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

The initiation of cardiac impulse is located in the sinus node, in the upper anterior part of the right atrium. The importance of the atrium is not only linked to the regulation of heart rate, but also to its haemodynamic function. Indeed, atrial depolarization leads to atrial contraction which can be responsible for up to 30% of cardiac output by way of ventricular filling. Supraventricular arrhythmias are related to one of the following mechanisms: abnormal automaticity, triggered activity, and reentry. Most of supraventricular tachycardias are due to a reentrant phenomenon (intranodal reentrant tachycardia, orthodromic circusmovement tachycardia, atrial flutter and atrial fibrillation). At the onset of a supraventricular tachycardia, the loss of efficacious atrial contraction as well as the increased heart rate may abruptly decrease ventricular filling. As a consequence, stroke volume is reduced, leading to a decrease in cardiac output and in arterial blood pressure, explaining that the patient may experience syncope. Usually, blood pressure reduction resumes within 30 seconds after activation of the autonomic adrenergic nervous system. In case of an underlying heart disease, the supraventricular tachycardia may lead to acute cardiac failure. When reentry is concerned, the tachycardia is going around a specific circuit. The existence of such a circuit in most of supraventricular tachycardias has led to the development of ablation therapy, the goal of which is to destroy a critical portion of the circuit hence making the recurrence of reentrant tachycardia impossible.
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PMID:[Atrial activity and its effects]. 823 2

A case is presented of a mechanical cardiac valve dysfunction occurring in a 19-year-old Nigerian 7 years after valve surgery and presenting with cardiac failure, supraventricular tachycardia and later, cardiogenic shock but initially masquerading as generalised bleeding probably from Warfarin-drug interaction. The problem of management of an artificial heart valve in our setting is discussed.
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PMID:Prosthetic valve dysfunction in a Nigerian. 823 73

Fetal supraventricular tachycardia may cause intrauterine heart failure and thus require transplacental treatment. During a period of nine years, we treated nine of eleven fetuses (gestational age ranging from the 26th to the 36th week) suffering from paroxysmal supraventricular tachycardia (10) or atrial flutter (1). The remaining two fetuses did not receive antiarrhythmic therapy because of only short lasting supraventricular tachycardia. Two fetuses were hydropic at the onset of therapy. Diagnosis of the rhythm disorder was established by m-mode echocardiography. All nine fetuses treated received digoxin after diagnosis of supraventricular tachycardia. Three of these reverted to sinus rhythm, one remained in supraventricular tachycardia which, however, was well tolerated. Five fetuses (three because of failure of digoxin alone and two because of a severely symptomatic supraventricular tachycardia) were treated with a combination of digoxin and verapamil. All five fetuses responded to the combined treatment, two of them, however, were delivered prematurely because of recurrence of supraventricular tachycardia in one and amnion-infection syndrome in the other. All patients survived and no severe fetal or maternal side effects were observed. Our experience confirms that digoxin and verapamil are usually effective in treating fetal supraventricular tachycardia. Some fetuses with short lasting and self limiting supraventricular tachycardia may not need any treatment, and a few not responding to digoxin and verapamil may require other antiarrhythmic drugs.
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PMID:[Intrauterine therapy of fetal supraventricular tachycardia with digoxin and verapamil]. 832 75

The authors demonstrate two cases of non-immunological foetal hydrops. In the first case the initial cause of foetal hydrops was hypoalbuminaemia (hypoproteinaemia), in the second case intrauterine cardiac failure resulting from supraventricular tachycardia of unknown aetiology. The authors explain the pathogenesis of the condition, its early diagnosis and therapy. They draw attention to possible intoxication of the neonate by digoxin administered to the mother during pregnancy.
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PMID:[Non-immunologic fetal hydrops]. 837 78

Severe intrauterine cardiac failure due to supraventricular tachycardia in a 29 week fetus was diagnosed using 2 dimensional and Doppler echocardiography. The prenatal tachycardia was successfully treated, the postnatal finding suggested Wolff-Parkinson-White syndrome. The fetal echocardiography by providing information on cardiac structure and haemodynamics may provide diagnostic and therapeutic useful informations. For the optimal pre- and perinatal management of this life-threatening condition absolutely essential a brief collaboration between the pediatric cardiologist and obstetricians.
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PMID:[Diagnosis and treatment of fetal and neonatal tachycardia]. 846 59

