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

The authors have made a retrospective study of the case notes of 200 patients with valvular disorders seen over the course of 35 months (excluding those due to constrictive endocardial fibrosis). The cases represent the frequency of cardiac failure, especially in the mitral group. The authors found 61% to have mitral valve disease, 28.5% aortic valve disease, and 9.5% disease of more than one valve. Mitral valve lesions were found most frequently in young females (average age 26 years); aortic valve lesions were found more commonly in an older age group of men (average age 47 years). The authors discuss the aetiology. Rheumatic fever was responsible in 60% of cases, and caused particularly mitral valve disease. Atherosclerosis and syphilis were the commonest causes in the aortic group. Indications for surgery were found in 74 cases (37%), and 28% of these were closed heart techniques. The course of the disease is best appreciated during the first hospital admission. The mortality rate was 5.5%, and most of the patients (65%) were stabilised on treatment.
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PMID:[200 valvular disorders seen in Abidjan]. 18 50

Left atrial myxomas are extremely difficult to diagnose since their variable manifestations mimic a host of clinical entities more commonly seen, e.g. mitral stenosis, endocarditis, rheumatic fever, cardiomyopathy or mesenchymosis. At the same time, early diagnosis followed by prompt surgical removal are mandatory to prevent mutilating or lethal complications of the tumor. Six cases of left atrial myxoma were diagnosed in our hospital during 2 1/2 years. We present the case histories, diagnostic procedures and surgical findings, consolidating the unique role of echocardiography in detecting left atrial myxomas. We propose the use of echocardiography as a screening examination for atrial myxomas in the following settings: suspected mitral obstructive disease, suspected endocarditis with negative blood cultures, peripheral embolism or thrombosis in young patients, unexplained cardiac failure and mesenchymosis with uncharacteristic presentation.
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PMID:The diagnostic challenge of left atrial myxoma. Importance of echocardiographic screening. 48 52

The case is presented of a 27-year old male with typical Reiter's sundrome (RS) and cardiac lesions. Eight months after the initial onset of the joint and mucosal symptoms, atrial fibrillation and signs of cardiac failure suddenly supervened. Rheumatic fever, hyperthyroidism and myocardial infarction were ruled out. Digitalization and Valsalva maneuvers produced a return to normal sinus rhythm. At the same time a diastolic murmur was heard and the diastolic pressure fell to 40 mm Hg, suggesting acute aortic insufficiency. This carditis was attributed to RS. The evolution was favourable, although a mild degree of aortic insufficiency persisted.
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PMID:[Auricular fibrillation and acute aortic insufficienncy in Reiter's syndrome]. 71 26

The results of 163 mitral valve replacement from 160 patients since August 1972 til August 1977 are presented, this is the second communication in Mexico related to mechanical mitral prosthesis. 95 patients were females and 55 males. With ages from 8 to 57 years, average 34; the 13% were child or teenagers. In 67% there were a clear background of rheumatic fever; 50% cardiac insufficiency and 19% previous mitral surgery from 8 months to 12 years before. 94% were class III or IV (N.Y.H.A.) and only 6% in I or II. Surgery was indicated according symptoms and hemodynamic data, 98% were catheterized. 26 Starr-Edwards and 137 Bjork-Shiley prosthesis were implanted in mitral position; in 112 cases only the mitral valve was substituted, in 41 cases a tricuspid procedure was done and in another 10 cases the aortic valve was also changed. The postoperative complications were: arrhythmies 32%; low cardiac output in 21%; infections 9%. Operative mortality in the isolated mitral replacement was 12%; in those cases with mitral-aortic or mitro-tricuspic lesions have been 33% in the first three years and 25% in the last three years. The long-term follow-up in 130 survivors is 29 months; 81% of them are actually in class I, 16% in class II and 3% in class III. The literature is reviewed and the facts responsive for the improved results are analyzed; special importance is given to the temporal external cardiac pacing in the management of the postoperative arrhythmies. Mitral valve replacement is considered as a good palliative procedure to the functional and socio-economical long-term rehabilitation in the survivors.
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PMID:[Mitral valve replacement, results in 160 patients]. 72 48

The early diagnosis of heart disease during or better before pregnancy is one of the most important problems, as cardiac diseases are the most common cause for maternal deaths throughout the world. The knowledge of hemodynamic alterations in circulatory and respiratory physiology during pregnancy complicated by heart disease is a prerequisite for their management. The following indications for therapeutic abortion of pregnancy complicated by heart disease can be concluded according to our own observations: 1. history of significant heart failure (more than grade IV according to the classification of the New York Heart Association), frequent attacks of angina pectoris and longstanding cyanosis: 2. in spite of the most careful heart treatment with digitalis, diuretics and salftree diet cardiac-thorax-rate of more than 55% in congenital heart disease, cardiac-thorax-rate of more than 60% in acquired heart disease, significant signs of heart failure, namely more severe than grade III, tachycardic atrial fibrillation, pulse deficit of more than 30/min, active inflammatory processes of the heart (rheumatic fever, subacute bacterial endocarditis, Takayasu's disease); 3. especially severe metabolic disorders, i.e. diabetes mellitus, malignant hypertension, kidney diseases; 4. primiparae of an age of more than 35 years with any heart disease. Commissurotomy can be accomplished during pregnancy if it is too late for therapeutic abortion. Pregnancy in case of artificial valves is not recommended in general because of impending hemorrhagic diathesis.
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PMID:[Indication for pregnancy interruption in patients with heart diseases]. 85 89

