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

From 1965 to 1979, 59 patients with the Marfan syndrome and cardiovascular complications underwent aortic root and aortic valve surgery. The hospital mortality was 12% (6.5% over the past 5 years). At follow-up an average of 5.1 years later, 2 patients had postoperative heart block, and late complications required reoperation in 4. There was 8 late deaths (overall mortality 25%). Survival at 6 years was 77% and improvement was noted in the functional class of 32 (74%) of the 43 survivors. 3 patients with abnormal preoperative ventricular function have continued in cardiac failure; 3 have moderate mitral regurgitation and 2 have aortic regurgitation. Aneurysms of the abdominal aorta and pulmonary artery have developed in 2 patients. Initially patients underwent surgery when their condition deteriorated despite medical treatment. Echocardiographic assessment of the aortic root has improved diagnosis and management; a large, progressively dilating aorta and evidence of ventricular dilatation were indications for surgery in 11 symptom-free patients. Although patients with Marfan syndrome are prone to other cardiovascular manifestation which affect survival, elective prophylactic surgery to the ascending aorta can be done with a low mortality and expectation of improved lifespan.
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PMID:Management of cardiovascular complications in Marfan syndrome. 610 79

The necropsy findings of a large cell lymphoma involving only the pericardium and myocardium in a 62-year-old woman are reported. The initial presenting symptoms were heart failure followed by rapidly progressive heart block. The diagnosis of cardiac lymphoma was suggested by gallium and blood pool isotope studies, and was subsequently confirmed by operative myocardial biopsy. The clinical course was abrupt, and the patient died before therapy was instituted. While primary cardiac lymphoma is an extremely rare condition, experience in this case suggests that noninvasive isotope studies, particularly gallium and blood pool, are helpful in the diagnosis of atypical cardiomyopathy.
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PMID:Primary lymphoma of the heart. A case report. 630 85

Sixteen consecutive patients with familial amyloidosis with polyneuropathy of varying duration and severity underwent 24 hour ambulatory electrocardiographic monitoring. A high incidence of sinus node dysfunction, supraventricular and ventricular arrhythmias, and disturbances of atrioventricular conduction was found. Considerably more arrhythmias and disturbances of conduction were detected by long term electrocardiographic monitoring than by conventional 12 lead electrocardiograms. During a follow up period of three to 14 months five patients needed treatment by a pacemaker, three of them because of symptomatic complete heart block, one because of second degree heart block with heart failure, and one because of symptomatic dysfunction of the sinus node. The tachyarrhythmias did not require specific treatment. Long term electrocardiographic monitoring is a useful adjunct in the evaluation of patients with familial amyloidosis with polyneuropathy as it may detect otherwise unrecognised symptomatic disturbances of heart rhythm. The results may be valid also for other forms of amyloidosis involving the heart.
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PMID:Disturbances of cardiac rhythm and conduction in familial amyloidosis with polyneuropathy. 632 51

To assess the effects of chronic left ventricular (LV) dysfunction on intravascular pulmonary blood volume (PBV) and extravascular lung water (EVLW) lung fluid volumes, 56 dogs were evaluated by means of double-indicator dilution techniques. PBV and EVLW were measured in seven control dogs, in eight dogs 4 hours after the production of left heart dysfunction, and then in three additional groups of dogs (n = seven in each group) 7, 14, and 30 days after the production of LV dysfunction. Twenty dogs were excluded because we were unable to produce elevations in LV end-diastolic volume greater than 25 mm Hg. EVLW was measured using heat as the diffusible indicator, and electric shock was used to create heart block and myocardial scarring in order to produce LV dysfunction. Plasma volume was calculated prior to death by means of radioiodinated albumin. In the remaining animals, electric shock acutely and chronically elevated LV end-diastolic pressure (control 2.3 +/- 1.0 mm Hg; postshock pressures greater than 25 mm Hg). PBV increased initially after cardiac failure and remained so as time progressed, although it represented a smaller fraction of the plasma volume as time passed (11.2 +/- 2.1% control, 15.9 +/- 3.4% at 4 hours after failure, and 12.6 +/- 2.0% at 7 days; the former p less than 0.005 vs control, the latter p less than 0.01 vs control). EVLW increased as time progressed, in consort with small but progressive increases in left atrial pressure. Thus, we conclude that the effects of acute and chronic LV dysfunction on pulmonary circulation are significantly different.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Intravascular and extravascular pulmonary fluid volumes during chronic experimental left ventricular dysfunction. 351 2

