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

A case study in which propranolol hydrochloride was used as adjunct therapy in the treatment of atrial fibrillation with rapid ventricular response, thyrotoxicosis and high output heart failure is presented to illustrate the pharmacokinetics of this drug. The relationship of propranolol dosage to blood levels, the effect of blood levels on pharmacological response, the metabolism and elimination of propranolol, and determination of rational dosage of the drug, are discussed.
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PMID:Pharmacokinetics in drug therapy. I: Propranolol hydrochloride as adjunct therapy in the treatment of thyrotoxicosis. 5 90

Incidence and type of arrhythmia, using continuous ECG monitoring, were examined in 79 patients six weeks to 24 months after acute myocardial infarction, the findings being compared with arrhythmias at rest and on exercise, and correlated with signs of heart failure and coronary insufficiency. Arrhythmias were revealed in 16% (n = 13 at rest) and 19% (n = 10 of 52) on exercise. But continuous ECG monitoring revealed it in 86% (n = 68). On the other hand, arrhythmias may occur in the resting ECG but be rare on continuous monitoring. Ventricular extrasystoles were the most common arrhythmia, often multifocal and giving rise to bigeminy, only rarely as a result of exercise. Such extrasystoles usually showed right or right and left bundle conduction delays. Their frequency increased with increasing age of the patient. They were particularly frequent in patient who already had cardiac symptoms at rest, in patients with a large heart, and those who could not easily be exercised. Arrhythmias were more frequent a year after infarction than shortly before discharge from hospital or six months after infarction.
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PMID:[Cardiac arrhythmias in the chronic phase of myocardial infarction (author's transl)]. 5 49

Ninety-six consecutive total repairs of the tetralogy of Fallot are reviewed. There was an overall hospital mortality of 8-3 per cent and a total incidence of low output cardiac failure of 18-8 per cent, and this was the principal cause of death and the most important source of postoperative morbidity. In 49 cases there had been a previous palliative shunt procedure and there was a strikingly lower mortality and a highly significant lower morbidity in this group. Other factors which correlated in a positive fashion with increased mortality and morbidity were chronic hypoxia (as evidenced by polycythaemia), age below 5 years, severe postoperative right ventricular hypertension, and (to a lesser extent) extensive right ventricular outflow tract reconstruction. Data are presented to support the hypothesis that a palliative shunt procedure should be considered in the severely polycythaemic child with a surgically 'unfavourable' right ventricular outflow. This policy carries a low early mortality in our hands (5-4%), and is associated with a low mortality (3-9%) at a subsequent repair. This compares with a mortality of 12-8 per cent for primary repair, and the incidence of low output cardiac failure is five times as high in the primary repair as compared to the previously shunted group.
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PMID:Tetralogy of Fallot. Risk factors associated with complete repair. 6 Oct 38

If it is not possible to arrest massive hemorrhage from esophageal varices within 48 h by conservative means or by endoscopic phlebosclerosation, surgery should be performed as soon as possible. In most cases a palliative operation is performed, by which irreversible shock and consequent heart failure can be avoided. The method of phlebosclerosation preferred by the authors is transection of the lower esophagus via a thoracic approach.
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PMID:[Blocking surgery for esophageal varices]. 6 93

A case of meningeal carcinomatosis associated with cerebral metastases from an adrenal neuroblastoma is described. The clinical picture was ushered-in by bilateral sciatic pain in a 50 years old female and was followed by rapidly progressive sensory-motor deficits of the arms and legs, leading to flaccid quadriplegia associated with paralysis of cranial nerves and episodes of mental confusion. Death occurred 4 months alter, in cardiac failure. At autopsy, a bilateral tumor of the adrenal glands was found. No metastases were detected anywhere except in the central nervous system. Histology identified the tumor as a neuroblastoma; meningeal carcinomatosis, radicular infiltration by tumor cells and parenchimal metastases were found in the central nervous system. Neuroblastoma is typically a tumor of childhood, only 13% of them being found in adult's according to Russell and Rubinstein. Meningeal metastases from adrenal neuroblastoma have not hitherto been reported in the literature. In our opinion, the most likely mode of spread of tumor cells to the central nervous system was hematogenous because of the presence of small multiple intraparenchimal metastases; however, possible spread through the perineural lymphatics, as proposed by others, cannot be excluded, due to the prominent localization of tumor cells at spinal roots level. The main differential diagnostic problems (paraneoplastic neuropathy (Wyburn-Mason) and infectious subacute or chronic meningitis) are discussed. The authors stress the emportance of complete cerebro-spinal fluid examination including a careful search for tumor cells.
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PMID:[Meningeal carcinomatosis: clinical and anatomical study of a case of suprarenal neuroblastoma (author's transl)]. 6

