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

In guinea-pigs, the oral and subcutaneous LD50 values were very similar (cf. 0,173 mg/kg over 48 h with 0,116 mg/kg over 24 and 48 h). When dosed subcutaneously, a cumulative effect was observed. Intravenous administration of cotyledoside to anaesthetized guinea-pigs resulted in: dyspnoea, increased heart rates and blood pressures, and electrocardiagraphic changes typical of cardiac glycoside poisoning. A positive cardiac inotropic effect was succeeded by a positive chronotropic one. In sheep, acute and subacute intoxication resulted in ruminal, respiratory and cardiac changes. The signs included ruminal stasis, cyanosis, cardiac arrhythmia, ectopic foci and AV dissociation, followed by hypotension and progressive respiratory and cardiac failure. The skeletal muscles were affected in only 1 sheep vide infra. In chronically intoxicated sheep typical clinical signs of "krimpsiekte" developed, e.g. weakness, reluctance to stand, unsteadiness on feet, tremor and paresis of hindquarter muscles, paresis of the neck, arching of the back and standing with the feet close together. Respiratory function was affected in all 3 cases; ruminal stasis, with concomitant loss of appetite occurring in one, and a transient change in heart function in another. The syndrome induced by acute cotyledoside poisoning is similar to that of other cardiac glycosides, but the paretic signs of chronic intoxication resemble "krimpsiekte", a disease associated only with intoxication with the plants of the family Crassulaceae.
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PMID:Studies on South African cardiac glycosides. II. Observations on the clinical and haemodynamic effects of cotyledoside. 718 41

A newborn baby is admitted in the second week of life with osteomyelitis and septicemia due to Staph. aureus infection. In his tenth week of life--the osteomyelitis nearly overcome--the infant shows signs of heart failure with a murmur and cyanosis. Cardiac catheterization reveals tricuspid insufficiency and thrombosis of the right pulmonary artery. Postmortem examination shows isolated polypous endocarditis of the tricuspid valve together with thrombosis of the right and recent embolus of the left pulmonary artery. A similar case has to the best of our knowledge not been described.
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PMID:[Isolated endocarditis of the tricuspid valve in early infancy]. 720 2

Thirteen of 308 patients (4.2%), who had received right-sided valved extracardiac conduits at the Mayo Clinic from November, 1972, to April, 1977, have required conduit replacement because of obstruction. Patients were 5 to 16 years old at initial operation and 8 to 20 years old at reoperation; the duration of conduit implantation was 27 to 79 months (mean 50). Four patients (31%) were asymptomatic; exertional dyspnea was present in eight (62%) and dizziness was reported in one (8%). Signs of conduit obstruction included increasing intensity of murmurs in 11 (85%), cyanosis in two (15%), and heart failure in one (8%). Peak pressure gradients from the right ventricle to the pulmonary arteries ranged from 50 to 140 mm Hg (mean 87) and correlated well with the degree of conduit obstruction. Catheter pullback allowed accurate localization of stenosis within the conduit, whereas angiography alone did not. The site of major obstruction was in the proximal conduit in five (38%), at the valve in nine (69%), and in the distal conduit or side branches in six (46%); stated differently, major stenosis affected the valve alone in five (38%), the graft alone in four (31%), and both the valve and the graft in four (31%). Valvular changes leading to stenosis included thrombosis, commissural fusion, and calcification, and changes consistent with insufficiency included tears, fusion of cusps to the conduit wall, and, in one case, infective endocarditis. Within the conduit, nonvalvular obstruction was due to formation of a thick fibrous peel (or neointima). Progressive thickening of the peel appeared to be due to organization of thrombus between the peel and conduit and not due to luminal mural thrombus. In one case, the peel formed a flap-valve, causing even further obstruction. Since many patients are asymptomatic, and since late conduit stenosis may develop unpredictably by several mechanisms, long-term follow-up is necessary.
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PMID:Clinicopathological correlates of obstructed right-sided porcine-valved extracardiac conduits. 720 68

Total anomalous pulmonary venous drainage is one of the cardiac malformations requiring early surgical correction. In our series of nine cases, 89% were under three months of age and none above six months. Clinically, two types were present: without obstruction and with obstruction to the pulmonary venous flow. In the non obstructive group, all had mild cyanosis, heart failure, cardiomegaly and systolic murmur. In the obstructive group, they had severe cyanosis, heart failure, small heart and pulmonary fields with a "ground glass" or mottled appearance on chest X-ray due to hypertension and edema. The second heart found was split in both groups. An increased right sided O2 saturation and pulmonary hypertension are due to the total anomalous pulmonary venous connection to the right atrium. Right atrium pressures were superior than left atrium pressures in two patients, requiring atrioseptostomy in one patient. Total surgical correction was performed in three patients, with one patient surviving; this patient is well one year after operation. It is noteworthy in our series the early symptomatology. Symptoms begun at birth in 77% of the cases. It was striking as well the absence of cases with drainage to the right atrium or the coronary sinus.
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PMID:[Total anomalous pulmonary venous drainage. Nine case reports (author's transl)]. 721 68

