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

A 15 year-old boy was admitted for myocardial infarction, of spontaneous occurrence, complicated by atrio-ventricular block and cardiac failure. Three months later, a ventricular-wall aneurysm was demonstrated by angiography, and the coronary arteries found to be normal. Skin biopsy revealed very premature signs of ageing. The comments concerned the frequency and aetiology of these infarctions in adolescents, the pathogenic problems in relation with the absent coronary obstruction, and the interest of skin biopsy, the changes of which might suggest an abnormally premature ageing of the coronary artery wall, a possible starting point for thrombosis.
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PMID:[Myocardial infarct in a 15-year-old boy. Normal coronary arteriogram; value of cutaneous biopsy]. 81 77

Combination of a right bundle-branch block with a left hemiblock was found in 38 of 590 patients with acuts myocardial infarction admitted to an intensive care unit (5.5%) was accompanied with a lethality of 51.5%. This severe immediate prognosis seemed related more to the degree of heart failure that to the onset of atrio-ventricular block. In 15 patients a pacing catheter was set "preventively". The late prognosis of the survivors was assessed after an observation period of 15.7 months. The efficiency of temporary pacing and its indications are discussed.
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PMID:[Right bundle-branch block with left hemiblock in the acute phase of myocardial infarct. Prognosis and role of cardiac pacing]. 81 6

In a series of 4000 patients subjected to coronary arteriography, 12 were found to have complete obstruction of three major coronary arteries, an incidence of 0.3 p. 100. The clinical manifestations did not follow a typical pattern. Although 9 had a previous myocardial infarction or heart failure, only 6 were incapacitated by angina or dyspnea. Except for one patient, the resting EKG was abnormal. Half had a markedly elevated resting end-diastolic pressure and gross abnormalities of left ventricular contraction. In spite of surgery in 7, with only one operative death, a yearly mortality rate of 20 p. 100 has been recorded during a 3-year follow-up. This extremely low survival rate, the severe functional impairment in half of the survivors, and the subsequent high yearly mortality rate, all suggest that surgery be considered before complete obstruction occurs in patients with significant disease of three coronary arteries. A 10 p. 100 yearly mortality rate reported in patients with triple vessel obstructions, also favours surgery in such patients with the hope of prolonging life, providing good distal runoff and satisfactory left ventricular contraction are present.
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PMID:[Profil and course of complete obstruction of 3 coronary trunks]. 81 16

Acute changes in the diastolic pressure-volume relationship of the left ventricle. Europ. J. Cardiol., 4/Suppl., 105-120. The present study was designed to investigate acute changes in the passive length-tension relations of isolated heart muscle and acute alterations of the left ventricular diastolic pressure-volume relationship of patients. In isolated heart muscle a constant lengthening and shortening technique with computer curve fitting was used to characterize the entire passive length-tension relation. There was no change in passive elastivity following an increase in stimulation frequency or an increase in muscle stretching rate. During the transition from stimulated to nonstimulated contractions, there was a shift to the left in the passive length-tension relation, with a shorter muscle length at the same resting force. In 10 patients undergoing revascularization for preinfarction angina, 7 patients showed a significantly reduced left ventricular enddiastolic pressure at the same enddiastolic volume, together with an improvement in postoperative ejection fraction. In 6 patients who experienced a perioperative myocardial infarction, variable changes in the pressure volume relationship occurred. These presumably reflected the opposite effects of stiffening of infarcted muscle and cardiac dilatation secondary to heart failure. 26 patients with chronic coronary artery disease had ventriculograms before and after 0.4 mg sublingual nitroglycerin. 9 patients showed a significant shift downwards in their pressure-volume relation, with a decreased enddiastolic pressure at the same volume. 2 showed a shift upwards, while the remaining patients showed no measurable change. It is proposed that this latter shift in pressure-volume relationships is due to hemodynamic factors rather than to intrinsic changes in muscle stiffness. Theoretical calculations utilizing A SIMPLIFIED SPHERICAL MODEL of the ventricle suggest that the magnitude of the changes observed cannot be explained by stiffening of the muscle alone and is therefore probably due to hemodynamic factors.
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PMID:Acute changes in the diastolic pressure-volume relationship of the left ventricle. 81 75

Among 400 patients with myocardial infarction who had been admitted to the intensive care department, pericarditis was observed in 64 cases (16%). It occurred more frequently with anterior wall infarctions. The influence of the pericarditis on the mortality and complications threatening in the acute period were particularly investigated: There was no significant difference with regard to the mortality (20.6% in the group with pericarditis, 26.2% in the control group) or the occurrence of cardiac insufficiency or arrhythmias as complications. Atrial flutter, however, is more frequent (25% against 15%). Anticoagulant therapy was discontinued when pericarditis appeared, with one exception. In spite of the high frequency of atrial flutter, embolic complications were not more frequent after discontinuing the anticoagulant therapy. A postmyocardial infarction syndrome was observed seven times (1.7%), it was frequently found in a pericarditis with angina pectoris (4/7) and with ventricular aneurysm (3/7). Hemopericardium occurred in one patient in whom anticoagulant therapy had not been discontinued.
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PMID:[Pericarditis and fresh myocardial infarction (author's transl)]. 82 12

