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

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

In a decade from 1980, 11 children aged 3 to 11 years presented with Takayasu's arteritis (TA). All were severely hypertensive. Operative correction was offered to 10 of 11 children presenting with renovascular hypertension (RVH) including cardiac failure alone in 1 and both renal and cardiac failure in 8, a result of TA involving renal arteries by stenosis or occlusion. Nine patients had renal autotransplantation to an heterotopic site in the pelvis. Seven of 12 kidneys were salvaged by autotransplant with relief of RVH. Renal artery stenosis was successfully corrected by this procedure in 5 patients. Autotransplantation failed in 4 patients, 1 of whom subsequently had a successful allograft transplant. One patient was treated primarily by cadaver allograft transplantation. One patient whose autotransplant failed had a functioning contralateral kidney and is well with controlled RVH. One patient died prior to any treatment. Patient survival improved with the use of total lymphoid irradiation in the most recent 7 patients.
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PMID:Management of renal hypertension in children with Takayasu's arteritis using renal autografting or allograft transplantation in selected circumstances and total lymphoid irradiation. 135 25

Eight patients with the middle aortic syndrome are described. They were aged 2 months to 14 years at diagnosis; follow up was one to 11 years. Clinical presentations included asymptomatic hypertension (n = 5), severe headache, nose bleed, and chest pain (n = 1), and cardiac failure (n = 1). All had severe hypertension requiring multiple drug treatment. Diminished peripheral pulses were not helpful in the diagnosis, which is made on aortography. Associated clinical findings were Williams' syndrome (n = 3) and appreciable eosinophilia (n = 3). The differential diagnosis includes Takayasu's arteritis, fibromuscular dysplasia, and neurofibromatosis. Blood pressure was adequately controlled by medical treatment in six patients. Surgical angioplasty was performed in two. One patient remained normotensive without drug treatment 21 months after operation; the other died of sepsis and uncontrollable haemorrhage in the postoperative period. Medical treatment is satisfactory in most cases: surgery should be reserved for those in whom blood pressure cannot be controlled without unacceptable side effects of drug treatment. Although rare, the middle aortic syndrome should be considered in the differential diagnosis of hypertension when commoner causes have been excluded. Aortography is necessary for diagnosis.
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PMID:Middle aortic syndrome: clinical and radiological findings. 158 Jun 80

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

Between 1977 and 1989, 24 patients (19 women and 5 men) with Takayasu's disease underwent renal artery restoration. Mean age was 32.9 years (range 15 to 60 years). All patients were hypertensive and three had moderate, chronic renal failure. Renal artery lesions were unilateral in two patients (8%), bilateral in 17 patients (71%), and unilateral in a solitary kidney in five (21%). Associated lesions of the thoracic or abdominal aorta or both were found in 22 patients (92%). Lesions of the visceral arteries found located in 21 patients (87%) and of the supraaortic trunks in 16 (67%). Initial revascularization of the supraaortic trunks was performed in four patients (17%). Renal artery revascularization was unilateral in 11 patients (46%) and bilateral in 13 (54%). Concomitant aortic reconstruction was performed in 21 patients (87%), visceral artery reconstruction in 17 patients (71%), and supraaortic surgery in seven (29%). One patient who underwent combined aortic and renal artery restoration, and in whom visceral artery involvement had been neglected, died postoperatively of heart failure and intestinal infarction. Three patients were lost to follow-up. Twenty patients have been followed for a mean of 61.3 months (range 4 to 124 months). One patient died at 89 months of intestinal infarction secondary to embolization originating from a false aortic aneurysm. Five repeat renal revascularizations were required in four patients. Hypertension is presently cured in 12 patients (63%), improved in six (31%), and unchanged in one (6%). Even though surgical treatment of arterial lesions in Takayasu's disease often includes complex and repeat revascularization procedures, satisfactory long-term results suggest the use of renal artery reconstruction in this affliction.
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PMID:Reconstructive surgery of the renal arteries in Takayasu's disease. 196 59