Magnesium has previously been used in the treatment of various arrhythmias, but few randomized and prospective studies are available. In a single-blind study, the efficacy and safety of intravenous magnesium sulfate (bolus doses of 5 + 5 mmol followed by infusion of 0.04 mmol/min) versus verapamil (5 + 5 mg followed by 0.1 mg/min) was evaluated in 57 patients with supraventricular arrhythmias (supraventricular tachycardia, atrial fibrillation, and atrial flutter) of recent onset (less than 1 week). Fifteen (58%) of the patients receiving magnesium (n = 26) converted to sinus rhythm within 4 h, and 16 (62%) within 24 h. Verapamil caused a lower ventricular rate, but only six (19%) of the patients (n = 31) converted to sinus rhythm within 4 h (p < 0.01) and 16 (52%) within 24 h (NS). No side effects were observed during magnesium infusion, whereas six patients receiving verapamil had to be withdrawn from further study medication due to symptomatic side effects (hypotension in three, cardiac failure in three). Magnesium appears to be an effective and safe drug for the treatment of supraventricular arrhythmias. The overall efficacy for conversion to sinus rhythm is at least as effective as with verapamil, and its action is more rapid.
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PMID:The effect of magnesium versus verapamil on supraventricular arrhythmias. 850 78

Carboplatin is one of most commonly used chemotherapeutic agents in clinical oncology practice. We presented a case of subacute cardiotoxicity supposedly due to carboplatin. A patient with ovarian cancer had been treated with carboplatin based chemotherapeutic agent for about a month before surgery. Although she had not shown symptoms of cardiac failure, severe pulmonary edema developed immediately after general anesthesia. It disappeared within a week. For three days following the administration of carboplatin alone for two weeks after surgery, arrhythmias (SVT, SVPB and VPB) and hypotension appeared. Symptoms of congestive heart failure, resembling dilated cardiomyopathy, lasted for one month. It required about two months to restore the normal cardiac functions. Carboplatin seems to have infrequent but possible cardiotoxicity as many other chemotherapeutic agents.
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PMID:[A case report of cardiac failure caused by the new anti-neoplastic agent 'carboplatin']. 851 57

Fetal echocardiography was undertaken in 350 high risk pregnant females between 14 to 36 weeks of gestation at our institution. Significant fetal arrhythmias were diagnosed with the help of M-mode and pulsed Doppler echocardiography in 24 pregnant females. Three categories of arrhythmias were observed: (i) atrial or ventricular extrasystoles in 17, (ii) supraventricular tachycardia in 4, and (iii) congenital complete atrioventricular block in 3. The first category of arrhythmia was benign in 100 percent of cases with complete resolution before or just after birth. The second category was completely treatable with antiarrhythmic drugs given to the mother, thus preventing complications of heart failure and hydrops. In the third category, one fetus who had associated severe structural cardiac malformation, died in utero. The other two are doing well postnatally and are on medical follow up. Recognition of arrhythmias and appropriate prenatal treatment will prevent intrauterine death and also help avoid unnecessary operative or premature deliveries.
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PMID:Type and significance of fetal arrhythmias. 863 68

Fetal tachyarrhythmias are life-threatening conditions for the fetus. Long-standing tachyarrhythmias often lead to fetal cardiac failure, hydrops and death. Normalization of the fetal cardiac rhythm leads to resolution of fetal hydrops. This report describes the sequence and timing of fetal hydrops resolution after successful therapy. Fetuses with a persistent heart rate over 180 beats/min with a 1:1 atrioventricular conduction (on M mode) were defined as having supraventricular tachycardia. Fetal hydrops was diagnosed if the following signs were seen: pleural and/or pericardial effusion and/or ascites or/and skin edema. Five fetuses with sustained fetal tachycardia and hydrops who converted to normal rhythm with antiarrhythmic agents treated at Stony Brook University Hospital and North Shore University Hospital between 1988 and 1995 are included. Resolution of hydrops required from 4 to 6 weeks and occurred in the following sequence: diminution of ascites; pleural and pericardial effusions, and disappearance of skin and scalp edema. Minimal signs of fluid retention (small ascites, mild hydrocele) remained in studied fetuses until term. Understanding the natural history of hydrops in cases of fetal tachyarrythmias will allow for accurate patient counseling pertaining to the expected timing of hydrops resolution after successful therapy.
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PMID:Natural history of hydrops resolution in fetuses with tachyarrhythmias diagnosed and treated in utero. 882 11

A 7-month-old girl weighing 5.3 kg, presented with atrial septal defect (ASD) and paroximal supraventricular tachycardia (PSVT). The preoperative electrophysiological study could not be performed because of the severe heart failure. On suspicion of a concealed Wolff-Parkinson-White (WPW) syndrome, whose accessory pathways conduct in the retrograde direction only, the operation was performed. The intraoperative epicardial and endocardial mappings revealed the presence of a left-posterior retrograde accessory pathway. This accessory pathway was successfully ablated by a cryoablation using transseptal superior approach. The postoperative course was uneventful without a permanent heart block. We report a successful surgical repair for an infant with concealed WPW syndrome, who revealed severe heart failure because of PSVT and ASD.
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PMID:[Successful repair for concealed Wolff-Parkinson-White syndrome with atrial septal defect in infancy: a case report]. 891 72


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