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

27 cases of uremia with abnormal appearances on the chest films were analysed. The results showed that the clinical features were cough, expectoration dyspnea and hemoptysis. However, the degree of these symptoms was relatively mild as judged from the amount of pulmonary edema found on the chest films. The chest X-ray finding in these group of patients were characterized by pulmonary blood stasis, interstitial edema of the lung and edematous alveoli. The pathogenesis of uremic lung was said to be related to blood urea nitrogen and creatinine retention and the concurrent presence of left side heart failure may also play a role. Hemodialysis and other comprehensive treatments could help the patients with uremic lung for relief the symptoms. But the fundamental managements to improve the prognosis for this disease are early treatment of the primary renal diseases, in order to prevent the occurrence of renal failure. Kidney transplantation should be advised.
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PMID:[The uremic lung]. 263 29

The case histories of the 49 patients who died in a series of 165 patients admitted to the Medical Unit between 1958 and 1984 with polyarteritis nodosa (PAN) were reviewed. The causes of death of the 29 men and 20 women, mean age 51.44 +/- 7.4 years, were classified into 6 groups. Infection accounted for 26.5% (13/49) of deaths, the initial site of infection being pulmonary, complicated by septicaemia in 6 cases. Cardiovascular events were responsible for death in 24.4% (11/49): terminal cardiac failure (4 cases), myocardial infarction (1 case), ventricular tachycardia (1 case), stroke (1 case), pulmonary embolism (2 cases), fulminant hemoptysis (1 case). Gastrointestinal complications were the cause of death in 16.3% (8/49): ischemic necrosis (5 cases), acute pancreatitis (2 cases), oesophageal ulceration (1 case). Renal failure was observed in 10.2% (5/49), all occurring before 1972: acute renal failure (3 cases), chronic renal failure (2 cases). Cancer was the cause of death in 10.2% (5/49): primary bronchial carcinoma (2 cases), laryngeal carcinoma (1 case), carcinoma of the vulva (1 case), bone metastases (1 case). Finally, 14.2% (7/49) could not be classified in the preceding groups. Sudden death occurred in 3 patients, shock in 1 patient, multivisceral PAN in 2 patients and anaphylactic shock in 1 patient. Three of the 12 patients who had post-mortem studies had signs of progressive vasculitis. The results are compared with other reports in the literature and the pathogenic mechanisms are discussed. The infections and cardiovascular deaths occurred early or late and were not related to the state of the activity of the vasculitis. Immunosuppressive treatment seems to play an important role in their pathogenesis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Causes of death in systemic vasculitis of polyarteritis nodosa. Analysis of a series of 165 patients]. 290 28

A complication is occurred during insertion of a pulmonary artery catheter in a 73-year-old woman with class III NYHA cardiac failure. After easy insertion of the catheter, massive haemoptysis developed as the patient coughed while the balloon of the catheter was inflated. Despite prompt emergency measures, the patient did not survive. Autopsy revealed a 2.7-cm perforation of the proximal pulmonary artery with penetration into the right lower lobe bronchus. This complication and its prevention are discussed.
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PMID:[Catheter induced rupture of a proximal pulmonary artery caused by vigorous coughing in a spontaneously breathing patient]. 291 52

The records of 43 patients older than 18 years presenting with tetralogy of Fallot were retrospectively examined to determine the semiological characteristics of the disease in adults. One or more palliative operations had previously been performed in 27 patients. Full correction was carried out in 38 patients with results described below. Tetralogy of Fallot has the following characteristics in adults as compared with children: clinically, heart failure, attacks of angina, haemoptysis and sequelae of previous complications are more frequent; at electrocardiography, right atrial hypertrophy, right bundle disorders of conduction and ventricular extrasystoles are also more frequent; radiology shows that cardiomegaly is no longer exceptional; haemodynamic studies demonstrate an increase in right atrial and right ventricular end-diastolic pressures. These characteristics indicate a deterioration of haemodynamic adjustment to the disease with age. The operative morbidity mostly consisted of haemorrhages (55% of the patients), more frequent in subjects with permeable anastomoses (p less than 0.01), and heart failure (50% of the patients) the frequency of which increased with the subject's age, the duration of the operation and the use of an infundibulo-pulmonary prosthesis (p less than 0.05). The operative mortality (18%) depended on the extent of the pulmonary stenosis and on the presence of a previous anastomosis (p = 0.04). An analysis of the causes of death reported in the literature showed that in adults the presence of an anastomosis constitutes a separate risk factor in complete repair. The excellent long-term results of corrective surgery concerning cardiac function and survival suggest that except for those rare cases where the operative risk is very high all adults with tetralogy of Fallot should undergo complete repair.
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PMID:[Tetralogy of Fallot in adults. Apropos of 43 cases with 38 total corrections]. 312 10

An accidental rupture of the pulmonary artery in a 77 year old female patient is reported. She was admitted for total mastectomy, but her past medical history revealed an old myocardial infarct, treated arterial hypertension and asthma. She was under heparin as well for her varicose veins. Her clinical examination revealed a patient in mild chronic heart failure. It was therefore decided to carry out invasive monitoring during surgery and the recovery period. A Swan-Ganz catheter was put up. Its progression was controlled by looking at the pressure curves. Several attempts were made to obtain a wedge pressure, with no success. During these attempts, the patient developed a cough followed by massive haemoptysis. Despite adequate resuscitative measures, the patient died before a surgical procedure could be attempted. Postmortem examination showed the rupture to be 9 cm away from the origin of the pulmonary artery. This unfortunate accident confirmed that the following three factors, all present in this patient, should call for extreme care in the setting-up of Swan-Ganz catheters: age greater than 60 years, pulmonary arterial hypertension and anticoagulant therapy.
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PMID:[Perforation of the pulmonary artery during the insertion of a Swan-Ganz catheter]. 320 33