Diagnostic value of a scope of peripheric parameters of thyroid function was assessed in an unselected group of untreated patients with suspected thyroid disorder, further in untraeted selected patients (without cardiac involvement) and in treated patients. Comparison of relative values of individual tests was performed, based on relation to plasma thyroid hormone level represented by PBI. It was found that: 1. The diagnostic value of heart rate, plasma cholesterol level, B. M. R. and Hegglin's sign (T-2s interval) is of a very limited degree. 2. The diagnostic accuracy of AJT, Q-Kd interval and PEP was found to be of considerable interest even in unselected patients. Values of IRVD and D indices found for these tests are comparable and allow the immediate estimation of thyroid function in bedside diagnosis. 3. The diagnostic value of PEP could be enhanced by exclusion of patients with suspected or proved cardiac disorder or myocardial failure; this may be useful for physiologic studies. 4. While heart rate is profoundly and inconsistently influenced by beta-blockade, AJT is influenced to a minimal degree only and Q-Kd and PEP are uniformly shifted to higher values, allowing thus diagnostic evaluation during this form of treatment also. 5. As Q-Kd is considerably age-and height-dependent, AJT and PEP are believed to be the most suitable test for immediated clinical diagnosis.
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PMID:Comparison of diagnostic accuracy of different peripheric parameters of thyroid function. 6 35

The number of patients with cardiac failure admitted to hospital in Zaria, Nigeria, month by month during 1972-75 differed highly significantly between the cooler dry months and the hot wet months. The reasons are uncertain, but seasonal changes in blood-pressure and the effects of heat on the circulation and of humidity on the efficiency of sweating may be responsible.
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PMID:Seasonal variation of cardiac failure in northern Nigeria. 6 84

Twenty-three patients with recurrent ventricular tachycardia or ventricular fibrillation, or both, were treated with aprindine, a new antiarrhythmic agent. It was found that: (1) no patient had a recurrence of ventricular fibrillation after aprindine therapy was begun, except as a terminal event subsequent to the development of acute myocardial infarction and cardiogenic shock or refractory congestive heart failure; (2) 6 patients experienced ventricular tachycardia after the loading dose, but with continued aprindine therapy the ventricular tachycardia was suppressed in 3 of these 6 patients, and a fourth patient was asymptomatic during brief paroxysms of ventricular tachycardia; (3) in 2 patients, aprindine was ineffective and was discontinued; (4) electrical cardioversion was not required in any patient receiving aprindine; (5) premature ventricular extrasystoles were decreased in 18 of the 23 patients treated with aprindine; (6) aprindine was discontinued in 1 patient because of intolerable side effects, although ventricular arrhythmias were suppressed in this patient; and (7) 5 patients died from acute myocardial infarction or severe heart failure while receiving aprindine.
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PMID:Treatment of recurrent ventricular tachycardia and fibrillation with aprindine. 6

Of 80 patients with acute myocardial infarction who had a cardiac arrest without shock 42 (52.5%) were resuscitated in a cardiological intensive care unit. Twenty-six were finally discharged from hospital. After an average of four years, 21 patients were still alive. Prognosis of primary ventricular fibrillation, the most frequent cause of circulatory arrest (51) was more favourable than that of primary asystole (23 patients). The younger the patient the better the prognosis: the average age of the 21 who survived for several years was 12 years less than those who had died. Follow-up examination indicated that 13 had signs of heart failure. Ventricular extrasystoles were demonstrated by ECG in 11. Eight had depressive episodes. It is likely that a further decrease in death-rate can be achieved only if the interval between onset of infarction and admission to an intensive care unit can be shortened.
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PMID:[Short- and long-term prognosis of cardiac arrest in acute myocardial infarction (author's transl)]. 6 61

In 95 patients treated by electroimpulse techniques for their cardiac fibrillation the incidence and diagnostic importance of postextrasystolic depression of the sinus rhythm were studied. Two groups of patients were singled out for a comparative study of the value of different prognostic criteria of the stability of the restored sinus rhythm: group 1--53 patients with unsatisfactory results of treatment (the sinus rhythm was preserved for not more than 1 month), and group 2--21 patients with good late results (the sinus rhythm persisted for over 6 months). A study of the distribution of the incidence of different prognostic signs in either of these groups showed that their prognostic value may be presented in the following succession: presence of intraventricular conductivity, severity of cardiac insufficiency, frequent postconversion extrasystoles, history of cardiac fibrillation of over 3 years, presence of a postextrasystolic depression of the sinus rhythm.
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PMID:[Postextrasystolic depression of sinus rhythm during electroimpulse therapy of auricular fibrillation]. 6 42


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