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

Three cases of dilated cardiomyopathy in patients with IIIV/AIDS are being reported. The three patients are of young age group and they presented with cardiac symptoms for the first time. They were all heterosexuals and not known was as intravenous drug abuser. There was no history of rheumatic fever or hypertension or diabetes mellitus and ischaemic heart disease. Examination confirmed cardiac failure and investigations including chest x-ray, echocardiograph and electrocardiograph confirmed dilated heart. All the patients tested positive to HIV-1 antibodies. They were managed with the usual anticardiac failure regimen. Two of the patients died on admission, one developed multi organ failure and the other had tonic-clonic seizure. In other parts of Africa reports have also emerged describing the cardiovascular involvement in HIV/AIDS.
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PMID:Cardiovascular involvement in HIV/AIDS: report of 3 cases. 1188 84

The clinical and laboratory findings of eight (20%) cases of cardiac involvement of 39 patients with sepsis caused by S. aureus (Staphylococcus aureus) were reviewed retrospectively. Our purpose was to emphasize the importance of the cardiac findings in patients with sepsis caused by S. aureus in childhood. The ages of the patients ranged from 6 to 14 years. All patients had pericardial effusion which was confirmed by echocardiographic (ECHO) examination in all cases except the one in whom ECHO examination could not be performed because he died 2.5 days after admission to the hospital. This patient also had myocarditis and heart failure. Aside from these, mitral insufficiency was diagnosed in the other patient; it was accepted as a sequela of rheumatic fever acquired previously. Open pericardial drainage was conducted successfully in the case who had a progression to cardiac tamponade. In the other patients pericardial effusion completely resolved with supportive and antibiotic therapy one to two weeks. Two of eight patients died from sepsis and septic shock; the mortality rate was 25%. Our findings show that cardiac involvement was fairly high (20%) in S. aureus sepsis in childhood. Therefore, it is suggested that children with S. aureus sepsis should be carefully monitored for cardiac involvement.
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PMID:Cardiac findings in childhood staphylococcal sepsis. 1204 94

We recently encountered a 49-year-old female who developed fever due to group A streptococcal (GAS) bacteriaemia spreading to an abscess in the iliac muscle and a bacterial monarthritis of the right knee with a sterile arthritis of her left knee. Treatment was started with a six-week course of intravenous penicillin. She developed a mitral valve insufficiency and pericarditis on the tenth day of admission. In the third week heart failure developed with, on echocardiograph, a high output left ventricular failure without signs of valvulitis or myocarditis. Using a diuretic regimen she was recompensated. Because of the pericarditis with mitral valve insufficiency corticosteroids were given, which had a rapid beneficial effect. A discussion follows on the position of acute rheumatic fever versus post-streptococcal reactive arthritis in this clinical picture and the literature is updated.
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PMID:Cardiac failure following group A streptococcal infection with echocardiographically proven pericarditis, still insufficient arguments for acute rheumatic fever: a case report and literature update. 1273 24

Rheumatic fever (RF), a potential sequela of Streptococcus pyogenes pharyngitis, sometimes results in myocarditis and heart failure. Antibodies have been implicated in the pathogenesis of RF and anti-cardiac myosin antibody levels are elevated in RF patients. Since myocarditis is associated with altered cardiomyocyte calcium transients it was of interest to determine the direct effects of RF patient antibodies on calcium transients in cultured myocytes. RF patient polyclonal IgM treatment caused increased calcium retention by neonatal rat heart cells in vitro as determined with isotopically labeled calcium. Therefore, to further characterize this finding, calcium transients were evaluated by real time fluorescence spectroscopy and deconvolution imaging. RF patient polyclonal IgM produced increased calcium retention during the relaxation stage of the contraction cycle leading to a slowing of contraction rate, disorganized calcium transients, and eventual tetany. In contrast, calcium transient studies of cardiomyocytes following treatment with monoclonal anti-myosin antibodies revealed declining intracellular calcium levels, accompanied by disorganized transients and tetany. Treatment with both antibodies led to myocyte dysfunction and these novel findings suggest a role for antibodies in the pathogenesis of the myocarditis associated with rheumatic carditis.
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PMID:Effects of IgM from rheumatic fever patients on intracellular calcium levels of neonatal rat cardiac myocytes. 1289 33

Mainly because of rheumatic fever,infective endocarditis (IE) is frequent in our countries and is associated with many diagnostic and therapeutic problems. We perform a retrospective study on 86 cases of IE hospitalized from December 1986 to November 1996. The prevalence of IE is 4.3% and there is a female predominance (the sex ratio is 0.56). The mean age is 26.45+/-13.22 years. 74.4% of the patients have of low socioeconomic status. The mean duration of inhospital stay is 54 days and the average diagnosis retardation is 35 days. The source of infection is found in 19 cases (15 sources are dental). The main clinical signs are: fever (63.9%), anaemia (67.4%) and weight loss (38.3%). The underlying heart disease is mainly due to rheumatic valve regurgitation (95.3%). The blood culture find microbialagent in 12.7%. Echocardiography reveals vegetations in 69.7% of patients. The main complications are : heart failure (47.6%) and stroke (33.7%). The mortality rate is high (30.7%). The treatment is only medical, none of the patients has surgical repair. This study shows that IE is frequent and is associated with many complications and a high mortality rate. These observations amphasize the importance of prevention of rheumatic fever.
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PMID:[Infective endocarditis at the University Hospital of Dakar. Clinical, outcome, and therapeutic features]. 1577 74

