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

A study of 209 consecutive cases of hypertension, seen at the cardiac unit of the University College Hospital, Ibadan, Nigeria, showed that heart failure occurred more commonly in patients who were in the low socio-economic class. All those who had a haematocrit below 30% had heart failure. The lower the serum albumin, the greater the likelihood of developing heart failure. Hypertensives who were heavy alcohol drinkers were very prone to heart failure while a significant proportion of those who had cardiomegaly or cardiomegaly with aortic unfolding on chest x-ray had heart failure. Age, sex, Hb genotype, obesity and retinal changes had no influence on the development of heart failure. It is concluded that there are other factors, besides hypertension, which precipitate heart failure in Nigerian hypertensives. This may be responsible for the high incidence of heart failure among Nigerian with hypertension.
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PMID:Heart failure in Nigerian hypertensives. 631 94

This review examines the incidence, natural history, diagnosis, prophylaxis, and management of deep vein thrombosis (DVT) and pulmonary embolism (PE) in neurosurgical patients. Recent studies estimate the incidence of postoperative DVT detected by fibrinogen scanning in neurosurgical patients to be 29% to 43%. Specific factors that enhance the risk of venous thromboembolism include previous DVT, surgery, immobilization, advanced age, obesity, limb weakness, heart failure, and lower extremity trauma. Clinical diagnosis of venous thromboembolism is unreliable but can be augmented by noninvasive screening tests such as iodine-125-fibrinogen scanning, Doppler ultrasonography, and impedance plethysmography. As prophylactic measures, mini-dose heparin and external pneumatic compression of the legs have decreased the incidence of DVT in clinical studies of neurosurgical patients. However, no prophylactic measure has been convincingly shown to prevent PE in neurosurgical patients. Thrombi involving the popliteal, deep femoral, and iliac veins appear most likely to cause significant PE. Anticoagulation therapy constitutes standard management of DVT and PE; however, in neurosurgical patients the potential for precipitating intracranial or intraspinal hemorrhage may necessitate vena caval interruption. This appears to be an effective alternative to anticoagulation.
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PMID:Deep vein thrombosis and pulmonary emboli in neurosurgical patients: a review. 638 85

We evaluated 935 patients for risk factors of cholecystectomy. Factors assessed included reason for cholecystectomy, preoperative laboratory values, sex, age, weight, presence of associated disease, and pathologic findings. Evaluation revealed an overall significant complication rate of 10.50% and a mortality of 1.07%. Risk factors were age over 60 years, hypertension, atherosclerotic cardiovascular disease with prior heart failure, and acute cholecystitis. Incidental cholecystectomy was associated with an increased risk due to concomitant associated disease. Patients with obesity and uncomplicated diabetes had the same risk as the general population.
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PMID:Risk factors for cholecystectomy: analysis of 935 patients. 661 88

Hypertension and obesity are two disorders that have been closely related, each occurring in greater frequency with the other than in an otherwise normal population. Although a causal relationship has not been established between the two, their coincidence carries increased risk of cardiovascular morbidity and mortality. This report summarizes the pathophysiological studies from our laboratory concerning their interrelationship and offers a rational hypothesis for the mechanisms underlying this enhanced risk. Patients with hypertension demonstrate an increased total peripheral resistance that explains hemodynamically the rising arterial pressure with advancing vascular disease. In response to this increased afterload imposed upon the heart, the left ventricle adapts itself structurally through a process of concentric hypertrophy. In addition, in most patients with essential hypertension, plasma volume progressively contracts and renal vascular resistance increases in proportion to the rise in arterial pressure and total peripheral resistance. In contrast, in obesity-hypertension there is a superimposed factor of volume overload upon the hemodynamic abnormality. The result is an additional cardiac stimulus for eccentric hypertrophy due to the increased ventricular preload. This factor enhances left ventricular stroke work and its attendant myocardial oxygen demands, thereby providing a dual overload on cardiac function that can explain the increased risk of heart failure related to these associated conditions. In contrast to the compounding adverse hemodynamic effects on the heart, there does not seem to be an additive hemodynamic effect of obesity on hypertensive renal vascular disease.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The problem of obesity and hypertension. 662 65

