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

Combined rapid atrial flutter/fibrillation and recurrent ventricular tachycardia occurred in an 82 year old man with acute myocardial infarction. Both arrhythmias were promptly terminated by intravenous sotalol, suggesting another use for this unique drug in the absence of hypotension, heart block or cardiac failure.
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PMID:Successful termination of combined rapid atrial flutter/fibrillation and ventricular tachycardia by intravenous sotalol. 365 68

We used hemofiltration to treat a patient with digoxin overdose complicated by refractory hyperkalemia, congestive heart failure, chronic renal failure, and complete atrioventricular heart block. Hemofiltration was associated with a progressive fall in plasma digoxin level and potassium level. This was accompanied by resolution of the heart failure and complete heart block. Hemofiltration appears to provide a therapeutic alternative in digoxin overdose.
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PMID:Hemofiltration in digoxin overdose. 371 10

Eighteen patients in whom shock developed after acute myocardial infarction are described. There was electrocardiographic evidence of acute inferior infarction in 11, of inferolateral infarction in three, and of anteroseptal infarction in four. In all cases the right atrial pressure was the same as or exceeded the end expiratory pulmonary artery wedge pressure. Plasma volume expansion of 100-2500 ml was needed to produce an optimum pulmonary artery wedge pressure. Eleven patients needed additional inotropic support with dopamine. Despite the absence of a critical increase in pulmonary artery wedge pressure, potential or actual hypoxia was almost always present. Six patients needed endotracheal intubation and mechanical ventilation because they had severe hypoxia that was unresponsive to supplemental inspired oxygen. Life threatening arrhythmias were also common (ventricular fibrillation in seven patients and complete heart block in four). Five patients died. All surviving patients are well and only one requires treatment for heart failure.
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PMID:Cardiogenic shock without a critically raised left ventricular end diastolic pressure: management and outcome in eighteen patients. 371 92

Exercise capacity was assessed by means of a simple six minute walking test in a group of 18 patients with heart block whose only presenting symptom was breathlessness. None was in overt cardiac failure. Patients were studied before and after implantation of a transvenous, ventricular, demand pacing system (study group). Eight patients with an implanted pacemaker admitted for elective generator replacement were assessed in the same manner (control group). Exercise capacity in the study group was significantly increased within 48 hours of pacing, and this improvement was maintained in most patients during the follow up period of up to 30 months. In contrast, exercise capacity was unaffected by generator replacement in the control group. Simple ventricular pacing produces symptomatic benefit in patients with heart block accompanied by breathlessness. This benefit is apparent within 48 hours of pacing and is maintained; it can be assessed objectively by a six minute walking test.
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PMID:Ventricular pacing improves exercise tolerance in patients with chronic heart block. 376 16

We present a case of non-Hodgkin's lymphoma with massive cardiac involvement in a previously well 65-year-old man, presenting with pericardial tamponade and heart failure of recent onset. Results of echocardiography and of pericardial and pleural fluid cytology suggested the diagnosis. Within two weeks the patient's condition progressed to complete heart block and he died. Primary cardiac tumors are rare when compared with metastatic involvement of the heart. Their presentation includes congestive heart failure, cardiomegaly, pericardial effusion, and sudden death. The clinical diagnosis has seldom been made.
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PMID:Cardiac presentation of non-Hodgkin's lymphoma. 380 Jun 10

Assessment of extravascular lung water (EVLW) is imprecise in vivo, yet of both clinical and investigative relevance in patients with cardiac disease. Recently, a double-indicator method using thermal-green dye has been proposed as a nondestructive technique for in vivo quantification of EVLW. In our 5-yr study, indocyanine green dye was used as the intravascular indicator and heat as the diffusible indicator in 44 control dogs, 74 dogs administered intravenous oleic acid, 63 dogs in whom left atrial pressure was altered with a left atrial balloon, and 31 dogs with low-output cardiac failure (electrical shock and complete heart block). In these animals, in vivo measures of EVLW correlated closely with standard gravimetric techniques (r = 0.87, p less than .001), although the indicator dilution technique tended to underestimate actual lung water at higher volumes. In an additional 26 dogs, fluid (lactated Ringer's solution) was administered directly into a distal pulmonary airway, producing alveolar rather than interstitial edema. In these animals, as the infused volume was increased, the thermal technique underestimated consistently the actual amount of infused fluid. Nonetheless, we conclude that in most clinical and experimental situations where moderate changes in lung water are anticipated, this technique can provide reasonable estimates of extravascular fluid accumulation.
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PMID:In vivo validation of the thermal-green dye technique for measuring extravascular lung water. 354 76

