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)

A 26-year-old man, in daily contact with pigs was admitted to hospital with septic shock which appeared to be caused by Streptococcus suis type 2 infection. Despite immediate antibiotic therapy a multiple organ failure developed, with ARDS, cardiac failure, disseminated intravascular coagulation and acute renal failure. Streptococcus suis infection is a zoonosis. The bacterium can be isolated from the tonsils of a significant part of the Dutch pig population. Mainly people who are in close contact with pigs or pork become infected. Usually meningitis develops. Sepsis, as this case, is rare and often fatal.
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PMID:[Fulminant sepsis caused by Streptococcus suis]. 238 12

To evaluate the early and late results of mitral valve replacement and reconstruction for mitral insufficiency due to ruptured chordae tendineae respectively, 74 consecutive cases were analyzed. Fifty-five (74.3%) of the patients were men, and the mean age was 48 +/- 12 years old (range 16 to 76). The causes of the mitral disease were idiopathic in 50 (67.6%), rheumatic in 7 (9.4%) and infective endocarditis in 11 (14.9%) patients. In idiopathic 50 cases, 24 had mitral valve prolapse and 16 had both mitral valve prolapse and hypertension. Forty-one (55.4%) of the patients were in NYHA functional class III or IV preoperatively. Thirty (40.5%) cases underwent surgery within one year after their initial symptoms of heart failure onsets including six emergency operation cases due to uncontrollable acute lung edema. Chordae to anterior mitral leaflet were ruptured in 31 (a5, m16, p10)[41%] patients, to the posterior mitral leaflet in 45 (a4, m23, p18)[59%], and to both leaflets in one patient. Mitral valve replacement was performed in 68 patients (91.9%) and 6 patients (8.1%) underwent mitral valve repairs. Twenty cases underwent associated procedures that included tricuspid valve annuloplasty in 8, aortic valve replacement in 5 and myocardial revascularization in 4 cases. There were two operative deaths (2.4%); both occurred after replacement, left ventricular rupture in one and DIC in one. Mean follow-up period was 4.5 years (range 1 to 17) in 67 cases. There were four late deaths; all occurred after replacement. However five patients sustained mild mitral insufficiency after mitral valve repair including one that became worse of regurgitation three years after isolated Kay's annuloplasty, there were no cases that had needed reoperation and no late death after reconstruction. Left ventricular function and pulmonary arterial pressure were almost normalized in more than 90% cases postoperatively. Our data indicated that mitral valve reconstruction (McGoon's plus Kay's method as standardized maneuver) was the procedure of choice for selected patients with mitral insufficiency owing to ruptured chordae tendineae to the posterior mitral leaflet, including more limited patients with ruptured chordae to the anterior mitral leaflet.
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PMID:[Mitral insufficiency due to ruptured chordae tendineae--clinical features, early and late results of valve replacement and repair]. 273 33

Hemangioendothelioma is seldom seen in adults. Its severe evolution is due, not so much to the exceptional transformation into hemangiosarcoma, but mainly to haemorrhagic complications by rupture or consumption coagulopathy and to severe cardiac insuffficiency secondary to arteriovenous shunts. The case reported here concerns a 64 year-old woman presenting pain in the left hypochondrium and splenomegaly. A splenectomy was performed and the histological findings were compatible with the diagnosis of hepato-splenoganglionic hemangioendothelioma. The evolution was unfavorable. The patient died a few months later in a picture of haemorrhagic syndrome and cardiac insufficiency. Histological findings on autopsy specimens indicated a cavernous hemangioma. The treatment of these diffuse hemangiomas is a difficult one. Hepatic artery ligation has been advocated in certain desperate situations. Nevertheless, because of a collateral circulation, recurrences are frequent.
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PMID:[Lymph node-hepatosplenic hemangioma in an adult with consumption coagulopathy and fatal cardiac insufficiency]. 343 34

In a 3170 g newborn with a large cavernous hemangioma at the left thigh, heart failure was evident. Echo- and angiographically a large perimembranous ventricular septal defect was found. An important a-v shunt within the hemangioma could be excluded by hemodynamic investigation and selective arteriographic examination of the vascular tumor. Thrombocytopenia present from the first day of life was only temporarily overcome by corticosteroid therapy but nevertheless consumption coagulopathy (Kasabach-Merritt-Syndrome) developed and additional therapy with heparin was necessary in order to normalize the coagulation factors. However, no regression in size of the tumor occurred over the first 8 weeks of life and a total exstirpation of the hemangioma was performed. Postoperatively no further cortison or heparin therapy was necessary. Despite vigorous medical treatment the congestive heart failure persisted. After surgical closure of the ventricular septal defect at the age of three months the infant thrived and could be discharged without pathological symptoms.
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PMID:[Cavernous hemangioma and disseminated intravascular coagulation (Kasabach-Merritt syndrome) in a newborn infant with a large ventricular septal defect]. 380 21

