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

PAE can occur as a consequence of heart failure. Depending upon the extent of left ventricular failure, pulmonary edema can vary widely in severity. To anticipate potential health care needs and, ultimately, to treat PAE, the critical care nurse identifies common nursing diagnoses. Once the nurse understands the physiologic or psychological mechanisms for the particular nursing diagnoses, he or she can serve as a reference point to identify expected nursing outcomes.
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PMID:Common nursing diagnoses for pulmonary alveolar edema patients. 174 82

We have studied 130 patients with diabetes mellitus and 455 patients without. All the patients were consecutively admitted to our Coronary Care Unit with their first myocardial infarction. We have observed a higher incidence of heart failure, in-hospital mortality, atrial fibrillation, conduction abnormalities, and post-infarction angina among diabetics. Nevertheless, diabetic patients do not show evidence of larger infarcts than those without diabetes. In our patients the higher mortality among diabetics is related to an increased occurrence of left ventricular failure. Moreover, post-infarction ischemic episodes are more common compared with non diabetics. Since infarcts in diabetics do not seem to be more extensive than in non diabetics, we suggest, in accordance with others, that the poorer outcome among diabetic patients with AMI could be related to an underlying cardiac dysfunction of diabetics in addition to coronary artery diseases.
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PMID:Clinical correlation between diabetic and non diabetic patients with myocardial infarction. 178 49

We studied sympathetic and renin-angiotensin systems activity in a series of 175 patients suffering from acute myocardial infarction. These two systems were both overactivated especially in the cases complicated by hemodynamically documented left heart failure. The response of these systems to acute heart failure was in the same range for patients younger or older than 65 years and the witness (norepinephrine and plasma renin levels) of sympathetic and renin-angiotensin activities were good independent prognostic factors of in-hospital mortality.
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PMID:[Activity of the sympathetic nervous system and of the renin-angiotensin system in the acute stage of myocardial infarction]. 181 13

The systemic and regional hemodynamic effects of arginine vasopressin receptor antagonism (AVPA) and angiotensin-converting enzyme inhibition (ACEi) were examined in rabbits with acute left ventricular failure induced by repetitive direct current (DC) shock. Hemodynamic measurements in 24 rabbits 24 h after DC shock compared with 6 sham-operated controls demonstrated a lowered cardiac output (602 +/- 26 vs. 920 +/- 35 ml/min, P less than 0.01), increased left ventricular end-diastolic pressure (LVEDP, 13.6 +/- 1.3 vs. 1.9 +/- 0.5 mmHg, P less than 0.01) and a raised peripheral resistance (9,734 +/- 495 vs. 6,479 +/- 305 dyn.s.cm-5, P less than 0.01). Cerebral blood flow was not altered in rabbits with acute left ventricular failure but intestinal (29 +/- 2 vs. 53 +/- 9 ml/min, P less than 0.01) and renal (82 +/- 6 vs. 130 +/- 8 ml/min, P less than 0.01) blood flows were significantly reduced. No hemodynamic changes were observed after AVPA alone in the acute heart failure group and ACEi alone reduced LVEDP and increased renal vascular conductance. Treatment with both drugs (i.e., AVPA + ACEi) resulted in a significant increase in cardiac output (21%) and a decrease in blood pressure (19%) and peripheral resistance (34%) and restored renal and intestinal blood flows to near normal levels. Thus both vasopressin and angiotensin contribute to the overall increase in peripheral resistance in this model and to the decrease in intestinal and renal blood flow observed. Presumably blockade of one system produced little hemodynamic change because of compensatory increases in the other system.
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PMID:Systemic and regional effects of vasopressin and angiotensin in acute left ventricular failure. 182 56

Peripartum cardiomyopathy is characterized by congestive left ventricular failure appearing during the last trimester of pregnancy or during the 6 months following delivery, without any specific etiology or pre-existing cardiac disease. The present report describes the case history of a woman presenting with severe cardiac failure immediately after the delivery of twins.
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PMID:Peripartum cardiomyopathy: a case report. 183 98

Twenty five infants with truncus arteriosus underwent complete surgical correction in the first year of life between January 1984 and June 1990 at Marie Lannelongue Hospital. All had cardiac failure and pulmonary hypertension. Another severe cardiac malformation was present in 6 cases. Complete repair was carried out under cardiopulmonary bypass with moderate hypothermia. After closing the ventricular septal defect the continuity of the right ventricle and pulmonary artery was reestablished by a valved Dacron conduit with a bioprosthesis (13 patients), by an autologous pericardial conduit with the same type of prosthesis (5 patients), by a valveless conduit (1 patient) or by direct insertion of the pulmonary artery (6 patients). Eight children (32%) died shortly after surgery. Seventy one per cent of children operated in the first month of life died compared with only 17% of those operated after one month of life (p less than 0.05). The seventeen survivors have been followed up for an average of 21 +/- 22 months. Three secondary deaths were observed at 33 days, 2 and 10 months after surgery: the first child died of left ventricular failure and pulmonary vascular disease related to the complexity of the associated cardiac malformations; the other 2 deaths were unexpected. The one and three year survival rate is 54%. Pulmonary stenosis with a systolic pressure gradient of more than 30 mmHg was found in 7 patients of whom 6 had valved Dacron conduits (p less than 0.01). One child was successfully operated 60 months after the total correction and another child is on the waiting list for reoperation 69 months after the total correction.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Immediate and mid-term results of complete repair of truncus arteriosus during the first year of life]. 189 4