Fourteen children with the Prader-Willi syndrome have been managed at the Royal Alexandra Hospital for Children between the years 1964-1980--twelve male, two female. Six male children developed features of the obesity hypoventilation syndrome. The age of onset of this complication ranged from 4.0 to 12.6 years. With one exception those children with the obesity hypoventilation syndrome were more obese than those without it. At the time of onset of the syndrome, five of six patients had weights greater than or equal to 6.5 standard deviations above ideal body weight. Those children without the obesity hypoventilation syndrome had a range of standard deviations 1.0 to 4.2 above the ideal body weight. In four of six cases weight reduction and a cardiac failure regimen resulted in reversal of the obesity hypoventilation syndrome. With two of the six children there had been cardiomegaly and increased pulmonary venous vascularity on x-ray at a chronological age of three months. Two of the six children died.
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PMID:The obesity hypoventilation syndrome and the Prader-Willi syndrome. 667 26

A prospective study of 208 consecutive survivors of acute myocardial infarction was undertaken to determine the differences between Q- and non-Q-wave infarction, concerning data from the history, clinical course, and 6-month follow-up. There were 177 patients with Q-wave infarction and 31 patients with non-Q-wave infarction. There were no significant differences for the following variables: age, sex, diabetes mellitus, smoking, positive family history, hypertension, obesity, previous infarction, history of unstable angina, heart failure or chronic obstructive pulmonary disease (COPD), Killip class in the Coronary Care Unit (CCU), arrhythmias and conduction defects in the CCU as well as drugs used. Patients with non-Q wave infarction had a higher incidence of stable angina before the myocardial infarction and a lower value of creatine kinase (CK) and serum glutamic oxalacetic transferase (SGOT). During the 6-month follow-up, 9 cardiac deaths and 17 reinfarctions occurred, while 74 patients presented angina. There were no differences between the two groups concerning the incidence of cardiac death or angina, but patients with non-Q-wave infarction had a higher incidence of reinfarction at 6 months (p less than 0.001). We conclude that although patients with non-Q-wave myocardial infarction have a lesser degree of myocardial damage, they have a high incidence of early reinfarction which puts them in a high-risk group.
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PMID:Q- versus non-Q-wave myocardial infarction: clinical characteristics and 6-month prognosis. 671 48

During a 1-year period all Black patients admitted to two medical wards in the Johannesburg General Hospital were screened for malignant hypertension. Of the 62 patients eligible for inclusion in the study, 51 were thought to have essential malignant hypertension (hospital prevalence 2,2%). There was a striking absence of the cardiovascular and hypertensive risk factors usually described -- excessive smoking, alcohol consumption and obesity. The presenting features and complications were similar to those described in other series. Cardiac failure was present in 45% of the patients, neurological complications in 33%, and advanced renal failure in 47%. Twenty patients required dialysis. No evidence of ischaemic heart disease or atheromatous vascular disease was found. Red cell fragmentation was present in 25% of the patients. The hospital mortality rate was 25%. Only 24% of the patients had previously been diagnosed as having hypertension, although 43% had been examined by a doctor during the preceding 2 years. Of the patients discharged to the hypertension clinic, only 28% returned for short-term follow-up. Malignant hypertension is therefore a major medical and social problem in the Johannesburg Black community.
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PMID:The malignant phase of essential hypertension in Johannesburg Blacks. A prospective study. 708 52