Eleven percent of 905 consecutive patients with acute myocardial infarction admitted to the coronary care unit at Duke University Medical Center experienced cardiac arrest. Subgroups of patients at high and low risk for cardiac arrest were identified. Cardiac arrest was experienced by 17 percent of patients with signs of heart failure on admission but by only 3 percent of patients without diabetes mellitus, prior myocardial infarction or heart failure by history or on admission. Only 59 percent of patients with cardiac arrest survived hospitalization compared with 88 percent of those without cardiac arrest. Long-term survival for the 765 hospital survivors was significantly greater in the group without than in the group with arrest at each yearly interval from 1 through 5 years; the 2 year survival rate was 50 and 77 percent, respectively, in these two groups. Many of the deaths among the hospital survivors occurred in patients with signs of heart failure during hospitalization. Among 668 hospital survivors who had mild or no heart failure during hospitalization, cardiac arrest continued to be a significant predictor of mortality. The mode of death among hospital survivors did not differ in the groups with and without cardiac arrest; for example, the incidence rate of sudden death in the two groups was 44 and 37 per cent, respectively. In light of recent reports suggesting that the prophylactic use of antiarrhythmic agents can virtually eliminate virtually fibrillation during the hospital phase of acute myocardial infarction, we contend that such use may substantially reduce both long-term and hospital mortality after acute myocardial infarction.
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PMID:Cardiac arrest complicating acute myocardial infarction: predictability and prognosis. 83 30

Since 1959, 51 patients underwent open heart surgery for correction of an acute dissecting aneurysm of the ascending aorta. Upon admission, 33 patients were severely hypotensive or in progressive heart failure. Acute aortic insufficiency was found in 24 patients, and hemiplegia or hemiparesis in four. In 45 patients the ascending aorta was reconstructed with a woven Dacron graft. After excision of the dissected part of the aorta, primary anastomosis or patch aortoplasty was performed in six patients. The aortic valve remained intact in 26 patients, and resuspension of the commissures restored competence of the aortic valve in another nine. Sixteen patients required aortic valve replacement because of disrupture of the commissures. Dissection extended into the coronary ostia in nine cases. Reconstruction of the coronary system was accomplished by reimplantation of the ostia, interposition of a vein graft or aortocoronary bypass. Nine patients died within the early postoperative course from uncontrollable hemorrhage (four), further dissection (three) and myocardial infarction (two). Within the first year after surgery, another five patients died from acute aortic dissection (two), pseudomonas infection causing rupture of the proximal graft anastomosis (one) and myocardial infarction (two). Contraindications of antihypertensive treatment of acute dissection of the ascending aorta are discussed. We recommend prompt surgical intervention in acute dissecting aneurysms of the ascending aorta.
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PMID:Surgical treatment of acute dissecting aneurysm of the ascending aorta. 83 90

In vitro experiments employing the polarographic technique of in-rush currents have demonstrated that adrenalin and noradrenaline in concentrations approaching those found in blood of myocardial infarction patients during the early days of the disease inhibit the tissue respiration of the cardiac muscle by 10--50%. A 10-minute intensive pain stimulation was found to inhibit the aerobic processes in the myocardium by 20--24%. Hypercatecholaminemia observed in the acute period of myocardial infarction is suggested to play an important role in the pathogenesis of cardiac insufficiency during myocardial infarction, since it causes histotoxic hypoxia of the intact portions of the cardiac muscle. The importance of eliminating the pain syndrome in patients with myocardial infarction and angina pectoris is emphasized.
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PMID:[Effect of exogenous catecholamines and pain action on the tissue respiration of the myocardium]. 85 43

A haemodynamic study was conducted in 96 patients with acute myocardial infarction. The method of right heart catheterization at the bedside using the Swan-Ganz floating balloon-tipped catheter is safe and feisible. An elevation of pressure in the pulmonary circulation was revealed in patients with transmural myocardial infarction and in those without clinical signs of heart failure. The pressure elevation is detected the more often the sooner after the onset of infarction the examination is conducted. To evaluate fast pressure changes heart catheterization is essential and cannot be substituted by any other technique of examination Digoxin administration during the acute phase of myocardial infarction fails to produce any significant reduction of the pulmonary circulation pressure, but a prompt reduction of the pulmonary circulation pressure can be achieved by way of Phentolamine infusion. The pulmonary circulation pressure measurements during the acute phase of myocardial infarction are believed to be an indispensable component of examinations for the heart failure therapy.
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PMID:[Hemodynamic observations in acute myocardial infarct]. 85 47

From 22 patients in the late period of recovery from myocardial infarction, cardio-pulmonary data were recorded at rest and during exercise. The physical work was increased stepwise until patients reached their individual limit of exercise. According to the different work capacity four groups of patients were formed with the aim to demonstrate the adaption processes of cardio-pulmonary parameters until reaching the peak of work capacity. In one half of the patients we still found signs of cardial insufficiency at rest. After only slight physical work signs of cardiac insufficiency appeared also in the other half of patients.
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PMID:[Cardio-pulmonary parameters after myocardial infarction in the late period of recovery. Investigation at rest and during exercise (author's transl)]. 85 84


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