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

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

A newborn infant presented with cardiac failure secondary to a peripheral cavernous haemangioma. She was successfully treated surgically but was later diagnosed as having GM1 gangliosidosis.
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PMID:Peripheral arteriovenous fistula as a cause of neonatal cardiac failure. 394 36

The presentation of 129 cases of cerebral angioma is reviewed. There were 4 main methods of presentation: haemorrhage, epilepsy, deteriorating neurological signs and headache. The fifth common method of presentation, heart failure, almost exclusively confined to infants, was not seen in the current series which includes no paediatric cases. Standard techniques of investigation principly angiography and CT scanning were used in diagnosis and the current indication for surgery was haemorrhage. The mortality rate per haemorrhage in the series considered in natural terms was 3.6%, neurological deficit as a result of the haemorrhage, either major or minor, occurred in a total of 8%, 4% each. Complete excision of the angioma was performed in 69 cases, although in 3 of these it was necessary to reoperate following postoperative angiography which was then used again to confirm total removal. There was 1 death in this series of radical removals, a mortality rate of 1.5%. Six cases however, showed significant neurological deterioration postoperatively, a major morbidity of 8.7%. From the period of observation of these cases and the instance of haemorrhage the annual bleeding rate would appear to be 4.2%. From follow-up of our cases where the lesion was not completely removed the re-bleeding rate would appear to be 2.6%.
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PMID:The management of cerebral arteriovenous malformations. 397 44

An infant presenting with high-output cardiac failure and a single large diffuse haemangioma of the liver is described. Corticosteroid therapy failed to produce any improvement, but hepatic artery ligation was followed by dramatic disappearance of the signs of cardiac failure and a decrease in the size of the liver without any evidence of lasting liver damage.
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PMID:Ligation of the hepatic artery in the treatment of heart failure due to hepatic haemangiomatosis. 543 Mar 79

Benign liver tumors are relatively uncommon and, even when large enough to be symptomatic, they usually remain undiagnosed prior to exploratory laparotomy. Hemangiomas constitute the majority of benign hepatic neoplasms and are 9 times as frequent in females as in males. Most are asymptomatic but abdominal swelling, a mass, or symptoms due to compression of adjacent organs may occur and abdominal hemorrhage is reported in 4.5% of patients. Hepatic hemangioma may produce a large arteriovenous communication serious enough to cause heart failure. Recently an increased frequency of liver tumors, mostly adenomas, has been noted in women taking oral contraceptives (OCs); the cause has been attributed to estrogens. The exact incidence is unknown but believed to be low. It is most common in women in their late 20s who have been on OCs for 7 years or more. The tumor occasionally completely regresses on withdrawal of the OCs. The tumor may be discovered incidentally at laparotomy or may manifest inself by pain, a palpable mass, or catastrophic hemoperitoneum. Hepatic adenoma is usually a solitary lesion and infrequently degenerates into malignancy. Differential diagnosis includes chronic gall bladder disease and peptic ulcer. Focal nodular hyperplasia (FNH) is apparently much less frequently related to OC use and is less likely to bleed seriously than adenoma. Hepatic chemistry is usually normal in adenoma and FNH, but slight increases in serum bilirubin, serum alkaline phosphatase, and serum transaminase may occur. Primary liver cancer (hepatocellular carcinoma or hepatoma) is mostly a disease of males and in the US and Western Europe seldom develops before age 40. Fibrolamellar carcinoma, which characteristically develops in adolescents and young adults, occurs with equal sex incidence. Doubt has been expressed about its relationship to OCs. In the US about 75% of primary hepatocellular carcinomas are associated with cirrhosis, and about 5% of cirrhosis cases develop primary liver cancer. Clinical manifestations of hepatoma have been divided into 5 groups: frank cancer (62.7%), acute abdominal cancer (8%), febrile cancer (8%), occult cancer (16%), and metastatic cancer (5%). Detection of large amounts of alpha fetoprotein has proven useful in diagnosis of hepatocellular carcinoma, but values may be negative in OC users. It has been estimated that 1/3 to 1/2 of all malignant tumors eventually metastasize to the liver.
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PMID:Hepatic neoplasia: selected clinical aspects. 619 95

