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

Echocardiographic assessment of left ventricle functions was performed in 52 cases with idiopathic prolapse of mitral valve, confirmed on the base of the simultaneous presence of the well known auscultatory, phonocardiographic and echocardiographic criteria. Mitral prolapse was established not to be a homogenous group as regards left ventricle function. The majority of the cases (80.7%) had normal EchoC-indices for the pump and total and local contraction function of left ventricle. The cases without (25%) or with light stage (55.7%) mitral regurgitation are included here. In the presence of hemodynamic significant mitral insufficiency -- 13.5% of the cases. EchoC-manifestations for volume left-ventricle loading were found -- enlarged telediastolic dimension and volume of the left ventricle cavity, light hypertrophy and hypercontractility of the interventricular septum and/or the unattached posterior wall of left ventricle, enlarged left ventricle, increased velocity of EF-segment of the anterior mitral cusp. As a rule, a moderate mitral regurgitation is concerned in those cases. In a small number of cases with mitral prolapse (5.8%) EchoC-manifestations for a light to moderate pump and general and/or local contraction function of left ventricle was established without clinical data for a stasis in left ventricle cardiac insufficiency. Grounds exist to admit that in the last cases, a rather not severe local or more diffuse lesion of the left ventricle myocardium is concerned, its relationship with the mitral valve prolapse remaining obscure.
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PMID:[Echocardiographic evaluation of left ventricular function in mitral valve prolapse]. 49 32

The conditions associated with prolapse of the posterior leaflet of the mitral valve are multiple. The mechanisms of mitral valve prolapse as well as the pathogenesis of pain and ectopic impulse formation are reviewed. Propranolol appears to be the drug of choice for the symptomatic treatment of patients with this syndrome since it decreases myocardial oxygen demand and wall tension thus reducing or abolishing the discrepancy between myocardial oxygen demand and supply within the mitral apparatus. It has also been reported to modify the auscultatory findings associated with this condition. The frequency of this mitral valve abnormality in patients with obstructive coronary artery disease is reviewed. It appears that prolapse of the posterior leaflet scallops in patients with significant obstructive coronary artery disease represents an intermediate stage before mitral insufficiency occurs. This group of patients with papillary muscle dysfunction includes those with prolapsed leaflets without mitral insufficiency, those with systolic murmurs and compensated heart failure and others with progressive cardiac decompensation and severe mitral regurgitation.
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PMID:Mitral valve prolapse. Recent concepts and observations. 93 60

We report the cases of eight children with Marfan syndrome. Seven (87.5%) were diagnosed with cardiopathy, everyone with auscultatory findings. Electrocardiographic patterns were nonspecific. Enlargement of the aortic root was present in two of the cases as seen by thorax x-rays. Echocardiography detected the presence of mitral valve prolapse in 87.5% of the patients (7 cases) and aortic enlargement in 75% of the patients (6 cases). Echocardiography also detected the presence of aortic dysplasia, tricuspid valve prolapse and right and left ventricular hypertrophy. During the follow-up period, no case had cardiac failure. There was no mortality. The aortic enlargement was progressive and was not modified by propranolol treatment. Surgical treatment was not needed. Family history related to this condition was present in a very small percentage (37.5%). We comment on one infantile form of Marfan syndrome with its own phenotype different from that of classical Marfan syndrome.
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PMID:[Marfan syndrome in childhood: cardiovascular manifestations. Echocardiographic changes]. 141 16

A 57-year-old man was admitted with dyspnea and bloody sputum. The chest X-ray showed unilateral alveolar infiltration, and alveolar cell carcinoma was suspected. Physical examination showed orthopnea and a loud systolic murmur, and the echocardiogram showed mitral valve prolapse. A chest X-ray 4 days later revealed bilateral infiltration. The cardiac catheterization showed pulmonary congestion and the capillary wedge pressure revealed a prominent V wave. Papanicolaou's test of sputum was negative. These findings suggested heart failure due to mitral regurgitation rather than lung carcinoma. The patient underwent mitral valve replacement because of his refractoriness to the medical treatment. During the operation, the chordae tendineae of the anterior mitral leaflet was found to be completely ruptured. The mechanisms of unilateral pulmonary edema could not be ascertained, but the effect of posture and gravity was thought to be a possible mechanism.
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PMID:[A case of unilateral pulmonary edema associated rupture of mitral chordae tendineae]. 155 65

Bicycle ergometry and echocardiographic studies were carried out in 29 patients aged 17-29 years with first revealed mitral valve prolapse (MVP) without any signs of mitral regurgitation. According to bicycle ergometry, the patients manifested changes in hemodynamics pointing to dysfunction of the cardiovascular system. Echocardiography discovered a reduction of the mass and a rise of the rate of contraction of the circular fibers of the left ventricle, evidence of the myocardial genesis of the hemodynamic changes. Comparison of the findings of bicycle ergometry and echocardiography allowed a conclusion about the necessity of the follow-up of patients with MVP in spite of the high level of threshold load and the lack of the clinical signs of heart failure.
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PMID:[The hemodynamic support of physical loading in patients with mitral valve prolapse]. 175 4