We describe a case of fatal falciparum malaria, with severe pulmonary insufficiency in the absence of fluid overload or cardiac failure. At autopsy the most striking change was a marked pulmonary interstitial edema. The endothelial cell was the most altered structure, showing marked cytoplasmic swelling which narrowed the capillary lumen. Monocytes were also found occupying the capillary lumen. The edematous interstitium also showed macrophages with endocytes and malarial pigment. There was no disseminated intravascular coagulation or other terminal complications. The patient's respiratory insufficiency seems not to have derived from the complications usually associated with the fatal malaria but from malaria-induced alveolar septal changes.
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PMID:Ultrastructure of the lung in falciparum malaria. 388 10

Diffuse neonatal hemangiomatosis is an often fatal disorder characterized by widespread capillary hemangiomas of the skin and visceral organs. Ultrasound and computed tomographic scans may be useful in determining the extent of visceral disease. The organs most commonly affected are the gastrointestinal tract, brain, liver, and lung. Complications include high-output cardiac failure, gastrointestinal bleeding, hydrocephalus, and consumption coagulopathy. Despite therapy with corticosteroids, the mortality rate is high.
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PMID:Diffuse neonatal hemangiomatosis. 395 31

Problems and limitations of medical management for infective endocarditis were studied and surgical indications were discussed based on the retrospective analysis of 55 episodes. Since perioperative complications still occur during highly active infection, antibiotic treatment was suggested as the primary management. Intractable or progressing heart failure appeared to be a definite indication for emergency surgery, but medical therapy was recommended for mild to moderate heart failure. For uncontrolled infection of more than one month duration despite the best available antibiotics, surgical debridement of the infected tissue was indicated. Occurrence of peripheral or fatal emboli was difficult to predict from clinical features and echocardiogram and therefore presented a therapeutic dilemma. Since major or fatal emboli frequently occurred during highly active infection, early initiation of effective antibiotic therapy was considered to be of primary importance. Demonstration of vegetation by echocardiography alone did not seem to justify urgent surgery. In addition, disseminated intravascular coagulation appeared to be a serious complication and thus sedimentation rate should be followed carefully. In the healed stage, prophylactic surgery seemed unnecessary for prevention of recurrent infection or embolization, as they were relatively rare.
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PMID:Medical management of infective endocarditis; limitations and indication for surgery. 402 Oct 66

A retrospective review was done of all patients undergoing surgical repair of abdominal aortic aneurysm (AAA) on whom coagulation studies were obtained. Those patients with laboratory documented disseminated intravascular coagulation (DIC) were selected and their clinical records reviewed. This included 7 patients studied in the periods 1964-1965 and January 1971-July 1973. Of these 7 cases, 4 occurred in patients undergoing emergency operation for ruptured aneurysm and 3 were in elective cases. All 7 patients exhibited clinical evidence of abnormal bleeding, while 6 of the 7 progressed rapidly to renal shutdown. The seventh patient recovered spontaneously. Of the 6 patients with full blown clinical and laboratory evidence of DIC, 2 recovered. Both cases received heparin therapy and multiple hemodialyses. A third patient was started on heparin but died at 36 hours in heart failure. All 3 patients receiving heparin showed clinical cessation of abnormal bleeding and disappearance of soluble fibrin monomer complexes within 24 hours of starting therapy. The study suggests a higher incidence of DIC than has previously been appreciated in both the emergency and elective repair of AAA. The prompt recognition and treatment of this complication may reverse the abnormal intravascular clotting, minimize its more serious results and avoid futile and dangerous operative intervention.
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PMID:Disseminated intravascular coagulation as a complication of abdominal aortic aneurysm repair. 485 4

The concentration of antithrombin III (AT) was determined with a chromogenic method in plasma samples from 1,302 patients referred for evaluation of the haemostatic system. A clearly subnormal AT level (below 60%) was found in 129 patients. In ten cases, this was explained by known (8 cases) or suspected (2 newborns) hereditary deficiency. Only in 5% of the 600 cases referred with definite or suspected thrombosis, AT was below 60%. These cases had a lethality of about 20%. In about 30% of the cases with liver disease, AT was below 60%. In a group of 72 patients with either severe infection, cardiac insufficiency, malignancy or suspected DIC for other reasons, AT was below 60%. Also in this group lethality was about 50% despite lack of a clear DIC blood profile in 67 of the 72 patients. The results indicate that an AT value below 60% of normal, unexplained by hereditary deficiency, carries a grave prognosis.
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PMID:On the clinical significance of acquired antithrombin deficiency. 608 56

In the present review, an attempt has been made to describe the modern concept of circulatory shock (Part I). The shock inducing insults (low circulatory volume/vascular capacity equation, heart failure, or disturbance of cellular metabolism induce physiological defense mechanisms, which result in peripheral vasoconstriction in order to maintain adequate blood pressure and perfusion of vital organs (compensatory phase). However, when the insult is too aggressive or too prolonged, deterioration of the cardiovascular system and cellular function ensues as a result of anaerobic metabolism, loss of vascular tone, reperfusion injury, depression of the reticuloendothelial system, disseminated intravascular coagulation, and myocardial failure (decompensatory phase). This leads to widespread cellular destruction, autodigestion, and finally death of the patient. Recent features of shock therapy will be discussed in part II of this review.
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PMID:[Shock: a review. I: Pathophysiology]. 615 Dec 64


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