patients with BA/EMD arrests (129 +/- 3 vs. 133 +/- 4 meq/l, p = 0.025).(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Diverse mechanisms of unexpected cardiac arrest in advanced heart failure. 259 30

Over 8 years, 20 cases of infarction with normal coronary angiography have been reported, representing 0.9% of the patients who underwent a coronary angiography after a myocardial infarction. The main characteristics of these patients are compared with those taken from the literature. The occurrence of this disease mainly depends on the age: especially higher when the patients are younger, ranging between 1 and 4% in major series, but it may reach 25% in case of infarction occurring before the age of 30. Therefore, this entity mainly affects young patients (mean age in the literature: 34.3 years), with a large proportion of women (27%). The main risk factor is smoking, found in 3 out of 4 men an more than half of the women; on the contrary, hypercholesterolemia and arterial hypertension are only seldom found. In women, administration of estro-progestative medications in mentioned in almost every other case. Coronary heredity is mentioned in one out of 3 cases. In 68% of the cases, the infarction is the original manifestation and frequently occurs during stress: 60 p. cent of the cases. The site of the necrosis is insignificant. Mortality is low: 2 p. cent but in 5 p. cent of the cases, the course may be complicated by recurrence or heart failure. According to recent findings on coronary angiography during the acute phase, the pathogenesis could involve an arterial coronary thrombosis, perhaps developing on minimal coronary lesions, caused by a spasm and/or a platelets hyperaggregation; then this coronary thrombosis is revascularized.
 ...
PMID:[Infarction with angiographically normal coronary vessels. (20 cases)]. 266 Jul 27

Sudden cardiac death, most often due to ventricular fibrillation, is caused by three vessel coronary disease in over 90% of the cases. At autopsy acute coronary thrombosis superimposed on an arteriosclerotic plaque is often found. However, a terminal myocardial ischemia can also develop without coronary thrombosis. In these cases platelet thrombi or coronary spasm may be the cause of ventricular fibrillation. In approximately one fourth of all patients with coronary disease sudden death is the first manifestation of the patient's illness. After myocardial infarction a high risk patient group can be detected by non-invasive methods: patients with cardiac failure, high enzyme values, a positive exercise-ECG and malignant ventricular arrhythmias three weeks after myocardial infarction have a significantly higher mortality in the following 12 months than patients without these complications. In this group of patients prevention of sudden death should be tried by an aggressive management of myocardial ischemia, heart failure and ventricular arrhythmias.
 ...
PMID:[Sudden cardiac death]. 399 33

Early recanalization of infarct-related coronary arteries has been attempted in 40 patients with acute myocardial infarction (AMI) and angiographically proven total occlusion by brief high dose intravenous streptokinase infusion (IVSK). In 24 patients (60%) recanalization was achieved after 48 +/- 14 min of IVSK at an infusion rate of 30,000 to 40,000 IU/min (group A), in 16 patients there was a late (greater than 2 h) or no recanalization (group B). The total dose of SK was 1.7 +/- 0.48 Mio IU in group A and 1.74 +/- 0.41 Mio IU in group B, the time from the onset of symptoms to peak myocardial enzyme of creatine phosphokinase (CKMB) 11 +/- 3 h in group A and 22 +/- 6 h in group B (p less than 0.001). Biplane left ventricular ejection fraction increased from 55 +/- 9% at the time of acute angiography to 58 +/- 10% after 14 to 24 days in group A (p less than 0.1) and decreased from 49 +/- 11 to 41 +/- 11% in group B (p less than 0.005). There were four reocclusions in group A, two could be reopened by i.v. urokinase (1 Mio IU over 30 min). During a follow-up period of 18 +/- 8 months one patient in group A died from an early ventricular rupture 2 hours after recanalization, and one patient in group B from heart failure 7 months after IVSK. There was no serious bleeding or other complication related to IVSK. We conclude that IVSK is an effective and safe means of early recanalization of coronary thrombosis in AMI, and feasible in the majority of patients with AMI.
 ...
PMID:High dose intravenous streptokinase in acute myocardial infarction. 662 71