The effect of streptolysin O (a streptococcal exotoxin) on the myocardial contractility of isolated and intact mammalian and amphibian heart has been investigated. Streptolysin O caused marked reduction or complete cessation of myocardial contractility of mammalian and amphibian heart both in vivo and in vitro. The effect of submaximal doses of streptolysin O on isolated atria was reversible after repeated washings and the myocardial depressant effect of streptolysin O on isolated atria was reversible after repeated washings and the myocardial depressant effect of streptolysin O was not antagonised by atropine. These observations would suggest that streptolysin O is cardiotoxic and may be involved in the causation of myocardial failure associated with acute rheumatic fever in man.
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PMID:Studies on the toxic effects of streptolysin 'O': effect on the contractility of isolated and intact mammalian and amphibian heart. 97 85

The sick sinus syndrome is caused by dysfunction of the sinus node and includes various forms of arrhythmia. In its chronic form the underlying disease may affect not only the sinus node but also the atrial, junctional and intraventricular conduction tissue. The most important clinical symptoms are, in decreasing order, dizziness, syncope, palpitations, cardiac failure, systemic embolism, and cerebrovascular insult. The main diseases causing dysfunction of the sinus node are coronary heart disease, myocarditis, and rheumatic fever. The diagnosis is based on history, clinical findings, ECG, specific provocative tests and, if necessary, long-term ECG monitoring. The sick sinus syndrome is most frequently seen in patients aged over 50 years. Treatment with drugs alone, such as atropin, catecholamines, digitalis or antiarrhythmic drugs is often difficult becuase of the frequent changes between bradycardic and tachycardic arrhythmia. In chronic and progressive cases, the best treatment is implantation of a cardiac pacemaker.
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PMID:[Sinus node syndrome]. 100 72

1. The authors present 86 children and adolescents with rheumatic heart disease of the Pediatric Cardiology Service of the Instituto Nacional de Cardiologia who received valve replacements in the period between September, 1964 and April, 1973, a series which is more numerous and of longer follow-up than any published up to the present 2. In order to obtain comparable results, patients with mitral heart disease of other origen and aortic replacement as well as those subjected to double or triple exchange, were omitted from the study. 3. The symptomatology, the presence of compensated heart failure, the progression of cardiomegaly, the radiologic and electrocardiographic changes, the presence of atrial fibrillation, the mean venocapilary, pulmonary arter, and left right ventricle telediastolic pressures, the pulmonary resistence figures and the results of cineangiocardiography were the fundamental elements used to establish the surgical indication. 4. None were operated with clinic or laboratory data suggesting rheumatic activability. The shortest period between the last bout of rheumatic fever and surgery was 10 months. 5. The clinic improvement was remarkable. Half of the cases receiving digitalis and diuretics were released without this prescription and only 10% continue to take digitalis. With the exception of five patients, the physical capacity is normal and most play sports. The postoperatory radiologic and electrocardiographic changes were remarkable, most were obtained a few months after surgery. With the exception of one case, atrial fibrillation disappeared (in 58% before six months in a group of 31 patients). 6. The later complications attributed to the valve replacement as well as the 15 deaths in the total lot were analyzed. It was pointed out that the hospital death rate was 12.6% and the later was 5.3%, extraordinarily low figures if it is taken into account that the material corresponds to nine years of work and the problems inherent to the initial period are included. It gains still greater importance if compared to the series published up to the date. The global mortality rate of 17.9% is small in relation to the only comparable publication, -30 and if only the results of the last three years are compiled (61 cases equals 70 of the series), the global death rate was 9.8%. 7. It was noted that the results are due to the system adopted for establishing the surgical indication, to the good state of the myocardial fiber...
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PMID:[Mitral valve replacement in children and in adolescents. Surgical indication and long-term results in 86 cases]. 113 59

We reviewed the clinical features of 26 children with Takayasu's arteritis. In contrast to what is often seen in adults, in this age group inflammation of different systems is a conspicuous feature. Eighty five percent of cases had arterial hypertension. The high incidence of arthritis and heart failure provoked confusion with rheumatic fever. There was a high frequency of positive purified protein derivative (73%) and lymphadenopathy (38%) with a histological picture of caseating granulomas, suggesting a link between Takayasu's arteritis and an atypical mycobacterial infection. No improvement of the arterial obstruction was observed with corticosteroid therapy. Takayasu's arteritis in children presents as an aggressive often lethal disease. The mortality rate was 35% over an observation period of 5 years.
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PMID:Takayasu's arteritis in children. 168 Nov 2

Patients with rheumatic mitral diseases and chronic cor-pulmonale associated with pulmonary hemodynamic disorders were examined for the intravital status of microcirculation in the bulbar conjunctiva. Systemic derangement of microcirculation was discovered, with all the components (resistive, metabolic, capacitance) being involved. In patients suffering from rheumatic fever, the analogous microcirculatory alterations were revealed in the conjunctiva and in the visceral pleura of pulmonary biopsy specimens. This reflects the generalized character of microcirculatory response under pathological conditions. The significance of microcirculatory disorders in the pathogenesis of arterial pulmonary hypertension, respiratory and heart failure is under discussion.
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PMID:[The characteristics of the microcirculatory disorders in rheumatic mitral defects and chronic cor pulmonale]. 209 1


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