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

Pulmonary function and cardiopulmonary complications were studied in a group of 40 patients with cystic fibrosis who reached the age of 25 years. Mean values for vital capacity (VC), functional residual capacity, residual volume (RV), the ratio of RV over total lung capacity (RV/TLC), conductance, and the ratio of the forced expiratory volume in one second over VC were abnormal. There was a variable pattern of progression from patient to patient. The men differed from the women only in that they had a significantly larger TLC and inspiratory capacity than the women. The resultant preservation of VC may have an advantage for survival in those patients in whom it is observed. Pseudomonas aeruginosa was encountered with increasing frequency with age. Massive hemoptysis did not result in early death. The occurrence of rightsided heart failure secondary to cor pulmonale, with or without respiratory failure, was a poor prognostic sign.
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PMID:Pulmonary function and morbidity in 40 adult patients with cystic fibrosis. 10 32

Thirty-one patients with cystic fibrosis of varying severity were examined by echocardiography. Right ventricular dimension (RVD) was above upper normal limit in 14 patients and right ventricular dimension index (RVD index) was higher than the upper normal limit in 11 patients. Furthermore, there was a significant relationship between increasing RVD index and 1) decreasing forced vital capacity (FVC) both actual test results and average 6 months values; and 2) decreasing peak-expiratory flow rate (PEFR) both actual test results and average 6 months values. This observation suggests a persistent heart involvement. Five patients had either heart failure and/or electrocardiographic evidence of right ventricular abnormality. These patients had increased RVD index and one patient with the highest RVD index died 8 weeks after the examination. The present study has shown the usefulness of echocardiographic measurement of right ventricular dimension and of septal motion in assessing cor pulmonale, before development of electrocardiographic abnormalities and right heart failure.
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PMID:Assessment of cor pulmonale in cystic fibrosis by echocardiography. 14 4

Left ventricular function was studied at rest and during post-extrasystolic potentiation in 18 patients with chronic obstructive lung disease. The contractility indices used were obtained from pressures recorded in the isovolumetric period (left ventricular end-diastolic pressure, Vmax., VECmax., dP/dtmax.) and from volume variations during ejection (end-diastolic volume, ejection fraction, VCF). Left ventricular diastolic compliance was also evaluated. All patients were hypoxic (PaO2 = 58 +/- 7 torr); six of them had cor pulmonale (group B); the remaining 12 patients constituted group A. Left ventricular function of groups A and B was similar; we conclude that right cardiac failure, in cor pulmonale, is not secondary to left ventricular failure. However, left ventricular dysfunction exists; the left ventricle is hypertrophied (probably resulting from chronic hypoxia). Pump function is altered (abnormal ventricular function points are found), but left ventricular kinetics is normal or exaggerated (ejection fraction and VCF are increased). Isovolumetric phase contractility indices are diminished; however, they may increase normally during post-extrasystolic potentiation. Left ventricular compliance is abnormal due to left and right ventricular hypertrophy and to paradoxical movement of the interventricular septum which impedes diastolic expansion of the left ventricle. These changes are responsible for decreased left ventricular output. There seems to exist an impairment of left ventricular function related to both intrinsic (secondary to hypoxia, hypercapnia, left ventricular hypertrophy) and extrinsic factors (right ventricula hypertrophy deviating interventricular septum, lowering of left ventricular preload).
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PMID:[Left ventricular function in chronic obstructive lung disease (author's transl)]. 15 43

The case files of 4,456 medical admissions in 1975--1976 at Ahmadu Bello University Teaching Hospital, Kaduna, Nigeria, included 354 cardiovascular patients. The most common causes were hypertension (45.5%), cardiomyopathy (20.6%) and chronic rheumatic heart disease (14.4%). The mean age of hypertensive and cardiovascular patients was lower than in Europe. The majority of hypertensive patients suffer from essential hypertension. Congestive cardiac failure is the commonest complication of hypertension and cardiomyopathy. Rheumatic valvular disease with mitral incompetence is frequent and sometimes severe in young people. Other cardiovascular diseases included pericardial disease, bacterial endocarditis, cor pulmonale, anaemic heart failure, congenital and syphilitic heart disease. Coronary heart disease was only encountered in non-Africans. Cardiovascular mortality in hospital was high (20%).
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PMID:Cardiovascular disease in Northern Nigeria. 31 94

A phonocardiological analysis of the first heart sound was made and systolic time intervals were measured in 40 patients (ischaemic heart disease, hypertensive heart disease, cardiomyopathies) with incipient cardiac failure (functional groups I--II according to the NYHA) with auscultatory changes of the first heart sound and in controls of randomly selected healthy persons or patients in whom cardiopulmonary disease was excluded. The patients in all diagnostic groups differed significantly (P less than 0.05--0.001) in practically all the phonocardiographic indicators from the controls. The most constant abnormal finding was a pathological split of the first heart sound which may be divided into three phonocardiographic forms. Simultaneously, systolic time intervals alterations (P less than 0.02--0.001) were also found in these patients and indicated a lowered performance of the left ventricle. The results suggest that 1) a certain relation exists between systolic time intervals and the phonocardiographic pattern of the first heart sound in patients with cardiovascular diseases and those without it; 2) the modified (pathologically splitted and prolonged) first heart sound could be a sign of incipient cardiac failure.
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PMID:The first heart sound abnormalities accompanied with alteration of systolic time intervals in incipient heart failure. 53 4