Three cases (one, newborn infant and two infants--one of them recently published--) who present electrocardiographic and enzymatic alterations comparative with diagnosis of ischemia and myocardial infarction are reported. Rarity of this entity in infants is stressed as most of published cases are secondary to ananomolous coronary artery. Etiology of the cases presented shows a myocardiac fibrosis with Schwachman's syndrome in one case, a coronary thrombosis secondary to a disseminated intravascular coagulation in a second case, and finally a generalized hypoplasia of coronary arteries. Hypoxia appears in these cases a factor acting in favour of myocardial ischemia. Diagnostic criteria of acute myocardial infarction are based on typical electrocardiogram and rise of isoenzymes of LDH and CPK-MB. Although rare, it is a diagnosis to be considered in cases of unknow cardiac insufficiency in newborns and infants.
 ...
PMID:[Myocardial infarction and myocardial ischemia in newborn children and infants, not secondary to an abnormal coronary]. 666 Jun 44

24 cases of cardiac rupture (CR) (12%) were found in 200 necropsies of patients who died from acute myocardial infarction (AMI). Examination of the various factors that may affect the onset of this complication showed that age, sex, the site of AMI, the presence of coronary thrombosis, the association of persistent arterial hypertension, diabetes mellitus or previous angina syndrome and anticoagulant and corticosteroid treatment are insignificant. On the other hand, previous myocardial infarction would appear to reduce incidence considerably. CR was much more frequent in the first 3-4 days after onset of AMI and never occurred more than 21 days after. An important premonitory sign is persistent precordial pain in the absence of pericardial friction. Cardiokinetic therapy was used in 70% of the CR cases examined here. Over the past decade, the frequency of CR secondary to AMI has risen appreciably and it is hypothesised that this increase may have been influenced by the readiness with which cardiokinetics are employed now during AMI, often in very high doses. Particularly in the case of patients at high CR risk, it is considered that cardiokinetic therapy should only be employed in cases of clear cardiac insufficiency, in small, fragmented doses and after diuretics and vasodilators have proved ineffective. Such patients can also usefully be transferred to specialist wards for emergency surgery or preventive infarctectomy.
 ...
PMID:[Heart rupture in acute myocardial infarct]. 721 92

Coronary sclerosis is generally supposed to be the most important factor for coronary thrombosis, myocardial infarction and coronary heart death. Stenosing coronary sclerosis may be postmortally documented by angiography and morphometry. It is possible to obtain sufficient morphological data to suggest acute cardiac insufficiency, if the maximum grade of stenoses as a functional parameter and the heart weight are regarded in addition to the quantitative results of the three main branches of the coronary arteries (lumen and intima areas). Generally the cardiac results of autopsy are used individually and subjectively for the explanation of the cause of death. The conclusiveness of these results of autopsy depends on the circumstances of death and the existence of further pathological findings. Competing causes of death may exist in the form of illnesses, injuries, alcoholic and drug effects, physical strain and emotional stress or medical provisions. The quantitative valuation of the cardiac findings with a critical limit for an acute coronary death permits a more exact interpretation of such competing causes of death. This method of examination may also reveal an unpresumed competing cause of death, for example an intoxication. This was demonstrated by four autopsy cases.
 ...
PMID:[Morphometrical examinations in cases of stenosing coronary sclerosis and their importance for evaluation of competing causes of death (author's transl)]. 729 65

The incidence and pathologic features of cardiac lesions in 184 autopsied aged patients with disseminated intravascular coagulation (DIC) were reported. Coronary thrombosis was noted in 31 (16.8%), fresh myocardial necrosis in 60 (32.6%) and massive myocardial hemorrhage in 49 (26.6%) of these patients. Fresh myocardial infarction was present in 16 (8.7%) patients, 13 of whom manifested coronary thrombosis. The site of thrombi deposition was closely related to preexisting stenotic lesions of the coronary arteries. Only 3 of 16 patients with disseminated intravascular coagulation and acute myocardial infarction had typical cardiac symptoms. In most patients, the electrocardiographic changes were equivocal or not diagnostic for the diagnosis of acute myocardial infarction. We suggest the possibility that coronary thrombi in disseminated intravascular coagulation may gradually increase in extent and severity, leading to confluent areas of myocardial necrosis. The possibility of death due to heart failure, arrhythmia or cardiac rupture, points to the importance of recognizing the frequent cardiac involvement in aged patients with disseminated intravascular coagulation.
 ...
PMID:Disseminated intravascular coagulation in the aged complicated by acute myocardial infarction. 733 11


1 2 3 4 Next >>