A comparative analysis was carried out of 126 patients (group I) with chronic right bundle branch block (RBBB) and left anterior (LAFB) or left posterior fascicle block (LPFB), and of 44 patients (group II) with the same bifascicular block associated with an ECG pattern of incomplete left bundle branch block (ILBBB). The two groups were found to be clinically different. In group II, heart failure, arrhythmia and first-degree atrioventricular block occurred significantly more frequently. During a mean follow-up period of 1581 +/- 118 days (85-6260 days), complete heart block (CHB) developed in 3.2% of patients in group I and in 22.7% in group II (p less than 0.01). In the same period, sudden cardiac death (SCD) occurred in 3.9% in group I and in 15.9 in group II (p less than 0.01). These results were analysed assuming a quadrifascicular character of the intraventricular conduction system. This made it possible to isolate on the basis of standard ECG findings patients with trifascicular block (group II--RBBB and LAFB or LPFB and septal LBBB) in whom prophylactic pacemaker implantation should be considered in view of high risk of CHB and SCD.
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PMID:Clinical significance of the pattern of incomplete left bundle branch block with bifascicular block. 399 93

A 39-year-old woman had a 2-year history of heart block, which had necessitated pacemaker implantation, and a 6-month history of heart failure. Endomyocardial biopsy specimens initially revealed lymphocytic myocarditis but subsequently showed giant cell myocarditis. She died suddenly, and autopsy disclosed extensive cardiac sarcoidosis with minimal extracardiac involvement. Cardiac sarcoidosis may be difficult to diagnose clinically because the extent of cardiac and the extent of extracardiac involvement tend to be inversely related. Endomyocardial biopsy may be helpful in diagnosing such cases.
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PMID:Cardiac sarcoidosis: a potentially treatable form of myocarditis. 402 46

This study was designed to analyze the effects of carbocromene and dipyridamole on the haemodynamic and electrocardiographic side-effects resulting from imipramine infusion in anaesthetised rats and dogs. Imipramine was infused at 1 mg/kg/min until cardiac failure and vascular collapse terminated the experiment at 21 +/- 2.3 min in rats and at 29.5 +/- 2.1 min in dogs. This was characterized by hypotension, bradycardia, intraventricular conduction delay, cardiac tachyarrhythmia and A-V block. Carbocromene (4 mg/kg i.v., followed by 80 micrograms/kg/min) protected the animals against heart failure. This was associated with delayed hypotension and negative inotropy, and lower incidence of heart block. Survival time increased to 37 +/- 1.5 min (P less than 0.05), and 54.2 +/- 2.6 min (P less than 0.02) in rats and dogs, respectively. Dipyridamole (0.5 mg/kg i.v., followed by 80 micrograms/kg/min) failed to decrease imipramine toxicity as judged by the haemodynamic and electrocardiographic parameters and did not alter survival time of imipramine controls. These results suggest that carbocromene is an effective treatment for imipramine-induced cardiovascular collapse and cardiac arrhythmias, the beneficial effects being largely due to metabolic and membrane stabilizing effects. Carbocromene has both therapeutic and prophylactic value and appears to be superior to dipyridamole therapy.
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PMID:Treatment of haemodynamic and electrocardiographic side-effects resulting from imipramine toxicity in rats and dogs. 404 78

A study of 203 patients with chronic heart block treated with oral long-acting isoprenaline showed that 85 (42%) were maintained satisfactorily on the drug for a mean period of 18.2 months. The survival rates at one, two, and three years were 76%, 64%, and 57% respectively. In 115 patients treatment by pacing became necessary to control symptoms, and in these patients the survival rates at one, two and three years were 83%, 72%, and 60%.The two most valuable guides to patients' response to oral isoprenaline are the response to a trial dose of intravenous isoprenaline and the type of dysrhythmia associated with their Adams-Stokes attacks. Patients with heart failure with slow ventricular rates and those with angina of effort do not respond to treatment with sympathomimetic drugs.The majority of patients with chronic heart block are elderly, and in view of the complexity of pacing systems, and the need for skilled supervision of paced patients, oral long-acting isoprenaline remains of value in the longterm management of chronic heart block, provided patients are carefully selected for this form of therapy.
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PMID:Conservative treatment of chronic heart block. 576 91


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