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 pathological changes in blood vessels observed in primary (essential hypertension) are similar to those seen in secondary hypertension due to renal disease or other causes. In benign hypertension, the major changes are in the small arteries and arterioles especially in the kidney. Interlobular arteries exhibit intimal thickening and duplication of the elastic lamina (elastosis) and there is hyaline change in the media of many arterioles. In some respects these changes are an accentuation of vessel ageing. Malignant hypertension usually presents in a younger age group (35--50 years) and is characterized pathologically by fibrous endarteritis in the interlobular arteries of the kidney and fibrinoid necrosis in the walls of a proportion of the efferent glomerular arterioles. Similar vessel changes are seen in other organs but many of the pathological changes in the heart and brain of patients with benign hypertension are related to the accentuation of arterosclerosis. There is an increased mortality from cardiac failure, myocardial infarction, cerebral haemorrhage and subarachnoid haemorrhage due to ruptured berry aneurysms in patients with benign hypertension. Although there is ischaemic damage to the kidneys in benign hypertension, death from renal failure is uncommon. Severe ischaemic damage to renal glomeruli and renal failure does, however, occur in malignant hypertension.
 ...
PMID:Vascular pathology in hypertension. 46 85

A 25 year old asymptomatic man with a past history of pulmonary tuberculosis presented with a continuous murmur. Selective arteriography revealed a left internal mammary arteriovenous malformation in communication with vessels in the left upper pulmonary lobe. No significant hemodynamic abnormalities were detected. This is the 26th reported case of internal mammary arteriovenous fistula and the 6th with a pulmonary communication. Review of the data in previous cases suggests that surgical indications are limited to symptomatic relief, heart failure during infancy or the possible risk of endarteritis, proximal arterial degeneration or rupture.
 ...
PMID:Internal mammary arteriovenous malformation with communication to the pulmonary vessels. 110 39

Chronic rejection, the most serious complication in long-term survivors of cardiac transplantation, was studied in 5 cardiac grafts obtained at retransplantation and in 15 post-mortem studies of patients who had survived 3 months to 10 years after transplantation. The usual clinical presentation was cardiac failure. Coronary angiography was performed in several cases and showed narrowing and non-opacification of small arteries often accompanied by thrombosis. Histology showed three types of vascular rejection: the most characteristic one, usually observed after the 6th month, was a stenosing fibrous endarteritis; another type of rejection, occurring earlier, was associated with acute myocardial rejection and presented as an inflammatory arteritis; the third type of vascular rejection was accompanied by widespread atheromatous lesions. The significance and pathogenesis of these lesions are discussed with respect to the clinical context with electron microscopic and immuno-histochemical data.
 ...
PMID:[Intermediate and late changes in human cardiac graft]. 212 89

The more prevalent complication in patients with a long survival rate after heart transplantation is chronic rejection, which was studied in a series of 80 necropsies and five cardiac grafts surgically removed for retransplantation after chronic rejection. In the material obtained at necropsy, 11 of 14 patients with a survival rate of more than 6 months died from chronic rejection. Clinically, the usual manifestation was heart failure. Anatomic angiograms were performed in several cases. They demonstrated narrowing and nonopacification of small coronary arteries, often accompanied by thrombosis and ischemic complications. The histologic study detected three types of rejection. (1) The more typical rejection is observed after 6 months. It is characterized by a stenosing fibrous endarteritis. (2) Another type of rejection occurs earlier and is associated with acute rejection; its anatomic substratum is an inflammatory panarteritis. (3) This type of rejection is accompanied by large atheromatous deposits. The significance and pathogenesis of these lesions are discussed in correlation with their clinical context and with the electron microscopic observations.
 ...
PMID:Chronic rejection in human heart transplantation. 304 80

Eight hundred and four patients with persistence of the ductus arteriosus were seen in Edinburgh between 1940 and 1979. Thirty-seven of them reached the age of 50 years, and in 32 the shunt was exclusively from left to right. Fifteen of the 32 were subsequently treated surgically. None of the 32 was lost to follow-up. Duration of clinical observation averaged 17 years and extended to over 30 years in eight patients. Their features have been correlated with those from reports of 48 comparable patients in an attempt to clarify the management of the persistent ductus in the older patient. Impairment of left ventricular function is shown as the major risk, even when the ductus is small. Bacterial endarteritis is infrequent. Surgical treatment carries greater risk than in childhood and early adult life but usually reduces heart size and restores exercise tolerance. Left ventricular dysfunction, however, occasionally vitiates the benefits; symptoms are then incompletely relieved and death from heart failure may occur months or years after operation. Experience in older patients thus emphasises the value of elective operation in childhood, however well the child, however trivial the shunt. It is concluded that in older patients, the presence or the development of symptoms or cardiac enlargement are almost always indications for surgical treatment. As age increases, especially by the eighth decade, medical treatment may be preferable. Continued follow-up of symptomless patients without cardiomegaly is important because increase in heart size usually precedes further deterioration which can then be prevented by timely surgical treatment.
 ...
PMID:Persistence of ductus arteriosus with left to right shunt in the older patient. 713 11

