Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two cases of congestive heart failure in utero with fetal hydrops are reported. The diagnosis was made during pregnancy by means of echography. Cardiac failure, derived from supraventricular tachycardia not associated with structural anomalies of the heart, was observed in one of the patients. By digoxin administration and vagal stimulation the rhythm reverted to sinus, one hour after birth. In the second case fetal echography showed a fetus with serious bradycardia (45/min.) and ascites. On the bases of a median located and symmetric liver and of a complex heart malformation a diagnosis of "isomeric syndrome" was supposed. One hour after vaginal delivery, the newborn dead and autopsy confirmed a left isomeric syndrome with polisplenia and complex congenital cardiopathy (left ventricle and mitral hypoplasy, double outlet right ventricle, pulmonary stenosis, anomalous systemic and pulmonary venous return).
 ...
PMID:[Fetal hydrops caused by cardiac failure in utero: description of 2 cases and pathogenetic considerations]. 653 1

Ebstein's anomaly with pulmonary atresia was diagnosed in utero for the first time by fetal echocardiography. The fetus, examined at 35 weeks' gestation, had no extracardiac sonographic evidence of heart failure, but the heart filled the anterior portion of the chest. Two-dimensional echocardiography revealed a huge right atrium. The tricuspid valve, instead of originating from the anulus, was demonstrated as originating from the wall of the right ventricle, thus dividing the ventricle into two parts: the true ventricle and the "atrialized portion" of the right ventricle. These features corresponded with Ebstein's anomaly. Short episodes of supraventricular tachycardia (250 bpm) corresponded with the tachyarrhythmias frequently associated with Ebstein's anomaly. Pulmonary atresia was suspected, as movement of the pulmonary valve could not be demonstrated. The baby was delivered at 40 weeks' gestation and died 3 days later. Postnatal cardiac catheterization and angiocardiography and postmortem examination confirmed the prenatal diagnosis.
 ...
PMID:Prenatal echocardiographic diagnosis of Ebstein's anomaly with pulmonary atresia. 662 95

Chronic therapy with propranolol has been shown to reduce the incidence of sudden death in patients with hypertrophic cardiomyopathy (HCM). However, the long-term effect of beta blockade on exercise capacity has not been studied adequately. Therefore, 32 patients with HCM (21 men), mean age of 47 years (range = 14 to 80 years), were evaluated for dyspnea and chest pain and underwent stress testing (ST) prior to therapy. At entry, ST was contraindicated in four patients, because of heart failure (three patients) and sustained supraventricular tachycardia (one patient). The remaining patients completed 4.9 +/- 3.2 min (mean +/- S.D.) of the Bruce protocol with a functional aerobic capacity (FAC) of 51 +/- 28%. All were placed on propranolol, unless a beta blocker with other characteristics was indicated. Dosage was adjusted to achieve a standing heart rate of 60 beats/min unless adverse effects occurred. At last follow-up, 25 patients were receiving 501 +/- 147 mg propranolol/day while the remainder received nadolol or metoprolol. On the most recent ST, patients exercised 6.6 +/- 3.1 min (38% increase), while mean FAC increased by 24% (both P less than 0.05). The FAC improved by more than 15% in 21, by less than 15% in five, was unchanged in five and was worse in only one, a noncompliant patient. The 21 patients with an FAC increment much greater than 15% exercised longer at entry than the remaining 11 (6.6 +/- 3.3 vs 3.9 +/- 2.8 minutes, P less than 0.05). The mean peak ST blood pressure-heart rate product of the group decreased from 26 550 to 17 898 (P less than 0.05), while the symptom scores of dyspnea and chest pain declined from 2.2 +/- 0.8 to 0.8 +/- 0.7 and from 1.4 +/- 1.0 to 0.3 +/- 0.8, respectively (both P less than 0.001). We conclude that beta blockade produces sustained improvement in exercise capacity. Improvement was greatest in those with the least initial impairment, and appears to be related to a reduction in blood pressure-heart rate product.
 ...
PMID:Long-term medical management of hypertrophic cardiomyopathy: usefulness of propranolol. 668 31

