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

Pulmonary function and cardiopulmonary complications were studied in a group of 40 patients with cystic fibrosis who reached the age of 25 years. Mean values for vital capacity (VC), functional residual capacity, residual volume (RV), the ratio of RV over total lung capacity (RV/TLC), conductance, and the ratio of the forced expiratory volume in one second over VC were abnormal. There was a variable pattern of progression from patient to patient. The men differed from the women only in that they had a significantly larger TLC and inspiratory capacity than the women. The resultant preservation of VC may have an advantage for survival in those patients in whom it is observed. Pseudomonas aeruginosa was encountered with increasing frequency with age. Massive hemoptysis did not result in early death. The occurrence of rightsided heart failure secondary to cor pulmonale, with or without respiratory failure, was a poor prognostic sign.
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PMID:Pulmonary function and morbidity in 40 adult patients with cystic fibrosis. 10 32

Pulmonary infarction is a very uncommon cause of pneumothorax. The authors report two patients with pneumothorax arising as a complication of pulmonary infarction. One was a 72-year-old man who had hemoptysis, pleural effusion, and alveolar condensation. Four days later he developed a hydropneumothorax and pulmonary cavitation. He died of heart failure. The pulmonary infarction was not septic in this case. The other patient was a 12-year-old boy who suffered a septic embolism with cavitation as a result of an infected wound. He later developed a tension pneumothorax and died in a state of shock. The authors have found only 16 cases of pneumothorax as a complication of pulmonary infarction in the literature. It is surprising that, even though all infarctions are in contact with the pleural surface, the incidence of pneumothorax is not higher. The infarctions may or may not be septic. Cavitation is not necessarily present, though infarctions are usually cavitated before pneumothorax develops. Tension pneumothorax occurs in some cases.
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PMID:[Pulmonary infarction as a cause of pneumothorax: report of two cases (author's transl)]. 47 Apr 94

Aneurysms of the pulmonary artery are very rare, very few have been reported in medical literature. It is the purpose of this paper to present and discuss 7 cases. The etiology was congenital in 2, syphilitic in 2, cystic medionecrosis in 1, and mycotic in 2. The diagnosis was confirmed by necropsis in 3, and by angiography in 4. The basic clinical aspects are hemoptysis, pulmonary ejective murmur, and the radiological findings. The evolution depends on the etiology. The mycotic aneurysms ruptured and the patient with cystic medionecrosis died in heart failure. One of the syphilitic aneurysms died from an unrelated cause, and the others are alive and asymptomatic. The medical treatment is determined by the etiology.
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PMID:[Aneurysm of the pulmonary artery. Analysis of 7 cases]. 119 Aug 98

The autopsy findings and clinical features in 60 patients with fatal pulmonary embolism (PE) in University College Hospital, Ibadan, between 1985 and 1989 are analysed in the current study. Pulmonary embolism occurred in 3,8 pc of all autopsied patients during this period. There was a male to female ratio 1,4 to one and average age was 47 years. Malignant neoplasms, infections and cardiac failure were the leading predisposing factors to PE identified. The ante-mortem clinical features consisted largely of non-specific respiratory symptoms of dyspnoea, cough, chest pain and haemoptysis. Of these patients, 15,6 pc were diagnosed ante-mortem as having PE. Pulmonary infarction occurred in 13,3 pc of the cases and was commoner in females and in patients with underlying cardiac diseases. This study emphasises the need for a high clinical index of suspicion to improve the antemortem diagnosis of this potentially fatal condition and to advocate a greater use of prophylactic anti-coagulant therapy in high risk patients.
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PMID:Pulmonary embolism in Ibadan, Nigeria: five years autopsy report. 130 38

A report of a rare case of successful repair of rupture of an aortic aneurysm into the pulmonary artery. A 55-year-old male was transferred to our hospital because of dyspnea with sudden onset, hemoptysis and palpitation. A loud, continuous, "machine-like" murmur was heard on the anterior wall of the chest. Various examinations revealed an acquired shunt between the thoracic aortic aneurysm and the pulmonary artery and high-output heart failure. Aortic arch replacement was performed expeditiously and the patient recovered, and was able to return to work. 108 cases of rupture of a thoracic aortic aneurysm into the pulmonary artery have been reported in the literature. Operation for repair was performed in only thirteen of these. Only four cases have been reported in the literature in which the patients were successfully treated.
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PMID:[A case of successful repair of aorto-pulmonary artery fistula secondary to aortic arch aneurysm]. 162 Sep 99