Eleven cats with spontaneous dirofilariasis were necropsied; ten were domestic shorthairs and one was a Persian. The cats ranged in age from 1 to 10 years, and 6/11 cats were male. One to three heartworms were present in the right ventricle and pulmonary arteries of each of the 11 cats. Patchy areas of rugose thickening of the intima of the pulmonary trunk and marked villous endarteritis of lobar and medium-sized pulmonary arteries were observed. Affected larger vessels were partially occluded by large villous intimal proliferations that were lined by hyperplastic endothelial cells supported by connective tissue stroma. Moderate to marked infiltration of eosinophils and mononuclear inflammatory cells was consistently observed in the intima of affected larger pulmonary arteries. Thrombosis of pulmonary arteries was seen in five cats. Medial hypertrophy, mild intimal proliferative changes, and focal infiltrations of leukocytes were seen in small pulmonary arteries. Lesions indicative of right-sided heart failure consisting of right ventricular dilation and chronic passive congestion of the liver were observed in four cats.
 ...
PMID:Pulmonary arterial changes in feline dirofilariasis. 844 29

Endocarditis is not usually considered a complication of AIDS. Because salmonellal bacteremia is common in HIV-infected patients and because salmonellae have a propensity to adhere to endothelial cells, these patients are at risk of endocarditis and endarteritis. We report two cases of endocarditis due to Salmonella enteritidis and review three previously reported cases. All five patients had underlying heart valve disease and developed fever, breakthrough or relapsing bacteremia, heart murmurs, and cardiac failure; four of five patients were older than 45 years. One patient died, but the other four were successfully treated with beta-lactam agents alone or in combination with aminoglycosides or with ofloxacin (valve replacement was not required). As AIDS patients get older, the number of cases of endocarditis or endarteritis due to Salmonella species may increase, particularly in geographic areas where Salmonella species are prevalent.
 ...
PMID:Infectious endocarditis due to non-typhi Salmonella in patients infected with human immunodeficiency virus: report of two cases and review. 872 47

A 68-year-old male with a 2-year history of rheumatoid arthritis was hospitalized due to severe polyarthritis. Since level of rheumatoid factor was high, and subcutaneous nodules and cutaneous ulcers were present, the case was diagnosed as malignant rheumatoid arthritis (rheumatoid vasculitis). On 10th day after admission, severe dyspnea developed due to acute heart failure, followed by severe melaena. The patient did not respond to various treatments including steroid pulse therapy, and died 3 days later. Autopsy revealed widespread hemorrhagic infarction that was extended from the colon to the rectum. Proliferative endarteritis was recognized in mesenteric vessels, however neither necrosis nor inflammatory changes were observed. The melaena was caused by the interstinal infarction. The intestinal infarction was thought to be responsible for the circulatory disturbances due to heart failure in obstructive vessel lesion of mesenteric vessels.
 ...
PMID:[An autopsy case of rheumatoid arthritis associated with proliferative endarteritis died of sudden severe melaena]. 881 May 42

A small patent ductus arteriosus (PDA) is compatible with a normal life span. A non-restrictive PDA may present with signs of heart failure, supraventricular arrhythmia's, bacterial endocarditis or endarteritis later in life. Fewer than 50% of patients, including those with small shunts, are symptomatic by the age of 50. Considering that 40% of patients with PDA's will die before the age of 45 as a result of bacterial endocarditis or heart failure, closure of the PDA is recommended. Exceptions are patients with a nondilated heart, a right-to-left shunt, or age greater than 60 years old. Because of the wider use of echocardiography, especially transesophageal echocardiography, many PDA's are now detected incidentally in patients without symptoms.
 ...
PMID:Intravascular ultrasound imaging of a patent ductus arteriosus in an adult. 1015 79

Persistent ductus arteriosus in the adult carries a risk for becoming symptomatic with dyspnoea or palpitations, developing infective endarteritis, and finally for developing pulmonary hypertension with ensuing heart failure morbidity and mortality. Surgical closure is considered more and more to be outdated as first choice treatment since percutaneous closure is a safe and effective alternative. Only the Eisenmenger syndrome remains a clear contra-indication for closure, whether surgical or interventional. We report on our own experience in nine patients with persistent ductus arteriosus including eight cases who underwent percutaneous closure and one patient with Eisenmenger syndrome. In addition, our experience with clinical features and therapeutic modalities is related to the literature.
 ...
PMID:Persistent ductus arteriosus in the adult: clinical features and experience with percutaneous closure. 1222 96


1 2 Next >>