A case of intrauterine paroxysmal supraventricular tachycardia (PSVT)--without heart malformations and fetal cardiac failure at the echographic assessment--is reported. After birth, the EKG of the newborn documented recurrent accesses of reentrant PSVT, likely related to the presence of a concealed Kent's bundle in the reentry circuit. Mother and grand-father of the newborn were affected by Lown-Ganong-Levine syndrome. The familial occurrence of pre-excitation syndromes--with different by-passes--and the possibility of autosomal inheritance are discussed. The importance of early identification of fetal cardiac dysrythmias and/or failure by monitoring pregnancies with familial history of PSVT is emphasized. Pharmacological approaches of fetal supraventricular tachycardia, as reported by several Authors in the literature, are presented.
 ...
PMID:[Apropos of a case of intra-uterine supraventricular tachycardia]. 671 51

The course of the disease of six cases with pheochromocytoma was analyzed in patients, aged from 19 to 65, with manifestations mainly of the cardiovascular system. The diagnosis was verified in five of them at necropsy and in one of them--intraoperatively. The arterial hypertension accompanied by distinct vegetative symptomatics were the basic clinical signs and in some of the cases--disturbances in the carbohydrate metabolism. In four patients the arterial hypertension was permanent, in two of them--with paroxysmal elevation opresf blood pressure. In the other two--with hypertonic crises on the background normal blood pressure. The duration of the hypertension--from a single hypertonic crisis during pheochromocytoma attack, had a lethal end, till the fifth year. In three of the patients rhythm disorders (supraventricular tachycardia or tachyarrhythmia) originated in a pheochromocytoma paroxysm and in three--acute left ventricular insufficiency (gallop rhythm, pulmonary edema). The clinical picture resembles heart defect, myocardial infarction with congestive cardiac insufficiency and rhythm disorders, renal insufficiency with symptomatic arterial hypertension and decompensated hypertonic heart, epilepsy, coggagenosis . The authors admit that the development of acute left ventricular failure in hypertonic patients, that could hardly be explained only by the increase of the heart afterloading (in advanced age, not enlarged and no data about grve heart lesions) or the origination of severe rhythm disorders, not coped by the modern antirhythm agents, are signs, indicating, the existence of pheochromocytoma. The catecholamine affection of myocardium, that was found in three of the deceased patients, very likely, contributes to the origination of left ventricular failure.
 ...
PMID:[Cardiological problems in pheochromocytoma patients]. 674 Nov 6

The imidazol-pyridine ARL-115 BS (sulmazol) has both positive inotropic and vasodilatory effects. Its hemodynamic effects were studied in 13 patients with shock after myocardial infarction. All patients required dobutamine or dopamine, while nine were treated with intra-aortic balloon counterpulsation. After a loading dose of 50 mg, sulmazol was administered at 50 mg/h followed by 100 mg/h during 30 or 60 minutes. At the highest dose of sulmazol, cardiac output increased from 4.3 +/- 1.1 to 4.9 +/- 1.5 1/min; systemic vascular resistance decreased from 1405 +/- 473 to 1228 +/- 439 dynes . s . cm-5, while pulmonary capillary wedge pressure decreased from 22 +/- 6 to 17 +/- 7 mm Hg. No changes occurred in heart rate or mean arterial pressure. The effect of sulmazol was greater than the effect of an increased dosage of dobutamine in five patients in whom this was studied. Episodes of supraventricular tachycardia occurred in two patients. No other side effects were observed. The hemodynamic changes caused by sulmazol favour its use in the treatment of acute cardiac failure, and cardiogenic shock.
 ...
PMID:Hemodynamic effects of sulmazol (ARL-115 BS), a new vasodilator and positive inotropic agent, in patients with cardiogenic shock. 683 91

We tested the effectiveness and safety of i.v. diltiazem in the management of paroxysmal supraventricular tachyarrhythmias in 39 patients, 21 with organic heart disease and seven in heart failure. Fifteen patients presented with supraventricular tachycardia, 12 with atrial fibrillation and 12 with atrial flutter. End points were conversion to sinus rhythm or slowing of the ventricular rate to 100 beats/min or less. Diltiazem was given as an i.v. bolus of either 150 or 300 micrograms/kg over 2 minutes. A second injection was administered to patients who received the lower dose and failed to reach either end point within 30 minutes. The overall success rate was 82% (32 of 39 patients). Time to end point was 5 minutes or less in 20 patients. Conversion to sinus rhythm occurred in 13 of 15 patients (87%) with supraventricular tachycardia and in two of 12 patients with atrial fibrillation. Treatment side effects included a slow ventricular rate in one patient who had a sick sinus syndrome and hypotension in two patients that rapidly responded to fluid administration. We conclude that i.v. diltiazem is effective and well tolerated and advocate its use in the management of paroxysmal supraventricular tachyarrhythmias.
 ...
PMID:Beneficial effect of intravenous diltiazem in the acute management of paroxysmal supraventricular tachyarrhythmias. 684 9