A 10 years old school boy, who had been known to have a small ventricular septal defect from 2 months after birth, was admitted to us with a diagnosis of subarachnoid hemorrhage on October 24, 1978. On admission, neurological examination revealed mild right hemiparesis and miotic pupils in semicomatose state, and thrilling, that was equivalent to Levine III, pansystolic murmur and cyanosis of nails were noticed. By CT scan, intraventricular hemorrhage originated from hemorrhage in the basal ganglia was shown and the left CAG revealed an arteriovenous malformation in the left basal ganglia. Electrocardiogram showed mild cardiac failure and chest x-ray showed pulmonary congestion. Neurological symptoms and abnormal cardiopulmonary changes made well manageable after bilateral ventricular drainage. Twenty four cases of arteriovenous malformation associated with congenital heart disease were reviewed in the reported literature, and 20 cases were found to combine with Galenic aneurysm with congenital heart disease. All of those cases had been in a little pause after the birth and the most of congenital heart diseases were of patient ductus arteriosus. The rest of cases including our present case were 4 cases, who had rather small arteriovenous malformation, and the severity of the congenital heart disease was attributable to the patients mortality. In all of the report at present only our case was the single survival. Embryological investigation on arteriovenous malformation of the brain and congenital heart disease indicated that association of both conditions could be attributable to the vascular malformation in a very limited gestational stage, and that the incidence should be much less than reported. Our case showed the intracranial hypertension was found to create serious cardio-pulmonary dysfunction when congenital heart disease being accompanied, and it was presumably relating to the relatively higher incidence of Galenic aneurysm associated with ductus arteriosus.
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PMID:[Arteriovenous malformation associated with congenital heart disease, with a remark on accompanying cardiopulmonary dysfunction (author's transl)]. 724 22

Pulmonary vascular disease and heart failure are the two major problems in complete transposition of the great arteries (TGA) with increased pulmonary flow. Hypertensive pulmonary vascular disease was observed in patients with complete TGA and increased flow (3.6%) as well as in those without increased pulmonary flow (3.3%). An intact ventricular septum or pulmonic stenosis did not appear to prevent the occurrence of progressive pulmonary vascular disease in all patients. The pulmonary lesion observed in these subjects cannot be explained by chronic severe volume overload alone. Clinically unrecognized pulmonary microthrombi are an additional cause for the development of pulmonary vascular disease in patients with complete TGA. Therefore cyanosis and its complications can be a major factor beside increased pulmonary flow in causing pulmonary vascular changes. Early corrective surgery performed after the age of 3 months is the therapy of choice to avoid progressive pulmonary vascular damage and other thrombo-embolic accidents.
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PMID:[Hypertensive pulmonary vascular disease in complete transposition of the great arteries (author's transl)]. 726 36

Persistent fetal circulation ("PFC") is a condition characterized by perduring after birth of fetal hemodynamic pattern: persistence of high pulmonary vascular resistance then occurs. "PFC" is a high mortality syndrome recently recognized as a cause of severe cyanosis and tachypnea in full-term newborns. Perinatal hypoxia, hyperviscosity, acidosis etc, may be also responsible of a persistence of high pulmonary vascular resistance. The increased right heart pressures cause a right to left shunt across the ductus arteriosus and foramen ovale not yet completely closed at birth. In this paper the clinical and angiographic evaluation of two full-term newborns, males, 5 days and 5 months old, are described, who presented with tachypnea, cyanosis and heart failure. Moreover we want to make a critical review of medical literature about this subject. The electrocardiogram of both patients showed right ventricular hypertrophy and myocardial ischemia. The chest roentgenograms showed cardiac enlargement and increased pulmonary vascular markings. Lung and central nervous system disorders were excluded by clinical and instrumental exams. Both patients underwent cardiac catheterization and angiocardiography in order to exclude a congenital heart disease. There was just evidence of pulmonary vascular resistance and right to left shunt at ductal and atrial level. O2 100% administration in one patient determined a decrease in pulmonary resistance and the shunting abolition. Clinical and hemodynamic patterns of this syndrome are very different. There are "simple forms" with normal myocardial function and "complex" higher mortality forms with evidence of cardiac involvement. It is often difficult to distinguish such forms from the other causes of central cyanosis and/or cardiac failure in the newborn as transposition of the great arteries, total anomalous pulmonary venous connection: the individualization of the syndrome then may be impossible without cardiac catheterization. A correct diagnosis for a precocious and reasonable treatment are extremely important for the survival of such critical newborns.
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PMID:[Persistence of fetal circulation. Clinical and angiographic evaluation of two cases. Review of the literature (author's transl)]. 734 16

