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

Significant variations in the ECG have been observed in a female aged 77 with heart failure and chronic atrial fibrillation during an occasional increase in blood potassium followed by normalization. The major phenomena observed during hyperkalemia, due to a severe dehydration, were a transient sinus rhythm with atrio-ventricular block followed by atrial activity disappearance and advent of interventricular and fascicular block. Therapeutic normalization of blood potassium leads to a progressive disappearance of intraventricular and fascicular block, a temporary sinus rhythm and finally the return to atrial fibrillation which was the steady state of the patient before the blood potassium imbalance.
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PMID:[Increase in blood potassium and subsequent normalization: effects on the electrocardiogram. Case report]. 260 90

An inappropriate antidiuretic hormone secretion (SIADH) has been recognized as the cause of hypotonic hyponatremia, and the occurrence of this syndrome, accompanied by an ADH-producing adenocarcinoma in the nasal cavity, is reported. In February, 1987, a 50-year-old male, showing sights of delirium, disorientation, and irritability was admitted to the hospital. The patient was observed to be healthy, except for a neck lymphnode metastasis that was present up to the time of his hospitalization. The hyponatremia was incidentally found, although dehydration or intravascular volume depletion were not noted. These neuropsychiatric symptoms were considered to be associated with hyponatremia due to SIADH. He had had a partial maxillectomy, a neck dissection, and irradiation to the nose and nasal cavity 32 months earlier, and then underwent a surgical resection of the neck metastasis; he had a total of 10 other operations before the onset of the symptoms. Upon initial inspection, since neither an intracranial invasion nor a brain metastasis was found, we diagnosed that his symptoms were due to an autonomic disturbance caused by surgical and mental "stress". When he died of cardiac failure due to a mediastinal invasion 8 months after the onset of SIADH, tumor tissues was extirpated in an autopsy and was then cultured. In this manner, it was proved that the tumor cells had been producing ADH. This procedure clarified that the syndrome had resulted from an ADH-producing tumor of the nasal cavity.
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PMID:[A case of adenocarcinoma of the nasal cavity associated with syndrome of inappropriate secretion of antidiuretic hormone(SIADH)]. 277 60

Using modern methods of investigation body water spaces were studied in 44 persons: 12 healthy ones and 32 patients with various degrees of heart failure. Significant changes in the content and distribution of water with regard to a degree of decompensation were revealed. Dilatation of the volume of extracellular fluid (VEF) was observed in patients with noticeable peripheral edemas as a result of an increase in the volume of circulating plasma (VCP) and an increase in the volume of interstitial fluid (VIF). A considerable increase in the total body water (TBW), VEF and vascular and interstitial portions were noted in the patients with stage IIB-IIIA heart failure in the presence of ascites. The division of the patients into 2 subgroups with relation to the results of subsequent dehydration therapy (22 patients were given diuretic therapy, in the other 10 patients it was supplemented with isolated ultrafiltration due to the refractory edematous syndrome) revealed distinct difference in the basal state of water spaces which manifested itself in a significant increase in VEF and VCP in patients with the refractory edematous syndrome. Thus a study of body water spaces in patients with chronic heart failure was important for the definition of groups of patients with resistance to diuretic therapy. A study of the time course of these parameters under the influence of various dehydration methods is of great interest. A special paper devoted to the problem, will be prepared by the authors.
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PMID:[Body water compartments of patients with chronic heart failure and the refractory edema syndrome]. 342 95

In a prospective study of 50 patients a good correlation was found between the central venous pressure and the sonographic appearance of the inferior caval vein (ICV) behind the liver in right paramedian scanning. Dependent on central venous pressure (CVP) there were typical variations in the configuration, width and respiratory movements. These changes allowed a reliable estimation of the CVP. Decrease of the width in anteroposterior diameter in connection with a reduction of respiration-dependent caval movement indicated a deficiency of circulating blood volume. These alterations were always positive in cases of dehydration. Elongation of the vessel together with a widening over 2 cm and the lack of the normal end-inspiratory collapse were signs of an increased CVP. This non-invasive method is without risks or inconvenience for the patient. It is easily and quickly applied and very reliable for analyzing ICV haemodynamics. ICV ultrasonography can be recommended as a diagnostic aid for dehydration and hyperhydration as well as right heart failure, especially unrecognized, that means cardiac insufficiency without peripheral edema, constrictive pericarditis, tricuspid valve disease and for the assessment of the course of right cardiac failure.
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PMID:[Relations of the ultrasonic image of the inferior vena cava and central venous pressure]. 614 Aug 70

Reduction of hospital stay and mortality rate due to dehydration and electrolyte imbalance in children suffering from severe marasmic Kwashiorkor was attempted. A program of parenteral nutrition providing 70 to 100 milliliters water, 30 to 40 kilocalories, and 3 to 4 grams amino acids per kilogram daily was given. Seventy-seven African children suffering from protein deficiency and calorie deficiency were given an intravenous perfusion of casein hydrolysate or cristalloid amino acids for a mean period of 6 days. An oral supplement of tea and sugar, boiled rice, and palm oil was also given. The total mortality has not been modified in comparison with that in children given an oral diet (semi-liquid) consisting of low fat milk and locally available proteins. In more than half of the cases, the parenteral nutrition has favored water and salt retention and the development of cardiac failure possibly due to adynamic circulatory state. Weight curve, serum albumins, serum and urine amino acids were followed closely for 1 month. In eleven patients, nitrogen balance studies were done. All were positive independently of the coexisting infectious pathology. Correlating the increase in serum proteins with the cumulative nitrogen balance allowed us to consider casein hydrolysate as particularly useful for hepatic protein synthesis while cristalloid amino acids seem to favor muscular protein synthesis. The introduction of parenteral nutrition as a therapeutic regimen for standard use in the malnourished child seems less favorable than oral realimentation programs and does not seem desirable in developing countries.
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PMID:Evaluation of clinical and biological parameters in marastic Kwashiorkor children treated by parenteral nutrition. 640 30