Thirteen fetuses with nonimmune hydrops (22 to 39 weeks of gestation) were evaluated with two-dimensional and M-mode echocardiography. Ten fetuses had cardiovascular abnormalities resulting in heart failure, and three had noncardiac causes of hydrops. In three cases, hydrops was caused by supraventricular tachycardia. One of these fetuses responded to cardioversion at birth, another responded to transplacental digoxin therapy, and the third died with atrial flutter and high-grade atrioventricular block before delivery. There were no cases of "idiopathic" hydrops. Our results show that fetal echocardiography is useful in determining cardiac causes of in utero heart failure resulting in hydrops fetalis. The fetal echocardiogram may also be used in monitoring transplacental therapy of heart failure.
 ...
PMID:Fetal echocardiography for evaluation of in utero congestive heart failure. 703 42

A wide variety of antiarrhythmic agents is used in treatment of both supraventricular and ventricular arrhythmias. Magnesium sulphate has previously been used mainly in the treatment of torsade de pointe arrhythmias but several reports show that this agent may be used in the treatment of arrhythmias of different aetiology. We describe 3 patients who exhibited arrhythmias affecting haemodynamic performance. Case #1 had a subarachnoid haemorrhage and developed a supraventricular tachycardia. In case #2, ventricular tachycardia appeared during the postoperative course after abdominal surgery. Case #3 experienced critical heart failure due to dilated cardiomyopathy and had an irregular heart rhythm with multiple ectopic beats. In all three cases the administration of intravenous magnesium sulphate was successful in treating the arrhythmias. Magnesium sulphate is an antiarrhythmic agent that is effective mainly in treatment of ventricular arrhythmias. The drug can also be employed as second-line treatment of supraventricular arrhythmias.
 ...
PMID:Antiarrhythmic effects of magnesium sulphate. Report of three cases. 748 48

The carotid sinus syndrome is a well-known cause of syncope: the cardio-inhibitory forms are the easiest to diagnose and probably the easiest to treat. However, the vasodepressive forms are as common but their outcome is mainly unknown. Eight hundred and fifty-three patients underwent endocavitary electrophysiological studies with invasive blood pressure measurement for unexplained syncope between October 1984 and January 1990. A carotid sinus syndrome was diagnosed in 215 cases. Fifty-two patients (24.2%) had a cardio-inhibitory form (ventricular standstill > or = 3 s during carotid sinus massage), 40 (18.6%) had a pure vasodepressive form (isolated fall of systolic blood pressure > 50 mmHg during massage) and 123 patients (57.2%) had a mixed form. The average age was 74.1 +/- 9.7 years with no difference between the different forms. A number of parameters was different on the cardio-inhibitory and vasodepressive forms: the number of men (75.6 vas 24.4%; p < 0.05) and the number of syncopes (83.3 vs 60%; p < 0.02) were greater in the cardio-inhibitory form; the vasodepressive forms were more often associated with a history of transient ischaemic attacks (15 vs 0%), a poor cardiovascular status (hypertension: 47.5 vs 15.7%; p < 0.01), coronary artery disease (47.5 vs 25.5%; p < 0.05), cardiac failure (27.5 vs 11.7%; p < 0.05), induction of sustained supraventricular tachycardia (50 vs 23.5%; p < 0.05) and a greater pacemaker effect (53.6 vs 34.8 mmHg; p < 0.01); of the 191 patients (84.9% of the population) followed up for an average of 21.2 months, 168 received treatment: implantation of a cardiac pacemaker in 108 patients, reduction of antihypertensive and/or potentially bradycardia-inducing drugs in 30 patients, prescription of antiarrhythmic therapy, in 30 patients.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Characteristics and influence of different clinical forms on the development and prognosis of carotid sinus syndrome. Apropos of 215 cases]. 748 32


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>