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

Three patients with interruption and seven with hypoplasia of the aortic arch were treated surgically. The subclavian artery and the aortic isthmus were employed for reconstructing the aortic arch in five, and a Dacron prosthesis was used to restore the aortic continuity in five. A ductus arteriosus coexisted in all patients and a ventricular or atrial septal defect in nine. Congestive heart failure and pulmonary hypertension were prominent clinical features, and the role of the ductus and other intracardiac anomalies on their pathogenesis in discussed. Six patients, one with an interrupted and five with a hypoplastic arch survived but three have evidence of either pulmonary vascular disease or significant pulmonary hypertension. Only one patient with hypoplasia of the arch is now considered cured after his ventricular septal defect was closed in a second operation. The analysis of this and other series in the literature indicate a high mortality rate of the conditions; however, early surgical treatment, which is the only effective means to control heart failure and avoid the effects of prolonged pulmonary hypertension, has brought upon a decline in mortality in recent years.
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PMID:[Surgical treatment of congenital interruption and hypoplasia of the aortic arch]. 13 70

The role of hypertension in cardiovascular disease was studied in the hypertensive coarcted monkey during the feeding of an atherogenic and nonatherogenic diet. During the 15-month period of observation, half of the hypertensive coarcted monkeys developed cardiovascular disease which included heart failure, ischemic heart disease, stroke, and sudden death. There were no cardiovascular complications in the control normotensive monkeys except for one cholesterol-fed animal. The incidence of ischemic heart disease and sudden cardiac death was higher in monkeys with both hypertension and hypercholesterolemia than in those with hypertension or hypercholesterolemia alone. Postmortem studies revealed that the former monkeys had both hypertensive and atherosclerotic heart disease, whereas the monkeys with hypertension or hypercholesterolemia had either hypertensive or atherosclerotic heart disease. Hypertensive heart disease was characterized not only by hypertrophy of the left ventricle but also by focal myocardial degeneration and fibrosis and by focal thickening and narrowing of the small coronary arteries, particularly the sinus node artery and the atrioventricular node artery. The finding of transmural myocardial infarction in two monkeys with patient coronary arteries suggests a possible role of coronary artery spasm in ischemic heart disease in hypertension. The cerebral vascular complications of hypertension included hypertensive encephalopathy, transient "ischemic" attacks, and hemorrhagic stroke. The complications were associated with severe hypertension and with hypertensive vascular disease or hypertensive and atherosclerotic vascular disease of the cerebral arteries.
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PMID:Role of hypertension in ischemic heart disease and cerebral vascular disease in the cynomolgus monkey with coarctation of the aorta. 14 28

EEG-findings of a group of 95 patients suffering from Parkinson's disease were related to accompanying diseases inducing cerebral hypoxic hypoxidosis. The EEG in 59 to 74 per cent of our patients was abnormal but the changes were not specific. There was a correlation between age and EEG-abnormalities. On the other hand no association could be seen between EEG-changes and duration of the Parkinson's disease. At least 74 per cent of the patients suffered from concomitant cardiovascular complications and 36 of them had a severe pathologic EEG as well as a pathologic ECG. The results lead to the conclusion that in treatment of parkinsonian patients attention is to be paid to accompanying diseases as heart failure, angiopathy or anemia.
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PMID:[EEG in Parkinson's disease and cerebral hypoxia (author's transl)]. 41 49