An isolated iliac aneurysm is an uncommon entity with a relative incidence to abdominal aortic aneurysm of 0.9 to 1.9 percent. Analysis of 16 cases with 20 isolated iliac aneurysms experienced at our vascular service makes the basis of this report. Seventeen aneurysms involved the common iliac artery, two the internal iliac artery and one the external iliac artery. As we experienced 341 abdominal aortic aneurysms during the same period, relative incidence of isolated iliac aneurysm to abdominal aortic aneurysm was 4.7 percent. Fifteen of the 16 cases were male; isolated iliac aneurysms had significantly higher preponderance for the male. Six of the cases were presented with ruptured aneurysms, giving a rupture rate of 37.5 percent. This rupture rate was significantly higher than that of abdominal aortic aneurysms of 11.1 percent. Operation was performed on 15 patients; the remaining one died before surgery. Although there was no operative death among the elective cases, three patients in the ruptured group died postoperatively giving a mortality rate of 60 percent. The least diameter of the ruptured aneurysms was 3.5 centimeter. Among the 16 patients 5 presented with a ruptured aneurysm and 3 had no symptoms related to the aneurysm. Five patients complained of a pulsatile abdominal mass. Two of the ruptured aneurysms were associated with an iliac arteriovenous fistula. Both of them involved the common iliac artery. Although emergency operation was performed on one of them, he died of acute renal failure due to preoperative dehydration and hypovolemia. The another one was operated on electively after intensive medical treatment for heart failure and the patient survived.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Isolated iliac aneurysms]. 650 53

An elderly woman with a history of cardiac failure treated with digitalis had both abdominal pain and dehydration. Parenteral fluid and electrolyte support failed to alleviate abdominal pain. Superior mesenteric arteriography combined with "spillover" method of estimating blood flow revealed an intestinal nonocclusive ischemic state which was treated successfully with 44-hour intraarterial infusion of prostaglandin E1. Laparotomy performed during the drug infusion revealed viable intestine.
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PMID:Nonocclusive intestinal ischemia treated with intraarterial infusion of prostaglandin E1. 720 Aug 29

Saluretic drugs like thiazide and benzothiadiazine (chloruretic sulfonamides), potassium-sparing diuretics (amiloride, triamterene and spironolactone) and diuretics with an effect on the loop of Henle (furosemide, ethacrynic acid, bumetadine and etozoline) support the efficiency of digitalis preparations in such cases, in which the load of the heart may be diminished by hemodynamic disburdening of the myocardium through reduction of preload. Here, reduced venous filling pressure is the result of increased elimination of sodium and of dehydration. These drugs are efficacious, but can endanger the patient even if prescribed under right indication and by right dosage. Therefore they should be taken only if necessary and only under continuous medical supervision. The therapeutic breadth of the different diuretics is more favourable than that of the digitalis glycosides. Thus the careful prescription of diuretic drugs can enhance digitalization significantly, especially for patients of higher age with increased sensitiveness on heart glycosides or with supposedly "refractory" heart failure. A rapid intravenous injection of furosemide is the best method for the emergency treatment of an acute pulmonary edema in consequence of left heart failure. This is efficacious in a shorter time and in a better manner than an initial injection of heart glycosides. The favourable effect of diuretic drugs in myocardial failure may be explained by improving the force-velocity curve of the heart with reduction of preload of the myocardium and with diminished venous congestion.
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PMID:[Therapy of coronary insufficiency with diuretics]. 722 49

Acute renal failure and acute heart failure are rare in Kawasaki disease. We experienced two patients with Kawasaki disease who presented acute renal failure and acute heart failure. These two patients gave us an important insight into the understanding of water balance and fluid therapy in Kawasaki disease. One patients showed acute prerenal failure due to fluid exudation from the intravascular to the extravascular space, and subsequent acute heart failure. The other patient showed acute heart failure caused by fluid infusion for the treatment of dehydration. It is suggested that acute renal failure could be caused by a fluid shift from the intravascular to the extravascular space in Kawasaki disease. It is also demonstrated that the reserve of cardiac function could be decreased in patients with Kawasaki disease due to myocarditis even with normal echocardiography and chest X-rays.
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PMID:Acute heart failure and acute renal failure in Kawasaki disease. 794 14

Freeze tolerance in the wood frog, Rana sylvatica, is promoted by multiple, integrated physiological responses to ice forming within body tissues. By analyzing the freezing responses of the sympatric, but freeze intolerant, leopard frog (R. pipiens), we sought clues to the evolution of anuran freeze tolerance. Physiological responses critical to R. sylvatica's freeze tolerance, such as the synthesis and distribution of the cryoprotectant glucose, protective dehydration of organs, and deferred cardiac failure, were present, but comparatively less pronounced, in R. pipiens. Both species were innately tolerant of hyperglycemia. Glucose supplements did not enhance the freezing viability of R. pipiens, although in vitro tests of cryoprotectant efficacy revealed that glucose and glycerol provided comparable protection to erythrocytes of both species. We conclude that the evolution of freeze tolerance in R. sylvatica is not only promoted by its desiccation tolerance and the fortuitous biophysical consequences of freezing (e.g., exothermic induction of cardioacceleration and moderation of cooling rate) but also involves a progressive enhancement of fundamental physiological stress responses.
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PMID:Physiological responses of freeze-tolerant and -intolerant frogs: clues to evolution of anuran freeze tolerance. 823 38


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