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

Intravenous trinitroglycerine was administered in 68 patients in cardiac failure during the acute phase of myocardial infarction. With a mean hourly dose of 1.58 mg, trinitroglycerine was effective against signs of left and right heart failure after about ten minutes for almost all the teams involved, its tolerance being excellent. Mean capillary pressure fell by 33% (from 22.4 +/- 0.71 mmHg to 15.5 +/- 0.60 mmHg; n = 68; p < 10(-9), as did mean pulmonary artery pressure. Mean right atrial pressure fell by 25% (from 9.96 +/- 0.53 mmHg to 7.48 +/- 0.58 mmHg; n = 68; p < 10(-9). Cardiac output increased by 10.7% (from 2.48 +/- 0.07 l/mn/m2 to 2.74 l/mn/m2; n = 68; p < 10(-7). Since cardiac output was unaltered, systolic index was improved, as was cardiac index, by 11.5% (from 28.4 +/- 1.08 cm3/syst/m2 to 31.7 +/- 1.15 cm3/syst/cm2; n = 68; p < 10(-5). Mean arterial blood pressure was slightly decreased (-9.3%; p < 10(-9), as were systemic resistance (-13%; p < 10(-6) and pulmonary resistance (-27%; p < 10(-6). Systolic work index was significantly improved by 8.37% (from 31.3 +/- 1.73 g-m/m2 to 33.7 +/- 1.74 g-m/m2); n = 68; p < 0.01), which reflects, in view of the decrease in the total work supplied by the heart, a redistribution in favour of more useful work. Treatment must be adapted for each patient, in order to determine the optimum hourly dose of TNT,. which ensures the best cardiac index whilst adequately reducing capillary pressure to levels of the order of 14 to 18 mmHg. Treatment must be closely observed and altered several times a day in relation to values of cardiac output and pulmonary capillary pressure.
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PMID:[Intravenous trinitroglycerin during acute myocardial infarction with cardiac failure. Cooperative study of 68 patients (author's transl)]. 12 16

Thirty-one patients with cystic fibrosis of varying severity were examined by echocardiography. Right ventricular dimension (RVD) was above upper normal limit in 14 patients and right ventricular dimension index (RVD index) was higher than the upper normal limit in 11 patients. Furthermore, there was a significant relationship between increasing RVD index and 1) decreasing forced vital capacity (FVC) both actual test results and average 6 months values; and 2) decreasing peak-expiratory flow rate (PEFR) both actual test results and average 6 months values. This observation suggests a persistent heart involvement. Five patients had either heart failure and/or electrocardiographic evidence of right ventricular abnormality. These patients had increased RVD index and one patient with the highest RVD index died 8 weeks after the examination. The present study has shown the usefulness of echocardiographic measurement of right ventricular dimension and of septal motion in assessing cor pulmonale, before development of electrocardiographic abnormalities and right heart failure.
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PMID:Assessment of cor pulmonale in cystic fibrosis by echocardiography. 14 4

A 55-year-old man had progressive dyspnea, recurrent atrial arrhythmias, and severe right heart failure following coronary bypass surgery. His condition improved only slightly with the usual decongestive therapy. When transferred for further studies 5 months after the operation, he had typical clinical and hemodynamic findings of constrictive pericarditis. Review of chest films following the bypass operation revealed a large pericardial effusion or hematoma, the incomplete resolution of which probably caused the pericardial constriction confirmed at thoracotomy. The man was treated by pericardiectomy. A recent report on the incidence of overt tamponade soon after bypass surgery suggests that a significant volume of pericardial fluid accumulates in the early postoperative course in many instances and that late constriction may not be a rare complication. In treating patients who have circulatory congestion after such operations, it is important that the physician consider constrictive pericarditis and not assume that the clinical findings are the consquence of myocardial failure.
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PMID:Pericardial constriction as a late complication of coronary bypass surgery. 30 90

Although postoperative constrictive pericarditis is rare, the diagnosis should be considered when unexplained right-sided heart failure develops after cardiac surgery. Within a 6 week interval, evidence of constrictive pericarditis developed in three patients who had recently undergone myocardial revascularization. One patient presented with biventricular failure, pericardial effusion and suspected tamponade. Severe constrictive pericarditis was demonstrated at subsequent operation. An apparent postpericardiotomy syndrome preceded evidence of right heart failure in the other two patients. Etiologic considerations include the possibility that pericardial irrigation with povidone-iodine (Betadine) solution may have contributed to subsequent fibrosis.
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PMID:Constrictive pericarditis after myocardial revascularization: report of three cases. 31 49

The left ventricle in left heart failure can be elliptical, spherical or funnel shaped. There is no firm correlation between the different shapes and the hemodynamics. Left ventricular failure results in dilatation, deformation and loss of funnel function of the left atrium. In more advanced stages of left ventricular failure the pulmonary veins become coiled, dilated and narrow stepwise instead of the normal harmonic narrowing to the periphery. The pulmonary parenchyma exhibits fibrosis and septal siderosis at that stage. Heart failure cells can be observed frequently. In later stages, when pulmonary arteries and the right ventricle is involved, secondary global heart failure develops. Right ventricular failure may lead to necrosis of liver cells with jaundice and elevated levels of liver specific enzyms. Primary global failure has no hemodynamic consequences on the pulmonary circulation, as long as left and right ventricular failure are of equal severity. If one form prevails, the clinical picture will be that of left or right ventricular failure respectively.
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PMID:[Morphologic consideration of heart failure (author's transl)]. 36 77

