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

In a patient suffering from obstructive cardiomyopathy (IHSS), the onset of septicaemia due to staphylococus aureus was accompanied: 1. by the appearance of massive mitral incompetence and of cardiac failure; 2. by a marked reduction in the left intra-ventricular pressure gradient; 3. by acute reversible renal failure (interstitial nephritis); 4. by a glomerulonephritis with immune complexes deposits. After the septicaemia had been treated, replacement of the mitral valve by a disc prosthesis of Lillehei was carried out. Twenty months after the operation, the patient was completely asymptomatic, and catheterisation showed that the left intra-venticular pressure gradient had disappeared, as had the haemodynamic signs of cardiac failure.
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PMID:[Endocarditis due to staphylococcus aureus during cardiomyopathy]. 41 81

Long-term results of operation for IHSS were reviewed in 124 patients operated upon between 1960 and 1975. Most patients improved symptomatically and manifested marked reduction in LV outflow gradient at rest postoperatively. However, ten (8%) patients died of causes related to operation, 14 (12%) had persistent or recurrent severe functional limitation, and 11 (9%) died up to 13 years postoperatively due to hypertrophic cardiomyopathy. Overall annual mortality rate was 3.5% and was 1.8% for late deaths alone. Of 11 late postoperative deaths, six were sudden and five were due to chronic heart failure. Atrial fibrillation was significantly more common in patients who died late postoperatively than in survivors. Nine of the 11 late deaths had associated medical problems that may have contributed to their outcome. In conclusion, long-lasting clinical improvement occurred in most patients who survived operation for IHSS. However, 12% of patients deteriorated clinically over the 5.2 year average follow-up, and there is continued, small annual mortality.
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PMID:Long-term clinical course and symptomatic status of patients after operation for hypertrophic subaortic stenosis. 56 64

Results of aortoventriculoplasty (AVP) are reported in 21 patients with various types of left ventricular outflow tract obstruction (LVOTO). The concept of AVP is based on creating a surgical aortoseptal defect which is patched to provide the largest possible outflow tract to the left ventricle. Lesions consisted of isolated diffuse fibromuscular subaortic stenosis in six patients, diffuse subaortic stenosis and associated other cardiovascular anomalies in five, hypoplastic aortic anulus in two, idiopathic hypertrophic subaortic stenosis (IHSS) in two, and stenosis of a previously implanted aortic valvular prosthesis in three patients. Ten patients had had at least one unsuccessful previous surgical attempt to relieve the LVOTO. The coexisting mitral incompetence in IHSS disappeared after AVP alone. Immediate postoperative hemodynamic results were excellent in all cases. Postoperative death in five patients was due to advance myocardial failure in two, brain damage in one, transection of a dominant septal artery in one, and severe acidosis with renal failure in the last case. However, in the last 16 patients (17 operations) the only death (5.8 percent) was that caused by uncontrollable acidosis. Follow-up results indicate that 16 patients are clinically doing well, and hemodynamic studies in 14 patients are rated as excellent or good from 1 to 25 months postoperatively. It is concluded that AVP is an effective operation for managing all types of LVOTO and can be used routinely with an acceptably low mortality rate.
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PMID:Results of aortoventriculoplasty in 21 consecutive patients with left ventricular outflow tract obstruction. 56 45

20 patients with hypothyroid cardiomyopathy were evaluated by M-mode echocardiography. The mean interventricular septum (IVSd) thickness was 1.94 cm before treatment and was reduced to 1.21 cm after 4-6 months of thyroxin therapy. The mean left ventricular posterior wall (LVPWd) thickness was 1.14 cm before and 1.05 cm after treatment. The IVS/LVPW ratio decreased from 1.7 to 1.15 within 4-6 months. Pericardial effusion was demonstrated in 15 of the patients, but disappeared during thyroxin therapy. The study confirms the importance of examining for hypothyreoidism in the case of patients with symptoms of heart failure of unknown cause, and of patients with echocardiographic evidence of asymmetric septal hypertrophy (ASH) and idiopathic hypertrophic subaortic stenosis (IHSS).
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PMID:[Hypothyroid cardiomyopathy--an underdiagnosed cause of heart failure]. 214 58

Diastolic dysfunction is being recognized increasingly as a primary cause of congestive heart failure. It may result from physiological abnormalities of myocardial relaxation, or anatomical abnormalities which increase resistance to ventricular inflow. With regard to physiological abnormalities, there is substantial evidence to indicate that myocardial ischaemia and hypertrophy are two conditions characterized by impaired inactivation and relaxation of myocardial cells. These conditions often co-exist in patients with idiopathic hypertrophic subaortic stenosis or calcific valvular aortic stenosis. Recent evidence also suggests a role for calcium overload in the diastolic dysfunction seen in some patients with advanced congestive heart failure. Diastolic dysfunction may be of fundamental importance in the pathophysiology of flash pulmonary oedema in patients with advanced ischaemic heart disease, since myocardial ischaemia in such patients may lead to a decline in relaxation rate, increased resistance to early diastolic filling and further impairment in diastolic coronary blood flow due to intramyocardial compression of capillaries and venules. During the transient ischaemia of angina pectoris, patients with multivessel coronary artery disease often show a striking upward shift in the left ventricular diastolic pressure-volume relationship, signifying a marked decrease in distensibility of the left ventricular chamber. With regard to anatomical abnormalities, diastolic dysfunction in heart failure may result from structural changes within the ventricular wall. Diastolic dysfunction of the left ventricle may result from extrinsic compression by pericardial effusion (tamponade), pericardial constriction, and right ventricular overload. Thus, a variety of physiological and anatomical abnormalities may lead to increased resistance to diastolic filling of one or both ventricles, resulting in diastolic heart failure.
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PMID:Diastolic function and heart failure: an overview. 218 38

Forty patients with idiopathic hypertrophic subaortic stenosis have been studied. It was established that these patients had early signs of cardiac insufficiency (cardiac palpitations, fainting fits, dyspnoea) as a result of morphological changes in the myocardium (micro- and macrofocal cardiosclerosis). With the aid of contrast methods of investigation and phonography it was shown that in microfocal cardiosclerosis the index of the systolic murmur varies from 0.5 to 3, the planimetric index from 0.8 to 1.0. In macrofocal cardiosclerosis from 1.5 to 0 and less than 0.8, respectively.
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PMID:[Clinicodiagnostic aspects of idiopathic hypertrophic subaortic stenosis]. 719 66