A double-blind study comparing verapamil with placebo was conducted in 16 Danish departments of internal medicine with coronary care units (CCU). All patients under 75 years of age admitted to the CCU with a suspicion of acute myocardial infarction (AMI) were evaluated. Of 7415 patients, 3917 were excluded on admission because of heart failure, heart block, other severely disabling diseases, or treatment with beta-blockers or calcium-antagonists. Treatment was started on 3498 patients with 0.1 mg kg-1 verapamil i.v. and 120 mg perorally on admission followed by 120 mg t.i.d., or matched placebo. Treatment was continued for 6 months for patients ascertained to have had an AMI according to all three WHO criteria. Treatment was stopped in patients in whom these criteria were not fulfilled. Of 1436 patients with AMI, 717 were treated with verapamil and 719 with placebo. After six months, 92 patients (12.8%) in the verapamil group and 100 patients (13.9%) in the placebo group were dead (NS). After 12 months the mortality rates were 15.2% and 16.4%, respectively (NS). By six months after entry a total of 56 reinfarctions were recorded in 50 patients (7%) in the verapamil group and 66 reinfarctions in 60 patients (8.3%) in the placebo group (NS).
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PMID:Verapamil in acute myocardial infarction. The Danish Study Group on Verapamil in Myocardial Infarction. 638 32

A double-blind study comparing verapamil with placebo was conducted in 16 Danish departments of internal medicine with coronary care units (CCUs). All patients younger than 75 years admitted to the CCU with suspected acute myocardial infarction (AMI) were evaluated for inclusion. Of 7,415 patients, 3,917 were excluded on admission because of heart failure, heart block, other severely disabling diseases or treatment with beta-blocking drugs or calcium antagonists. Treatment was started in 3,498 patients with 0.1 mg/kg of verapamil intravenously and 120 mg perorally on admission followed by 120 mg 3 times daily, or matched placebo. Treatment was continued for 6 months in patients verified to have had AMI according to all 3 World Health Organization (WHO) criteria. Treatment was stopped in patients in whom AMI was ruled out. Of 1,436 patients with AMI, 717 were treated with verapamil and 719 with placebo. After 6 months, 92 patients (12.8%) in the verapamil group and 100 (13.9%) in the placebo group had died. Fifty patients (7%) in the verapamil group and 60 (8.3%) in the placebo group had had reinfarction. After 12 months, 109 patients (15.2%) in the verapamil group and 118 patients (16.4%) in the placebo group had died.
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PMID:Verapamil in acute myocardial infarction. Danish Multicenter Study Group on Verapamil in Myocardial Infarction. 639 Nov 36

Extreme variations of heart rate caused clinical and radiographic findings of heart failure in six neonates in the absence of structural heart disease. Two infants had heart block with heart rates below 50/min and four had paroxysmal atrial tachycardia with rates approaching 300/min. Each infant had interstitial or alveolar pulmonary edema and most had cardiomegaly. After restoration of a normal heart rate, there was rapid and dramatic resolution of pulmonary edema and reduction in cardiac size.
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PMID:Heart failure in the neonate due to extreme abnormalities of heart rate: clinical and radiographic features. 644 42