Overnight studies were performed in 10 patients with severe chronic left heart failure (New York Heart Association grades III and IV) without pulmonary disease and in eight controls. Transcutaneous oxygen (Po2) and carbon dioxide tensions (Pco2) and oxygen saturation were measured and the electro-cardiogram was recorded. During sleep mean oxygen saturation fell to 92.7% (minimum 86.1%) from 95.1% when awake. During the night oxygen saturation was below 95% for 62% of the time, below 90% for 6% of the time, and below 85% for 1% of the time. In four patients there were oxygen desaturation dips (a fall of greater than 4% in oxygen saturation from a stable baseline that lasted greater than 30 s) with concurrent increases in Pco2. Two patients had bradycardia during the dips: in one there was non-sustained ventricular tachycardia during the dips and in the other there was ST depression (greater than 0.1 mV at 80 ms after the J point) during a dip. In the controls the fall in mean oxygen saturation from 95.4% when they were awake to 94.4% when they were asleep was less than the fall in patients with heart failure and there were no desaturation dips or arrhythmias. Thus patients with severe heart failure had episodes of oxygen desaturation during sleep, some of which were associated with arrhythmia. Such episodes may be related to the increased risk of sudden death in chronic heart failure.
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PMID:Overnight studies in severe chronic left heart failure: arrhythmias and oxygen desaturation. 190 36

A 52 year old patient presenting with spontaneous anginal chest pain for 4 days was admitted to hospital for a more intense and prolonged chest pain associated with signs of left ventricular failure (gallop, pulmonary crepitations, hypoxemia). Coronary angiography showed marked septal hypokinesia and spontaneous localised spasm of the left anterior descending and marginal arteries with a variable degree of luminal narrowing of the other segments of these two arteries and of the right coronary artery. These changes regressed after intracoronary injection of molsidomine. The signs of left ventricular failure disappeared in 48 hours. The wall motion abnormality, monitored by 2D echocardiography, regressed slowly over 3 days. On the other hand, the electrocardiogram, which showed anterior wall subendocardial ischaemia with prolongation of the QTc interval during the spasm, remained abnormal for a long time. Therefore, in the absence of organic heart disease, coronary spasms associated with vasoconstriction can induce a sufficiently severe and durable alteration of left ventricular function to create clinical signs of cardiac failure and profound and prolonged ST-T wave changes on the electrocardiogram.
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PMID:[Coronary spasm and diffuse coronary vasoconstriction responsible for transient left ventricular insufficiency]. 192 21

Five-year survival amongst 485 consecutive patients with their first acute myocardial infarction (AMI) was 78.2%. Univariate survival analysis showed that the following variables during the acute stage were of prognostic significance for survival: signs of left ventricular heart failure, enlarged cardiac volume, pulmonary congestion on chest X-ray, anterior myocardial infarction on ECG, and low left ventricular ejection fraction (LVEF), whereas enzyme analysis and Q/non-Q signs on ECG were not. In the multivariate analysis two equivalent models were found. The first pinpointed age and LVEF as independent predictors of mortality, and the second age and left ventricular heart failure. Finally, our subcohort of patients aged less than the mean 63 years and with normal LVEF values of greater than or equal to 50%, or no left ventricular failure had an observed survival for 5 years close to an age- and sex-matched group from the Norwegian population.
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PMID:First myocardial infarction: 5-year survival predicted from routine clinical, laboratory, and radionuclide findings during the acute stage. 193 10

Left ventricular failure is a common complication of the acute phase of myocardial infarction. The most appropriate current treatment, when an increase in preload is the predominant or sole feature, involves nitroglycerin by infusion combined in varying degrees with diuretics. The aim of this study was to assess the value of maintenance treatment following intravenous nitroglycerin based upon a long acting nitrate derivative designed to achieve a hemodynamic result. Twenty patients with a mean age of 62 and with left ventricular failure during the acute phase of a myocardial infarction were studied. They were all treated with IV nitroglycerin using an automatic pump syringe. Pulmonary artery diastolic pressure, cardiac output, blood pressure and heart rate were measured hourly for six hours then every 6 hours. When PADP fell to below 18 mmHg, maintenance treatment with placebo or long acting nitroglycerin was given double-blind (10 patients were given long acting nitroglycerin and 10 patients the placebo). Pulmonary artery pressures, blood pressure and heart rate were measured every 2 hours for 8 hours, then at 12 and 24 hours. No significant difference was found in heart rate, blood pressure, cardiac output nor PADP (10 +/- 3.5 mmHg cf. 12 +/- 2.8 mmHg; NS) between the two groups. In total, maintenance treatment with long acting nitrate derivatives following IV nitroglycerin for hemodynamic purposes in patients with an acute myocardial infarction complicated by regressive cardiac failure would no appear to be necessary.
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PMID:[Value of the replacement of intravenous trinitrin by oral trinitrin in the acute phase of myocardial infarction complicated by regressive left ventricular insufficiency]. 195 77


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