During the last 4 years 2040 patients with myocardial infarction were admitted to the C.C.U. of the National Institute of Cardiology. Thirty five patient under 40 years of age were studied. Three had Rheumatic heart disease and in 32 the etiology of the myocardial infarction was probably coronary atherosclerosis. The 32 cases under 40 years of age were compared to a group of patients with myocardial infarction older than 40 years of age. A great predominance of myocardial infarction was found in young males which were heavy smokers. There were no significant differences with the presence of obesity and arterial hypertension. In the younger group, myocardial infarction were more frequent in those with intellectual activity and in taxi drivers. The early hospital course was better in the young group they did not have cardiac failure, cardiogenic shock and none died. However, in the long term follow up the younger group had more P.V.C. and ventricular tachycardia. The cardiography of the younger showed an important predominance of lesions in the left coronary artery. It is concluded that in young people, myocardial infarctions seems to occur primarily in smokers with stress in their Kind of living. These patients seem to have less complications in the early and long term courses. However, more cardiac rhythm disorders are present.
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PMID:[Myocardial infarction in patients below the age of 40 (author's transl)]. 711 66

In order to assess the sensitivity and specificity of the range-gated pulsed Doppler echocardiogram for the detection of aortic regurgitation, a study with use of this technique was carried out in 46 patients. They were classified into 3 groups: Group I was composed of 19 patients with a variety of heart diseases but with a competent aortic valve. Cardiac catheterization revealed no aortic regurgitation in any of the 19 patients, and the Doppler echocardiogram detected no turbulent diastolic flow in the left ventricular outflow tract. Group II was composed of 17 patients who clinically and by auscultation had aortic regurgitation, which was confirmed by cardiac catheterization in 6. In all 17 patients the Doppler echocardiogram detected several grades of turbulent diastolic flow compatible with aortic regurgitation in the left ventricular outflow tract. Group III was composed of 10 patients with aortic regurgitation but without the expected clinical or auscultatory evidence. The echocardiogram detected mitral valve flutter in only 1 patient. Cardiac catheterization revealed aortic regurgitation graded 1/4 and 2/4 in 9 patients, and the patient who did not undergo catheterization had a murmur of aortic insufficiency 6 months later. In all 10 patients the Doppler echocardiogram detected a regurgitating turbulent flow compatible with aortic regurgitation in the left ventricular outflow tract. It is concluded that the Doppler echocardiogram was more useful than auscultation and echocardiography for the detection of mild aortic regurgitation. In this study the range-gated pulsed Doppler echocardiogram proved 100% sensitive and specific. However, it will be necessary to study larger groups in order to assess its utility in more complicated conditions (obesity, emphysema, and heart failure) and the differential diagnosis with other diastolic murmurs.
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PMID:Detection of mild aortic regurgitation by range-gated pulsed Doppler echocardiograhy. 713 29

In a randomised, double-blind study 5,000 IU heparin-dihydroergotamine mesylate (Dihydergot) or placebo were administered over 14 days to 107 patients with recent ischaemic cerebrovascular accident. The patients were studied daily for recent venous thrombosis in the legs by means of the 125I-fibrinogen test. Thirteen patients died before venous thrombosis had been demonstrated, 13 others were excluded by other causes. Of the 41 patients in the placebo group 23 developed venous thrombosis, but only 11 of the 40 drug-treated patients. Bilateral venous thrombosis occurred in six patients on the placebo and one patient on the drug. Univariate analysis indicated that heart failure, reduction of muscle tone, muscular power and level of consciousness favoured thrombosis. Multivariate analysis further indicated that both bed-rest of several days before start of the prophylactic treatment and extreme obesity favoured thrombosis. The relative thrombosis risk increased by a factor of 15.2 when prophylactic measures were omitted. Death rate in the treated group ws 17.4%, in the placebo group 28.0%. These results indicate that a prophylactic regimen of the type described is a practicable and effective measure after recent ischaemic cerebrovascular accident.
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PMID:[Prevention of venous thrombosis in recent ischaemic cerebrovascular accident: double-blind study with heparin-dihydroergotamine (author's transl)]. 734 84


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