Authors report the results of a retrospective study (January 1993-December 1996) concerning 56 patients. The aim of this study was to describe epidemiology, diagnosis, evolution and treatment of rheumatic fever during childhood in the Teaching Hospital of Brazzaville. The frequency of the disease was 1.17%. There were 36 girls and 20 boys (p = 0.02). The mean age was 10 years and 8 months. Past of sore throat and recurrences of acute rheumatic fever have been notified respectively in 27 (48.2%) and 11 cases (19.6%). Arthritis were observed in 3 patients (5.4%), and 7 others (12.5%) didn't have any carditis. Fourty nine patients (87.5%) presented carditis, among which mitral regurgitation was the commonest cardiac lesion. Heart failure was observed in 25 patients (44.6%). The inflammatory process was treated by corticoid drugs and penicillin. Surgery realized in 22 patients consisted in valvuloplasty (5), bioprosthesis replacing (12). Beyond mitral valve replacing, 3 children profited of: tricuspid commissurotmy (1), surgery of congenital heart disease (2). Two patients profited of aortic prothesis. Six patients(10.7%) died because of: cardiac failure(3), infectious endocarditis (2), probable thrombosis of mechanic aortic valve (1). Primary and secondary prevention of this severe affection are primordial in Congo.
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PMID:[Acute rheumatic fever among children in the Republic of Congo: report of 56 cases]. 1577 95

Peripartum cardiomyopathy is rare in developped countries, but still frequent in Africa. It is defined as a heart failure occurring during peripartum, without any underlying etiology. Authors present 3 cases showing that heart failure before or after delivery may be due to causes which are frequent in the Sahelian area but generally misdiagnosed. Anemia, hypertension and rheumatic fever were the causes of heart failure in these 3 patients, but they were not apparent when the initial diagnosis was made. These observations emphasize that, despite the complex hypothesis trying to explain heart failure during the peripartum period, one should think about some frequent causes which can be misdiagnosed because of the pregnant state or the heart failure itself.
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PMID:[Peripartum heart failure: the underestimated role of frequent diseases in the Sudan-Sahelian area]. 1577 67

Authors report the results of prospective and longitudinal study. The aims of this study were to evaluate among 35 patients, prevalence, diagnosis and treatment aspects of tricuspid stenosis (TS), as well as evolution and pronostical factors. The prevalence of TS was about 4.2%. The main clinical signs were: dyspnoea (94.2%), jugular veinus pulses (42.8%), superior cave syndrom (68.8%), diastolic rumble (74.3%). ECG showed sinus rhythm (51.4%), a right atrial hypertrophy (48.5%). Echocardiography showed tricuspid leaflets thickened (82.8%), a right atrial hypertrophy (48.5%), a mean gradient between right atrial and right ventricle: 8.6 +/- 3.14 mmHg (65.7%) and mean tricuspid area about 1.41 +/- 0.83 cm2 (continuous equation); about 1.74 +/- 1.29 cm2 (Hatle formula) and 1.11 0.84 cm2 (simplified Hatle formula). Aetiology was only rheumatic fever. After a follow-up of 8.53 +/- 6.06 months, the mortality rate was 28.5%. Complications were irreducible heart failure (24 cases), liver failure (2 cases) and stroke (3 cases). Factors associated with mortality were: severity of tricuspid stenosis and pulmonary hypertension, importance of dyspnea and heart failure (p < 0.041).
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PMID:[Tricuspid valve stenosis. A prospective study of 35 cases]. 1578 15

The Cochrane Collaboration provides growing and readily accessible resources to help ensure that medical decision-making is based on detailed, methodical, and up-to-date reviews of the best available evidence. We analyzed systematic reviews in the field of pediatric cardiology published by the Cochrane Collaboration's 50 Collaborative Review Groups. We found a total of 20 systematic reviews: 13 published by the Cochrane Neonatal Group, 6 by the Cochrane Heart Group, and 1 by the Cochrane Peripheral Vascular Disease Group. Systematic reviews in pediatric cardiology appear infrequently. They only concern evidence-based decision-making in the therapeutic management of patent ductus arteriosus and arterial hypotension in preterm infants, and in the management of children with Kawasaki disease. The quality of the clinical trials contained in the systematic reviews of acute rheumatic fever or obesity in children is limited. Consequently, the reviewers' conclusions provide an inadequate basis for inferring probable effects in clinical practice. In pediatric cardiology, many therapies continue to be used without supportive evidence. We found no systematic reviews of important cardiologic topics in childhood such as heart failure, shock, hypertension, congenital cardiopathy, and arrhythmia. Clinical practice guidelines complement systematic reviews, which can recommend only strategies that are supported by strong evidence or suggest further research when scientific evidence is inadequate.
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PMID:[Usefulness of Cochrane Collaboration for pediatric cardiology]. 1618 20

Intravenous immunoglobulin (IVIG) is efficient in various immune mediated conditions. Various cardiovascular diseases are mediated by inflammatory processes and autoimmune mechanisms. Therefore, it seems conceivable to employ IVIG as an immunomodulating therapy in such indications. In this paper we review the possible anti-inflammatory effects of IVIG transfusion, and discuss the possible clinical implications in cardiology. Besides the established use of IVIG in Kawasaki disease, IVIG may be beneficial in some cases of heart failure, dilated cardiomyopathy, myocarditis, pericardial diseases, neonatal lupus, in the prevention of cardiac rejection following transplantation, and in modulating atherosclerosis. IVIG has been proven to be ineffective in rheumatic fever. Although uncommon, complications may arise including myocardial infarction, renal failure and hyperviscosity. IVIG should be administered based on accepted modes of transfusion.
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PMID:Intravenous immunoglobulin - indications and mechanisms in cardiovascular diseases. 1855 60


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