Takayasu Arteritis (TA) was thought to only involve the aortic arch and its main branches, but subsequent studies demonstrated that the arteritis in not confined to these areas. The process can involve, among others, the coronary arterial tree and is capable to produce myocardial infarction. Many authors thought that when patients with TA presented with heart failure, it was generally a consequence of extramyocardial factors such as systemic or pulmonary hypertension and/or aortic regurgitation. We present the case of a young female with TA and calcified giant ventricular aneurysm. We discuss the probabilities of its origin and emphasize the relationship between the pathologic findings and the possibility of direct myocardial damage by TA, but our impression is that it is due to coronary involvement because we found a lesion in the anterior descending artery.
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PMID:[Takayasu arteritis with calcified giant ventricular aneurysm. Presentation of a case]. 286 Aug 77

The possibility of cardiac involvement in Takayasu's disease is well known, but this involvement generally appears to be secondary to reno-vascular hypertension or to pulmonary arteritis and, exceptionally, as a result of coronary disease. In the case reported here, the inflammatory myocardial lesion localised to the left ventricle was demonstrated while the patient was still alive. It was responsible for an episode of severe heart failure which finally resolved after 2 years. The inflammatory involvement of the myocardium was associated with laboratory signs of inflammation and with inflammatory arterial lesions. Several haemodynamic investigations were performed to follow the course of the disease. The diagnosis was confirmed by myocardial biopsies and by the pulmonary arterial and renal arterial involvement. A review of the literature revealed that this condition was extremely rare and has only been proven in a few autopsy cases.
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PMID:[Myocardiopathy and Takayasu's disease. Apropos of a case]. 286 27

A case of Takayasu's disease presenting in a young man as a solid abdominal mass is described. The literature is reviewed and classifications of the disease are discussed. Occlusive thromboaortopathy, also known as "pulseless disease" or Takayasu's disease, was first described in 1908 by Takayasu, who observed cataracts and peculiar arteriovenous anastamoses around the optic papillae in a young woman. It is a vasculitic disorder of uncertain etiology occurring mainly in young women and may involve part or most of the aorta, as well as the pulmonary artery. Early features include fever, malaise, weight loss, and a high ESR, and, later on, absent pulses, aneurysms, hypertension, and heart failure may occur. The authors describe an unusual case of Takayasu's disease in a young black South African man.
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PMID:An unusual case of occlusive thromboaortopathy (Takayasu's disease)--a case report. 289 76

Takayasu arteritis is a non-specific inflammatory disease of unknown etiology with segmental arteritis of the aorta and its major branches. Though this disease exists throughout the world it is more prevalent in Japan, India and South East Asia. The symptomatology of Takayasu arteritis includes a preocclusive phase with acute systemic manifestations, and an occlusive phase in which ischemic features secondary to arterial occlusion or stenosis dominate the clinical picture. Aortography leads to diagnosis by demonstrating arterial stenosis, and allows an evaluation of the extension of the disease. Deaths are caused mainly by heart failure and cerebral vascular lesions related to hypertension. The cause of the disease remains unknown: tuberculosis and genetic predisposition are the factors most often incriminated. Medical treatment with corticosteroids and antituberculous chemotherapy is useful during the inflammatory phase. Surgery is only warranted when serious complications occur.
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PMID:[Takayasu disease: an observation in a fourteen-year-old girl (author's transl)]. 612 36

Twenty-seven Japanese patients with occlusive thromboaortopathy (Takayasu's disease) associated with 33 pregnancies and deliveries were followed up prospectively, from the prepregnant period. Inflammatory activity of the disease was apparently not enhanced by the pregnancy, but various cardiovascular-related events occurred in the perinatal period. During the intrapartum uterine contractions, marked elevation of systolic blood pressure was associated with 10 pregnancies, including 1 case of subsequent cerebral hemorrhage; this did not occur in 13 normal control gravidas. There were no maternal or neonatal deaths. The birth weight of 25 infants of 21 patients without complications or with a mild single complication of Takayasu's disease was 3,023 +/- 442 g (mean +/- standard deviation). The birth weight of 8 infants of 6 patients who had a severe single complication or multiple complications of the disease was 2,599 +/- 394 g (p less than 0.05). Of 83 pregnancies, the present 33 plus 50 other reported cases there were no un-toward events in two fifths. Three fifths had various problems, most of which were related to pressure elevation and heart failure, including intrapartum cerebral hemorrhage in 4. These data should assist in predicting the outcome of pregnancy and delivery in patients with Takayasu's disease.
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PMID:Occlusive thromboaortopathy (Takayasu's disease) and pregnancy. Clinical course and management of 33 pregnancies and deliveries. 612 19


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