In an attempt to assess cardiac risk in non-cardiac surgery, 1001 patients over 40 years of age who underwent major operative procedures were examined preoperatively, observed through surgery, studied with at least one postoperative electrocardiogram, and followed until hospital discharge or death. Documented postoperative myocardial infarction occurred in only 18 patients; though most of these patients had some pre-existing heart disease, there were few preoperative factors which were statistically correlated with postoperative infarction. Postoperative pulmonary edema was strongly correlated with preoperative heart failure, but 21 of the 36 patients who developed pulmonary edema did not have any prior history of heart failure. Nearly all of these 21 patients were elderly, had abnormal preoperative electrocardiograms, and had intraabdominal or intrathoracic surgery. In the absence of an acute infarction, bifascicular conduction defects, with or without PR interval prolongation, never progressed to complete heart block. Spinal anesthesia protected against postoperative heart failure but not against other cardiac complication. By multivariate regression analysis, postoperative cardiac death was significantly correlated with (a) myocardial infarction in the previous 6 months; (b) third heart sound or jugular venous distention immediately preoperatively; (c) more than five premature ventricular contractions per minute documented at any time preoperatively; (d) rhythm other than sinus, or premature atrial contractions on preoperative electrocardiogram; (e) age over 70 years; (f) significant valvular aortic stenosis; (g) emergency operation; (h) a 33% or greater fall in systolic blood pressure for more than 10 minutes intraoperatively. Notably unimportant factors included smoking, glucose intolerance, hyperlipidemia, hypertension, peripheral atherosclerotic vascular disease, angina, and distant myocardial infarction.
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PMID:Cardiac risk factors and complications in non-cardiac surgery. 66 58

Thirty-two patients with double outlet right ventricle (DORV) were studied between 1960 and 1976. Associated congenital defects frequently compounded the difficulty of clinical diagnosis. Cardiac catheterisation was performed in 27 patients, and the ventriculograms were studied with particular regard to the relative positions of the great vessels to each other and to the ventricular septal defect. These relationships determine which corrective operation is possible. Correction has been performed in 12 patients with a perioperative mortality of 25%. Although mitral-aortic discontinuity was demonstrated in all cases, consideration of the anatomical spectrum included in the term DORV suggests that discontinuity is not an essential feature. In common with other clinical data and in contrast with necropsy studies, none of our patients was found to show the normal relationship of the great vessels to each other, in which the aorta lies posterior and to the right of the pulmonary artery. The reason for this difference between the clinical and necropsy findings is not apparent. A similar disparity was shown with regard to pulmonary stenosis, which was demonstrated at catheterisation in 68% of the 27 patients (mean gradient 68 +/- 3 mmHg), in contrast with incidences of 18% and 25% in recent necropsy series. Patients in the necropsy studies were frequently neonates or infants, in whom death may have been the result of intractable cardiac failure secondary to excessive pulmonary blood flow. In older patients without pulmonary stenosis and with pulmonary hypertension, frequent observation is imperative so that surgical treatment can be instituted before the development of irreversible pulmonary vascular disease.
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PMID:Double outlet right ventricle: clinical and anatomical spectrum. 68 64

From 1963 to September 1973, 60 patients underwent definitive repair of cardiac lesions for which pulmonary artery banding had been performed previously. Most bandings had been performed for intractable heart failure secondary to large pulmonary flow. The pulmonary artery band resulted in a fibrous reaction around the pulmonary artery or its branches in all instances. Angioplastic procedures on the main pulmonary artery or the left and right pulmonary arteries were usually necessary to relieve the stenosis produced by the band and the resultant scarring. The operative mortality in this group of patients was 28% and pulmonary artery banding was considered to be a factor in 4 of the 17 deaths. The absence of absolute protection from the development of progressive pulmonary vascular disease, the mortality associated with banding, and the mortality and increased technical difficulties associated with removing the band at the time of the repair support one-stage definitive procedures rather than palliative banding of the pulmonary arteries in all but the most exceptional situations.
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PMID:Removal of pulmonary artery band. 111 97