Endovascular infections that involve the right side of the heart present their own unique etiologies, pathophysiologies, clinical manifestations, and therapeutic issues. The pathology of the vegetations of right-sided endocarditis is identical to that of left-sided endocarditis. These vegetations are irregular, friable masses of varying size the contain platelets, fibrin, RBCs, and microorganisms. These lesions serve as a nidus for deep-seated infection and produce sustained bacteremia. Right-sided endocarditis occurs in 5% to 10% of all cases of endocarditis. The most common predisposing factors are IV drug abuse and congenital heart disease. S. aureus is the most common pathogen. The clinical manifestations include fever, chills, rigor, dyspnea, pleuritic pain, productive cough, and hemoptysis. The cardiac manifestations can be notably absent early in the course of the disease, with only 20% of patients initially showing a significant murmur on physical examination. Peripheral embolic lesions can be seen. Echocardiography is helpful in identifying vegetations on the tricuspid valve in a significant proportion of patients. The chest radiograph is characteristic, showing features typical of multiple septic pulmonary emboli. The radiograph shows multiple, small, fuzzy, patchy, peripherally located densities that can change rapidly on serial films. Complications of right-sided endocarditis include pulmonary infarction, pulmonary abscess, progressive right-sided heart failure, and renal abnormalities. The treatment of right-sided endocarditis includes prolonged therapy, with high doses of IV bactericidal antibiotics. Four weeks of antibiotic therapy is generally required, but newer regimens using combination antibiotic therapy can be successful in sensitive strains of viridans group streptococci and S. aureus. Surgical resection of the tricuspid valve is recommended for organisms that do not respond to initial antibiotic therapy, fungal endocarditis, resistant relapsing organisms, or coexistent infection with S. aureus and P. aeruginosa. The prognosis of right-sided endocarditis is generally favorable when compared with left-sided endocarditis. The prognosis is especially favorable in IV drug abusers infected with S. aureus. Patients infected with fungal organisms, Pseudomonas or Serratia, have a worse prognosis. The presence of significant right-sided heart failure also imparts a worse prognosis.
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PMID:Endovascular infections arising from right-sided heart structures. 173 55

123 patients with small cell lung cancer (SCLC) presented to the National Cancer Center Hospital (Tokyo) between 1978 and 1986. 22 of 71 patients with limited stage disease (LD) and none of 52 patients with extensive disease (ED) survived for 3 years. 15 of the 22 three year survivors had significant late complications. All patients received chemotherapy and either thoracic irradiation, resection or both. No prophylactic cranial irradiation was given. 4 patients developed cardiac failure, 2 with a dilated cardiomyopathy, despite the fact that no patient received over 420 mg/m2 of doxorubicin. 12 patients of the 17 who received thoracic irradiation developed radiation pneumonitis and 3 required hospitalisation for severe haemoptysis (2) or cavity formation (1). 1 patient who received nimustine developed a fatal myelodysplastic syndrome and 2 additional patients developed second primary tumours in the oesophagus (1) and stomach (1). Mild peripheral neuropathy (WHO grade 1) was persistent in 3 patients and asymptomatic azotemia (WHO grade 1) in 7. Despite advances in the treatment of SCLC there are very few asymptomatic long-term survivors.
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PMID:Late toxicities and complications in three-year survivors of small cell lung cancer. 185 18

An analysis of 500 consecutive pulmonary tuberculosis cases shows that lower lungfield tuberculosis occurs in 6.8 percent of the negroid population studied and therefore shows no racial predelection. The ratio of female to male involvement was 3:1. A clear association with young women and with pregnancy with or without other infections was demonstrated. Affected men were in the much older age group. Some association with diabetes and heart failure were also observed. The initial diagnosis of most of these patients was basal pneumonia or lung abscess. Therefore, the most useful clinical pointers were productive cough with or without haemoptysis unresponsive to various conventional antibiotics. The right base was most favoured and cavitation with fluid levels were frequent. We believe that the aetiological factors would include stress as could occur with pregnancies and poor basal tissue oxygenation due to diminished basal expansion in abdominal distension or cardiac failure.
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PMID:Lower lungfield tuberculosis in a rural African population. 206 90

A 62-year-old man was admitted to the hospital because of massive hemoptysis. Chest X-ray film, CT scan and IADSA demonstrated a large aneurysm of the thoracic aorta, extending from the ascending aorta to the descending aorta. Bronchoscopy revealed bleeding from left B1+2. Six days after the onset, replacement of the thoracic aorta with woven Dacron prosthetic graft, autoclaved after immersion in albumin, was performed with cardiopulmonary bypass and separate cerebral perfusion (700 ml/min) under moderate hypothermia (25 degrees C). Left upper lobe of the lung, adherent tightly to the posterior and medial wall of the aneurysm, was not dissected because bleeding from left bronchus was trivial even after systemic heparinization. Because of the cardiac dilatation, delayed chest closure was needed. Postoperative cardiac failure, necessitating much catecholamine support, was seen with gradual improvement and no neurological deficit was recognized. He was discharged from the hospital without any sequelae 2 months after the onset. Pathologic diagnosis was an atherosclerotic aneurysm.
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PMID:[Successful surgical treatment of ruptured thoracic aortic aneurysm into the lung]. 223 2

From March 1978 through July 1985, 23 patients underwent implantation of 24 intraluminal ringed prostheses (IRP). There were 18 men and 5 women, with a mean age of 54.7 years, range 15-74 years. Eleven IRP were placed in the ascending aorta, two in the transverse arch, and 11 in the descending aorta. Pathology included acute aortic dissection in four patients, chronic dissection in four, and aortic aneurysm in 16. There were eight hospital deaths (35%). Causes of death included acute cardiac failure in seven patients, and ruptured abdominal aortic aneurysm in one. IRP complications requiring revision included right coronary artery occlusion in three of 11 patients (27%) with an IRP in the ascending aorta. Graft revision was also required in three of 11 IRP implanted in the descending aorta (27%), due to graft occlusion in one and graft stenosis in two. Of the six patients with IRP complications, there were three hospital deaths (50%). All 15 hospital survivors were followed for a mean of 68.5 months, range 5-112 months. There were four late deaths (26.7%). Causes of late death included hemoptysis in one, cardiomyopathy in one, and aortic redissection and rupture in two. We conclude that patients undergoing repair of aortic pathology with IRP have an important risk of early phase events, as technical problems can occur due to malposition and slippage of the securing rings.
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PMID:Events following implantation of an intraluminal ringed prosthesis in the ascending, transverse, and descending thoracic aorta. 225 97


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