The sequential chamber analysis and angiographic, hemodynamic and clinical features, including those seen on electrocardiography, are presented in 18 patients with a univentricular heart of right ventricular type. In all cases a main chamber with a right ventricular trabecular pattern received both (or the sole) atrioventricular (A-V) connections, and a rudimentary chamber with a left ventricular trabecular pattern receiving no A-V connection was also present. The 18 patients were seen between 1971 and 1979; 6 died and the diagnosis was confirmed at autopsy. Twelve patients had double inlet, four absent right and two absent left A-V connections. Electrocardiography revealed right ventricular hypertrophy in all, and 11 had a superior mean frontal QRS axis. Chest roentgenography disclosed dextrocardia in 7 and levocardia in 11. Of 12 infants presenting with a marked decrease in pulmonary flow, 10 presented as ill neonates with hypoxia and acidosis. Four infants with increased pulmonary flow presented before 8 weeks with heart failure and mild cyanosis. Two with moderate pulmonary stenosis had mild cyanosis, but were asymptomatic. All had associated cardiac anomalies, pulmonary stenosis and persistent ductus arteriosus being the most common. For accurate diagnosis, angiographic demonstration of a posterior rudimentary chamber in addition to the main chamber of right ventricular trabecular pattern is mandatory.
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PMID:Univentricular heart of right ventricular type: clinical, angiographic and electocardiographic features. 741 90

Ten cases with pumonary atresia with intact interventricular septum were studied; they were divided in type I (6 cases) and type II (4 cases). In the cases with necropsy no distinct characteristics were observed in comparison to those reported in the literature. Cyanosis, heart failure, cardiomegaly and pulmonary oligohaemia were present in all cases. No correlation was found neither between right atrial middle pressure and the P wave amplitude (r = 0.014), nor between the AQRS and the right ventricular systolic pressure (r = 0.039). All the cases from type II showed hypertrophy of the two ventricles and only one case from type I showed right ventricular hypertrophy. In nine cases right ventricular hypertension was registered. Right atrial middle pressure and right ventricular telediastolic pressure were found increased in nine cases; the other one showed normal values (type II). The angiocardiographic study is a necessary diagnostic procedure. By means of it is possible to determine the ventricular cavity size, the right ventricular infundibulum characteristics and the atresic segment size.
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PMID:[Pulmonary atresia with intact interventricular septum]. 741 70

Prostaglandin E1 (PGE1) has been used prior to operation in 28 neonates (0 to 30 days) with congenital heart disease (CHD). The patients were divided into two groups. Group I consisted of 19 neonates with CHD resulting in marked cyanosis. Thirteen patients had pulmonary atresia, three had tetralogy of Fallot, and three had complex defects with pulmonary stenosis. All patients were markedly hypoxemic. The average oxygen saturation was 41%. PGE1 infusion, 0.1 mcg/kg/min, was successful in 17 of 19 patients, as it resulted in an increase in oxygen saturation from 41% to 79%, average increase 38%. Two patients did not respond to PGE1 infusion. One was 30 days of age and the other had no patient ductus arteriosus. All of the patients underwent a palliative shunt procedure. There were three hospital deaths in this group. No patient died of hypoxemia. Group II consisted of nine patients whose CHD was predominantly that of aortic obstructive disease with clinical manifestations of cardiac failure, hypoperfusion, and acidemia. Six of these patients had complicated coarctation of the aorta. Three patients had interruption of the aortic arch. The pH of these patients averaged 7.19. PGE1 infusion resulted in improvement of the pH to average of 7.37, improvement of congestive heart failure, and reappearance of femoral pulses. One patient failed to respond. All patients in Group II underwent operation. There were three hospital deaths in this group. No patient died intraoperatively. PGE1 infusion is a valuable aid to surgical treatment of desperately ill neonates with both cyanotic and acyanotic forms of CHD.
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PMID:Prostaglandin E1 as an adjunct to emergency cardiac operation in neonates. 745 32


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