The absorption of digoxin has been investigated in 8 patients before and after successful treatment of severe right heart failure. 3H-digoxin 0.1 mg as a solution, and un-labelled digoxin 0.25 mg as a tablet, were given to fasted patients. Blood samples were taken at various time intervals up to 120 hours and urine was collected over the same period. The concentrations of labelled digoxin in plasma and urine were measured in a liquid scintillation counter, unlabelled digoxin was estimated by radioimmunoassay, and various pharmacokinetic parameters were calculated. There was no significant difference in the plasma concentration curves in severe right heart failure and after its successful treatment, nor did any of the calculated pharmacokinetic parameters change significantly. Therefore, inhibition of the absorption of digoxin appears unlikely. In an additional study to estimate absolute bioavailability two different groups of patients in severe right heart failure were given 3H-digoxin 0.1 mg or unlabelled digoxin 0.25 mg i.v. and the pharmacokinetic parameters were compared with those from the previous study. The bioavailability of the 3H-digoxin solution and of the digoxin tablet were in the same range as values previously published for healthy volunteers, and patients both with and without cardiac failure.
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PMID:Absorption of digoxin in severe right heart failure. 37 88

Each day, for one year, the medical records of adult patients who died in hospital were reviewed before seeing the necropsy findings. For those patients who had had chronic left or left and right heart failure, a presumptive cause was assigned on the basis of antemortem clinical data. Of 740 consecutive patients who were studied at necropsy, 90 had had chronic heart failure. In 15 patients the cause of heart failure was not apparent by clinical criteria; of these, 7 were found at necropsy to have cardiomyopathic syndrome caused by coronary artery disease. In retrospect, the presence of overt diabetes mellitus was a clue that cardiomyopathy caused by coronary artery disease was the cause of clinically unexplained heart failure; 5 of 7 patients with unexplained heart failure who were found to have this at necropsy were diabetic, whereas only 1 of the other 8 patients with clinically unexplained heart failure was diabetic (P less than 0.05). Patients in whom clinically unexplained heart failure was found to be the result of cardiomyopathy caused by coronary artery disease had multiple myocardial infarctions on pathological examination, which, with one exception, were nontransmural. By contrast, myocardial infarctions were transmural on pathological examination in each of 7 matched 'controls' with heart failure, in whom the diagnosis of coronary artery disease had been clinically apparent (P less than 0.01).
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PMID:Cardiomyopathic syndrome caused by coronary artery disease. III: Prospective clinicopathological study of its prevalence among patients with clinically unexplained chronic heart failure. 46 32

A 39-year-old man had pain and swelling of the terminal phalanx of a finger. Radiograph was interpreted as osteomyelitis, and amputation through the mid-phalanx was performed. Histology revealed Ewing sarcoma. Lung metastases rapidly developed. Right lung irradiation and systemic chemotherapy, including doxorubicin, were instituted. He developed progressive severe right ventricular failure which was attributed to effects of large pulmonary metastases. Autopsy showed massive right ventricular metastases, the primary pathological cause of the heart failure, without evidence of doxorubicin cardiomyopathy.
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PMID:Ewing sarcoma: phalangeal primary with fatal cardiac metastases. 54 62

Congestive right ventricular heart failure of Montana cattle is characterized clinically by an accumulation of edematous fluid in the brisket region and ventral portions of the body but not of the legs. A well developed jugular pulse is first observed followed by a watery diarrhea and usually by the accumulation of excessive fluid in the pleural and peritoneal cavities. As the case develops over a period of two to three weeks, the ventral edema becomes more marked (Fig. 1) and straw-colored fluid may accumulate in the body cavities until the abdomen is distended and breathing labored. Death may occur as a result of respiratory failure due to the large volume of pleural fluid or from general debilitation as a result of the right ventricular failure. The incidence of this type of heart failure in Montana cattle is highest on moist mountain valleys. Eighty-one of 113 cases observed over a seven year period occurred in cattle that were maintained at altitudes of 1525 m or below. This paper describes the conditions under which the disease occurs in Montana and compares the hemograms of clinically ill and healthy cattle.
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PMID:Right ventricular heart failure of Montana cattle. 63 18

Following episodes of pulmonary embolism, the presence of thrombi in the pulmonary arteries leads to severe respiratory insufficiency and chronic right heart failure. We have operated upon 16 such patients, nine men and seven women from 23 to 68 years of age. All had severe dyspnea, 14 had chronic cor pulmonale, six had mental disturbances with syncope, and four had severe cardiac failure. The presence of clots was demonstrated by pulmonary angiography, and the permeability of the distal arterial bed was ascertained by selective injection of the bronchial arteries. In all cases but two a lateral thoracotomy was used so that the obstructed arterial branches could be approached distally. The inferior vena cava was always ligated to prevent recurrences. There were six operative deaths, three from cardiac failure, one from acute pulmonary edema, one from hemothorax, and one following a pyothorax. Ten patients are surviving after 6 months to 10 years. One is still limited because of significant pleuropulmonary sequelae. Six are enjoying good results with marked improvement in their functional limitations, a significant drop in the pulmonary artery pressure, and radiological permeability of previously obstructed arteries. Three are excellent condition--completely asymptomatic.
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PMID:Surgical correction of chronic postembolic obstructions of the pulmonary arteries. 70 66


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