The thirty nine patients (30 men and 9 women, mean age 49 +/- 14 years) who were implanted with an automatic cardioverter defibrillator (AICD) between October 1982 and April 1990 were reviewed retrospectively. This group included 22 patients with ischaemic cardiomyopathy (55%), 9 primary cardiomyopathies (23%) 5 ventricular tachycardias in patients with normal hearts (13%), 1 case of arrhythmogenic right ventricular dysplasia and two of mitral valve prolapse. The mean ejection fraction for the whole group was 38 +/- 14%. The indication for implantation of the AICD was life-threatening ventricular arrhythmias for which other forms of treatment were either ineffective (29 patients), impossible to assess (9 patients) or poorly tolerated (1 patient). Two patients died during the perioperative period and the follow-up is too short in two other cases. Therefore, 35 patients were studied over an average of 23.7 +/- 16 months. During follow-up, 5 patients died, 3 of progressive cardiac failure and 2 suddenly, one of whom was waiting for a replacement of an exhausted generator. The AICD never functioned in 40% of patients. In addition, it was impossible to determine for the majority of shocks delivered if they had been triggered by a sustained ventricular arrhythmia. Long term tolerance was generally good but two patients developed cardiac constriction induced by the epicardial patch electrodes. The results of this review confirm the efficacy of AICD in preventing sudden death at the expense of a low operative mortality and with good long term tolerance. Quite a large proportion of AICDs never functioned and the interpretation of the delivered shocks remains questionable.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Implantable automatic defibrillator. Evaluation after 8 years of use]. 176 17

Clinical characteristics of 60 (41 males, 19 females) patients with echocardiographically proven mitral valve prolapse were analysed, with special interest in the associated thoracic skeletal abnormalities. There was a male preponderance (2.2:1) and 91.7% of patients were symptomatic--atypical chest pain, palpitations, exertional dyspnoea and easy fatiguability being the major symptoms. Sixty seven percent had an asthenic body habitus, and 55% had high-arched palate. Thoracic scoliosis (55%), straight back syndrome (50%), flat chest (46.7%), and pectus excavatum (20%) were seen in association with the condition, with 81.7% having any one or combination of these features. Lateral chest radiography showed pancaking of heart shadow in 48.3%. Isolated non-ejection systolic click(s) was the major cardiac auscultatory finding (61.7%), while 60% showed pansystolic prolapse on echocardiography. Electrocardiographic ST-T-U changes in the inferior and/or lateral chest leads were seen in 46.7%, while 16.7% had cardiac arrhythmias. None had infective endocarditis, heart failure or cerebral embolic events. The findings corroborate the view that thoracic skeletal anomalies may be regarded as non-auscultatory features of this syndrome.
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PMID:Mitral valve prolapse syndrome and associated thoracic skeletal abnormalities. 130 Oct 49

Two 31 year old patients were interned with cardiac insufficiency (functional class III). Case number one infective endocarditis with mitral valve 8 months before. Case number two had previous rheumatic disease. Both had severe mitral insufficiency and were submitted to replacement of mitral valve. Surgical findings included the presence of aneurysm mitral leaflet (posterior in case one and both in case two). The pathologic study showed mitral valve prolapse and signs of previous endocarditis in case one and rheumatic lesion in the other case.
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PMID:[Mitral valve aneurysm associated with mitral insufficiency in absence of aortic insufficiency]. 188 91

Infective endocarditis is best characterized as a disease in evolution. The list of patients at risk, which formerly included almost exclusively patients with rheumatic heart disease, is being continuously modified and expanded. Nowadays, patients with prosthetic heart valves, users of illicit intravenous drugs, and patients with mitral valve prolapse rather than patients with rheumatic heart disease account for the majority of cases of infective endocarditis. Moreover, due to the widespread use of indwelling atrial catheters for parenteral nutrition as well as for intensive cytotoxic therapy, catheter-related right-sided endocarditis is emerging among nosocomial infections. With the advent of successful antimicrobial therapy, complications rather than endocardial infection pose the major therapeutic problems. In addition to progressive heart failure, myocardial abscesses, fungal endocarditis, relapsing infection, and major systemic emboli in the presence of large protuberant vegetations constitute indications for replacement of the valve. Despite progresses in diagnosis and therapy, infective endocarditis will most likely continue to challenge physicians even in the next future.
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PMID:[Infective endocarditis: a changing disease]. 209 78

Sixty cases of infective endocarditis were studied prospectively between May, 1985 and December, 1988. There were 40 males and 20 females with a mean age of 28 years. Endocarditis was found on normal valves in 13 patients, on rheumatic valves in 30, on congenital lesions in 8, on prosthetic valves in 4 and on mitral valve prolapse in 5 cases. Positive blood cultures were detected in 35 patients (58%). In addition bone marrow culture was positive in 1 and valves removed on surgery grew causative organisms in eight. Thus the total culture positive cases were 44 (73%). The commonest infective organism was Streptococcus viridans. Uncommon organisms accounted for 10 cases (17%). Two dimensional echocardiography (2D-Echo) was done in all cases and vegetations were detected in 48 patients (80%). 2 D-Echo was helpful not only in the detection of vegetations but also in the demonstration of other complications of endocarditis like ring abscesses, ruptured chordae, ulceration of aortic root, interventricular septum abscess, and mitral xenograft obstruction. Early surgery was performed in 31 patients. In this group of patients severe heart failure was present in 21, embolization in 10, persistence of fever in 15 and large vegetations in 19. Of the 29 patients treated medically, 2 died. The mortality in the surgical group was seen in 5 (16%) with a mean follow-up of 15 months. The major reason for a large number of our patients undergoing surgery is the fact that this is a referral Center and patients were sent later or when there was a failure of medical treatment.
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PMID:Infective endocarditis: a prospective study of 60 consecutive cases. 213 22


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