Sinus nodal dysfunction (SND) and complete heart block (CHB) in congenital heart disease (CHD) are commonly associated with congestive heart failure, syncopal attacks, and sudden death. Permanent cardiac pacing (PCP) is required to avoid these manifestations which are frequently associated with a high rate of complications, particularly in the younger age group. Twenty patients with CHD aged 4 months to 46 years underwent pacemaker implantation. Twelve (60%) were less than 20 years of age. CHB was present in 15 patients: in 10 it developed 1 week to 11 years following surgery, in two it was congenital, and in three patients it developed spontaneously with previous conduction disturbances. SND was present in 5 patients: it was congenital in two patients and developed post-operatively in three. Seventeen patients are alive and no syncopal attacks or bradyarrhythmias were recorded 2.5 to 12.5 years following the initiation of PCP. Improvement in the cardiac output was noted in most patients with heart failure. The three patients who died had adequately functioning pacemakers. Only nine re-implantations were needed, seven of them in adult patients after closure of an atrial septal defect. Our experience indicates a favourable outcome for patients with CHD needing PCP.
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PMID:Permanent cardiac pacing in congenital heart disease: a follow-up study of 20 patients. 649 55

A 48-year-old man with symptoms of presyncope and congestive cardiac failure had hypertrophic cardiomyopathy (HCM) without obstruction. Complete heart block (CHB), a rare complication of this disease, was preceded by complete left bundle-branch block. Right ventricular (RV) heart failure was a dominant clinical feature but improved dramatically after temporary transvenous RV pacing prompting the insertion of a permanent RV inhibited pacemaker. Repeated ventricular fibrillation was successfully controlled by amiodarone. This is the seventh case of HCM complicated by CHB reported in the literature, and the first in which RV endomyocardial biopsies were undertaken. Two other patients reported in the literature had RV inhibited permanent pacemakers implanted, and a further 2 had atrioventricular sequential pacemakers.
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PMID:Hypertrophic cardiomyopathy complicated by complete heart block. Case report and review of the literature. 654 53

1 To evaluate oral disopyramide phosphate in the prophylaxis of dysrhythmias occurring in acute myocardial infarction (MI) patients (presenting within 12 h of symptoms, age 21-70 years), a placebo-controlled, randomized double-blind, in hospital trial was conducted. After prognostic stratification (anterior and non-anterior MI at each of 4 regional hospitals) patients were randomly assigned to receive oral disopyramide phosphate (loading dose 150, 200, or 300 mg followed 6 h later by 100, 150, or 200 mg every 6 h for patients assessed to weigh less than 55, 55-85, or greater than 85 kg, respectively or matching placebo. The primary exclusion criteria were overt heart failure, systolic BP less than 100 mmHg, significant heart block or history of urinary retention. Active drug or placebo was continued for 7 days or until (a) detection of "warning arrhythmias' requiring i.v. lignocaine intervention (greater than 5 for 7 days or until (a) detection of "warning arrhythmias' requiring i.v. lignocaine intervention (greater than 5 premature ventricular contractions (PVCs)/min, R on T PVCs, multifocal PVCs, bigeminal PVCs, ventricular tachycardia or ventricular fibrillation) or (b) onset of exclusion criteria. In addition, plasma drug concentrations were determined and 24 h electrocardiographic tapes were obtained on day 1, and on one of days 4-7 but these results are not presented here. 2 Out of 121 patients entering the trial, 101 had confirmatory ECG and enzyme changes. Of these, 9 of 47 patients receiving disopyramide phosphate required lignocaine compared to 20 of 54 receiving placebo (19% v 37%; P = 0.047). Corresponding numbers for patients discontinuing trial medication for other non-fatal complications of MI were 5 and 3, and for those dying, were 3 (2 infarct extensions and 1 massive infarction), and 0, respectively. Respective numbers discontinuing trial medication for possible drug side effects (viz. urinary retention requiring catheterization) were 6 and 1 (P = 0.031). 3 In circumstances where i.v. therapy is deemed impractical, use of oral disopyramide phosphate given prophylactically in patients with acute MI may reduce the incidence of "warning arrhythmias' by a clinically significant extent.
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PMID:A placebo-controlled study to determine the efficacy of oral disopyramide phosphate for the prophylaxis of ventricular dysrhythmias after acute myocardial infarction. 675 87


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