A group of 278 patients, over the age of 60 years, and representative of geriatric and general medical admissions to the District General Hospital in Banbury, Oxforshire, was studied to correlate the prevalence of systolic murmurs to age, sex, cardiac failure, ischaemic heart disease, dysrrhythmias, hypertension, peripherial vascular disease and anaemia. The object was to establish the clinical significance of these murmurs and test a postulate that they could not be dismissed as benign. Seventy-five per cent of the murmurs were judged to be aortic and 12 per cent mitral in origin. The prevalence of systolic murmurs increased with age from 32 per cent at 60-64 years to 57 per cent over 85 years, and was greater in females (44 per cent) than in males (34 per cent). The presence of systolic murmurs was related to the presence of cardiac failure, ischaemic heart disease, dysrrhythmias, hypertension, peripheral vascular disease and anemia. Only 8 per cent of patients with systolic murmurs had none of the above-mentioned six cardiovascular abnormalities compared with 36 per cent of patients without such a murmur, while multiple cardiovascular abnormalities were also commoner in the former group. The mortality rate in hospital was similar for patients with or without a systolic murmur.
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PMID:The clinical significance of systolic murmurs in the elderly. 114 71

In a group of 91 patients with hypertensive vascular disease without any clinical symptoms and signs of cardiac insufficiency following pressures were measured at rest and during supine bicycle ergometer exercise: right atrial pressure, pulmonary artery pressure and pulmonary capillary wedge pressure (PCP). Cardiac output was measured by thermodilution at rest and during exercise. In 47 patients out of these 91 PCP was found to be normal and did not exceed 20 mm Hg during exercise, the remaining 44 patients developed pathologically raised PCP during exercise. The average cardiac output was normal at rest und during exercise. Those pathological PCP during exercise, which could be demonstrated in nearly 50% of all investigated hypertensive patients, reflect an elevation of left ventricular filling pressure, the reasons of which are briefly discussed.
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PMID:E1The question of stress cardiac insufficiency in hypertension. 121 May 27

One to ten years after laser coagulation for diabetic retinopathy, 229 type I diabetics (mean age 44.3 years) and 157 type II diabetics (mean age 65 years) were re-studied for morbidity and mortality (progression of late damage, duration of survival, cause of death). The duration of diabetes at the first laser coagulation averaged 23.1 years for type I diabetics (15.9 years for type II). Average period from the first laser coagulation to the re-examination was 6.5 years for type I, 5.1 for type II diabetics. Of those patients still alive 6.7% had gone blind (type II: 7.3%). 2.1% and 4.6%, respectively, were receiving dialysis treatment, while renal transplantation had been performed in 3.1 and 1.8%, respectively. Stroke was the most frequent macrovascular complications (8.4 and 16.5%), followed by leg amputation (3.6 and 14.7%) and myocardial infarction (3.7 and 18.3%). 83 patients had died: 35 (15.3%) type I and 48 (30.6%) type II diabetics. Causes of death were septicaemia 14.3% (0%), uraemia 11.4% (8.3%), myocardial infarction 14.3% (33.3%), heart failure 8.6% (29.2%) and stroke 5.7% (6.3%). 10.7% (24.2%) had died within the first 5 years after laser coagulation. Despite a lower incidence of blindness in patients with diabetic retinopathy, the vascular disease progresses in other vascular regions so that a large proportion of diabetics will develop renal failure or die early from macrovascular complications.
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PMID:[Morbidity and mortality in type 1 and type 2 diabetes mellitus after the diagnosis of diabetic retinopathy]. 142 83

An infant with scimitar syndrome, absent right pulmonary artery, and systemic blood supply to the right lung presented in severe cardiac failure. Cardiac catheterization revealed suprasystemic pressure of the left pulmonary artery and a high pulmonary vascular resistance. Right-sided pneumonectomy abolished cardiac failure and normalized both pulmonary artery pressure and resistance. Pure volume load affecting one lung--as in this case through absence of the right pulmonary artery plus additional left-to-right shunt from a systemic collateral--can lead to pulmonary hypertension. Early operative intervention can reverse this process and prevent pulmonary vascular disease.
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PMID:Scimitar syndrome with absence of the right pulmonary artery: a case with volume-induced, reversible, left-sided pulmonary hypertension. 161 17


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