Left ventricular aneurysm is a common sequela of anterior myocardial infarction. At the time of coronary artery bypass grafting, resection of this aneurysm is frequently undertaken to alleviate symptoms of heart failure and/or refractory ventricular tachycardia. Complications related to aneurysmectomy are uncommon. We describe an unusual patient who presented with hemoptysis related to the formation of a pseudoaneurysm which communicated with the lung parenchyma. The etiology of the pseudoaneurysm formation was an indolent, slow-growing infection.
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PMID:An unusual complication of left ventricular pseudoaneurysm: hemoptysis. 259 57

Due to the lack of specificity of the clinical picture in the right-sided infective endocarditis, the correct diagnosis is rarely made. We reviewed 30 cases with right-sided or right and left infective endocarditis, treated in the INC from 1946 to 1982. The average age was 20 years. Rheumatic fever (53%), congenital heart disease (40%) and cardiac prostheses (7%) were the more common underlying diseases. The diagnosis was made on an average 7.3 months after the first symptom. Heart failure (93%), fever (76%), weight loss (73%), haemoptysis (66%) and general malaise (53%) were the predominant symptoms. There was no diagnostic suspicion in 9 patients (30%) and in 7 from 16 with negative blood culture, the infection was exclusively right-sided. Peripheral and pulmonary embolism was the most frequent complication. (66%) There were 29 deaths (96.6%). In all of them the diagnosis was confirmed in the postmortem examination. Heart failure and septic shock were the main causes of death. Almost all patients were infected with gram-negative germs and staphylococcus Aureus. This diagnosis should be suspected in a patient with known heart disease, who develops unexplained heart failure, moreover if pulmonary emboli are a feature. The diversity of the isolated germs is different from other publication that have shown staphylococcus as the most prevalent microorganism. This difference can be explained by the lack of drug abuse in our cases. The mortality rate is higher than in the left sided endocarditis.
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PMID:[Right infectious endocarditis. Study of 30 cases]. 674 36

Quantification of heart failure is possible with hemodynamic parameters such as cardiac output and filling pressure at rest and during exercise. These parameters can easily but invasively be achieved by floating catheter measurements. In our experience, the risk of this method is low but existent. In greater than 20 000 patients with chronic diseases no death occurred in connection with the procedure; 26 patients developed ventricular fibrillation or ventricular tachycardias which made defibrillation necessary in 10 of these patients. In three patients asystolia demanded resuscitation. Hemoptysis did not occur. In the acute stage of a disease, e.g. in the acute myocardial infarction, the risk may be higher, especially if the catheter remains in the circulation for longer periods. The possibilities and limitations of the method will be discussed for the following patient groups: (1) Patients with acute myocardial infarction, (2) Postinfarction patients, (3) Patients with cardiomyopathies, (4) Patients with valvular heart disease.
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PMID:Does exercise testing with invasive measurements of cardiac output and pressure really contribute? 684 Jan 19

The most important and consistent symptom of acute PE is the sudden onset of dyspnoea unexplained by pneumonia, heart failure, pneumothorax, or exacerbation of airway obstruction. The features commonly remembered such as haemoptysis and pleural rub may be absent in up to two thirds of patients. With previous cardiorespiratory disease the signs and symptoms become nonspecific and a relatively minor PE can produce clinical features more suggestive of a large embolus. Hypoxia and a raised respiratory rate are also suggestive but cannot be relied upon if there is pre-existing cardiorespiratory disease or in the elderly. Although the radiological appearance of an infarct shadow may be recognized, the chest X-ray is frequently nonspecific or normal. A negative perfusion scan excludes any significant emboli and an abnormal perfusion scan is suggestive of PE but not diagnostic; its specificity can be increased considerably if facilities are available for a concurrent ventilation scan. A deep venous thrombosis when present is also indicative of PE, although its absence does not preclude the diagnosis. Factors predisposing to deep venous thrombosis are usually present in the patient with PE. No single diagnostic aid can be relied upon in the diagnosis of PE. As with many illnesses much of the evidence begins with a careful consideration of the presenting history and physical signs. Further help can be obtained from various investigations, but results must be interpreted with consideration of the patient's age and pre-existing health. The final diagnosis may need to be established by pulmonary angiography.
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PMID:Diagnostic criteria for pulmonary embolism. 701 62

Heart failure is not a common manifestation of hypothyroidism if there is no underlying heart disease. We report a case of familial primary hypothyroidism in a young male, that clinically onset with dyspnea, hemoptysis and serum CPK elevation, and in which further explorations revealed a dilated cardiomyopathy due to hypothyroidism. Because of its bad prognosis, we underline the need to identify those cases of dilated cardiomyopathy that can be treated with the appropriate therapy.
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PMID:[Heart insufficiency as first manifestation of familial primary hypothyroidism]. 938 Sep 39


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