Starting from general assumptions on the clinical aspects of homeostasis and on the functional correlations lung-heart in physiological and pathological states, the difficulty to diagnose an individual pulmonary heart disease is stressed, as well as the necessity to differentiate it from the cases of coronary heart disease, when respiratory failure aggravates the latent cardiac ischemia and induces a global cardiac failure. The diagnosis criteria of the two distinct pathological pictures are established, emphasizing the importance of this differentiation for clinical practice and epidemiological research.
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PMID:Clinical aspects of cardio-respiratory homeostasis. 66 38

Following episodes of pulmonary embolism, the presence of thrombi in the pulmonary arteries leads to severe respiratory insufficiency and chronic right heart failure. We have operated upon 16 such patients, nine men and seven women from 23 to 68 years of age. All had severe dyspnea, 14 had chronic cor pulmonale, six had mental disturbances with syncope, and four had severe cardiac failure. The presence of clots was demonstrated by pulmonary angiography, and the permeability of the distal arterial bed was ascertained by selective injection of the bronchial arteries. In all cases but two a lateral thoracotomy was used so that the obstructed arterial branches could be approached distally. The inferior vena cava was always ligated to prevent recurrences. There were six operative deaths, three from cardiac failure, one from acute pulmonary edema, one from hemothorax, and one following a pyothorax. Ten patients are surviving after 6 months to 10 years. One is still limited because of significant pleuropulmonary sequelae. Six are enjoying good results with marked improvement in their functional limitations, a significant drop in the pulmonary artery pressure, and radiological permeability of previously obstructed arteries. Three are excellent condition--completely asymptomatic.
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PMID:Surgical correction of chronic postembolic obstructions of the pulmonary arteries. 70 66

Cardiac involvement by systemic sarcoidosis is well known, but occurs rarely. It usually manifests as either heart block, heart failure due to direct myocardial involvement, or cor pulmonale. We present the case of a patient with cardiac sarcoidosis who had ventricular tachycardia and congestive heart failure. Although there was other organ system involvement, the cardiac manifestation was the first to become clinically apparent. Therapy consisted of quinidine sulfate to control the arrhythmias and chronic diuretic therapy to control congestive heart failure. Steroid therapy was initially associated with recurrence of the ventricular tachycardia and was discontinued. It was reinstituted 18 months later when other organ system involvement developed with no recurrence of the ventricular tachyarrhythmia. The patient responded well to therapy and is currently doing well. This case is presented to illustrate a somewhat unusual, but nevertheless important, etiology of ventricular tachyarrhythmias. The recognition of underlying sarcoidosis is critical because of the propensity for other organ system involvement by this disease process.
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PMID:Ventricular tachyarrhythmia due to cardiac sarcoidosis in a child. 70 4

Chronic cor pulmonale is more prevalent in northern India than in the south. It is equally common in men and in women and accounts for 20% of all admissions for heart disorder in Delhi. In a study of 766 patients (239 men and 527 women) carried out over a 15-year period there were some striking sex differences. Some 75% of men and 10% of women smoked. The women came from the poorest class and all of them cooked from an early age over smoky and primitive fireplaces in ill-ventilated huts, while only 7% of the men cooked their own food. Chronic bronchitis and bronchiectasis were the commonest associated lung disorders in both sexes. The women developed heart failure 10-15 years earlier and showed more severe congestive failure with larger hearts and greater derangement of pulmonary function. It is concluded that the cause of chronic cor pulmonale in women in Delhi was damage to the lungs from exposure to smoky cooking fuels from girlhood onwards, followed by repeated chest infections.
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PMID:Sex differences in chronic cor pulmonale in delhi. 99 Jan 63

Whether a person is medically fit to engage in sports depends not only on his or her present state of health but also on his or her previous medical history, age, personality, and of course, the nature of the particular sport in question. Anyone that feels fit, is physically in good condition, abstains from tobacco, alcohol and other intoxicant stimulants, and passes a thorough medical examination is healthy and fully capable of taking part in any sport whatever. Participation in any form of sport, on the other hand, is absolutely contra-indicated for persons suffering from severe or malignant hypertension, inflammatory or bacterial heart disease, severe angina pectoris - especially with an attendant risk of myocardial infarction - or haemodynamically significant arrhythmias that manifest themselves during, or are aggravated by, physical exertion. Physical activity is generally deleterious in patients with advanced pulmonary disease and chronic cor pulmonale, severe decompensated heart failure or severe renal insufficiency. Severe intercurrent infections also constitute an absolute contra-indication for sport. Between these two extremes of absolute fitness and absolute unfitness there are many intermediate states, e.g. diseases like essential hypertension (WHO Stages I and II), coronary disease and peripheral arterial circulatory disorders, in which patients can derive considerable benefit from properly chosen and carefully graded sporting activity.
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PMID:[Medical fitness for sports, with particular reference to cardiovascular conditions]. 102 Apr 74


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