A case of cardiac failure in a 54 year old man with a diffuse total arteriovenous aneurysm of the liver is reported. The aneurysm was arteriolarvenous, without a wide bore localised fistula. It occupied the whole hepatic mass, including the territories of the right subphrenic and anterior collateral of the gastroduodenal artery. The cause of cardiac failure was the elevated cardiac output, 15 1/min, which fell to 6 1/min at each peroperative occlusion of the hepatic artery. After ligature of this vessel, the cardiac output stabilised at 9 1/min and remained at this value 4 months after surgical cure. This case is comparable to the neonatal cardiac failure due to multinodular hepatic angioma with respect to the clinical, angiographic and CAT scan characteristics, and the surgical cure of the high cardiac output syndrome. Some of the histological features were suggestive, in places, of the structure of hepatic cavernoma, which makes the exact pathological classification of this diffuse aneurysm difficult; the closest possibility being an involuted from of diffuse capillary hemangioma of childhood allowing such long survival and, occasionally taking on the appearances of a cavernoma. Permanent surgical cure by ligature of the hepatic artery was an additional rare feature of this case.
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PMID:[Curable asystole in an adult caused by a diffuse and complete arteriovenous aneurysm of the liver. Cure by ligation of the hepatic artery]. 640 47

The authors describe a case of hepatic hemangiomathosis in a three months old infant with a clinical picture of multiple cutaneous hemangioma, epatomegaly and severe cardiac failure. The cardiac catheterization with selective angiography showed extensive communication between the mammary artery and the hepatic circulation with the presence of large bloody areas into the markedly enlarged liver. The medical treatment with digitalis, diuretics, and corticosteroids obtained rapid resolution of the cardiac failure and of the A-V fistula signs. A clinical picture of severe liver cholostatic disease developed few months later which was confirmed by histological examination. The subsequent course has been favorable with complete clinical resolution of the liver disease.
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PMID:[Hepatic hemangiomatosis with congestive cardiac failure and development into a cholostatic hepatopathy]. 653 23

Three cases of congestive heart failure are presented caused by a cerebral arteriovenous aneurysm, a pulmonary arteriovenous aneurysm and a placental angioma respectively. Such conditions should be borne in mind in otherwise unexplained heart failure in the neonatal period and in infants. The haemodynamic influence of the malformation depends on its anatomy, giving rise to various clinical pictures.
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PMID:Arteriovenous malformations as a cause of congestive heart failure in the newborn and infant. Three cases with different haemodynamic mechanisms. 654 77

Clinical details of two cases of arteriovenous angioma of the vein of Galen are presented. In one case a diffuse meningo-cerebral angiodysplasia was found at necropsy. Due to a large arteriovenous shunt both cases became apparent in the neonatal period by progressive and fatal heart failure as the main clinical feature. Increased head circumference and a loud cranial bruit suggested the final diagnosis. Improvement of diagnostic work-up by computerized axial tomography and two-dimensional ultrasound with less discomfort to the patient is emphasized.
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PMID:Arteriovenous angioma of the vein of Galen causing cardiac failure in the neonate. Report on clinical and pathological findings in two cases. 662 11

Capillary and cavernous hemangiomas of the skin and subcutaneous tissue, usually follow a benign course with enlargement in the first year of life followed by gradual involution. Hemangiomas of the liver, on the other hand, can be responsible for life threatening complications in infancy. The presence of major intrahepatic arteriovenous communications may produce a high output cardiac failure, refractory to intensive medical therapy. Use of radiation therapy and high doses of steroids have proven to be of limited success with a 90% mortality in infants managed with nonoperative therapy. Hepatic artery ligation in such patients may provide dramatic control of the high output failure, with negligible side effects. Two infants are reported in whom bilateral hepatic artery ligation provided prompt control of fulminant congestive failure secondary to hepatic hemangiomatosis, after failure of medical therapy.
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PMID:Hepatic artery ligation for hepatic hemangiomatosis of infancy. 685 87


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