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

A retrospective study of adults with Eisenmenger syndrome assessed at a tertiary referral center was performed to identify clinical characteristics and establish prognostic determinants. Mortality and cause of death are reported with baseline clinical data correlated with mortality to identify predictors of death. Clinical events during follow-up, including heart failure, atrial arrhythmia, hemoptysis, and syncope were also reviewed. A total of 109 adults with Eisenmenger syndrome (mean +/- SD age 29 +/- 11 years, 43% men) were followed for a median of 6.3 years. Sixty-six patients (61%) had simple cardiac anatomy (13 atrial septal defect, 43 ventricular septal defect, 10 patent ductus arteriosus). The remainder (43 patients) had complex cardiac anatomy (including atrioventricular septal defect, truncus arteriosus, univentricular heart, and transposition of the great arteries). There were 33 deaths and 9 transplantations during follow-up. Median survival was 53 years. Multivariate Cox regression analysis identified age at presentation (hazard ratio [HR] 0.90), supraventricular arrhythmia (HR 3.44), precordial electrocardiogram voltage (HR 1.61/mV increase), and poor New York Heart Association functional class (HR 2.60) as independent predictors of mortality. There is a large variation in the life expectancy for adults with Eisenmenger syndrome. Baseline characteristics associated with increased mortality include younger age at presentation (associated with complex anatomy), functional class, supraventricular arrhythmia, and an electrocardiogram index for right ventricular hypertrophy.
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PMID:Determinants of survival and length of survival in adults with Eisenmenger syndrome. 1049 38

Pulmonary embolism is nearly always a complication of deep venous thrombosis. The evaluation of risk factors for venous thromboembolism not only aids diagnosis but also guides decisions about the intensity of prophylactic measures. As both the extent and chronicity of pulmonary vascular obstruction vary widely, pulmonary embolism can produce widely differing clinical pictures. From the clinical, pathophysiological and therapeutical point of view, it is convenient to classify pulmonary embolism into four types: acute minor embolism (dyspnoea with or without pleuritic pain or haemoptysis), acute massive embolism (hemodynamic instability), subacute massive embolism (mimicking heart failure or indolent pneumonia), and chronic thromboembolic pulmonary hypertension (slowly progressing dyspnoea). This classification is of importance not only for the rational diagnosis and differential diagnosis, but also for the institution of adequate therapy. Because the disease has many nonspecific manifestations but no pathognomonic symptoms or signs, it is impossible to prove the diagnosis of pulmonary embolism alone on the basis of clinical presentation.
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PMID:[Clinical characteristics of pulmonary embolism]. 1121 69

Pulmonary blastomas are a group of rare malignant neoplasms subdivided into three categories: classic biphasic pulmonary blastoma (CBPB), well-differentiated fetal adenocarcinoma (WDFA), and pleuropulmonary blastoma (PPB). We report herein the cases of two men with CBPB. Both were heavy smokers and presented with a history of hemoptysis. Physical examination revealed slightly significant findings, chest radiographs showed a large pulmonary mass, confirmed by computed tomography, and bronchoscopic biopsies were not diagnostic. A left and right inferior lobectomy was performed and a diagnosis of CPBP was confirmed by histological examination. In the first patient, local recurrence with multiple bilateral lung metastases was found 6 months later and despite chemotherapy, he died of respiratory failure 1 year after his operation. In the second patient, a subcutaneous metastasis was found in the right subscapular region 2 months later, and a cerebral metastasis in the right posterior parietal lobe 4 months later. Partial remission was achieved by cerebral irradiation, but 6 months later the patient died of cardiac failure while in a coma. We conclude that more aggressive and multidisciplinary treatment should be adopted for CBPB, and because of its low incidence, it is important to unify individual experiences in a central registry to gather as much information as possible regarding the biological and clinical features of this unusual disease.
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PMID:Pulmonary blastoma: report of two cases. 1138 9

Massive hemoptysis is a life-threatening emergency that rarely occurs in association with heart failure and is even less frequent when the underlying cause is dilated myocardiopathy. We report the case of a 69-year-old man with undiagnosed heart disease who presented with severe hemoptysis. Images showed evident cardiac insufficiency. The unusualness of the case obliged us to rule out other diseases through differential diagnosis before starting to treat the underlying condition.
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PMID:[Massive hemoptysis secondary to cardiac insufficiency in a context of dilated myocardiopathy]. 1148 Oct 60

Dyspnea, cough, recurrent airway infection, hemoptysis are the most common pulmonary symptoms of mitral valve disease and heart failure. Pathophysiological mechanism of those disturbances is complex and airway status is one of the most important. The aim of the study was to assess airway function disturbances reversibility after mitral valve replacement. The study group consisted of 30 patients qualified to mitral valve surgery. Patients were assessed by clinical cardiac noninvasive investigation and airway function study. Post-operative study was performed minimum 6 months after mitral valve replacement (mean after 8 months) and again after minimum 3 years (mean after 40 months). In most of assessed--22 patients (74%) airway obstruction was noticed, in 8 patients without obstruction nonspecific histamine provocation test was performed. Increased airway reactivity was found in 4 patients only, in another 4 patients (13%) there was no airway function disturbances. After mitral valve replacement significant improvement in all cardiac parameters including NYHA functional class was observed. No airway function improvement occurred. Only small tendency to improve airway function was noticed as far as it concerns VC, FEV1, MEF50, MEF75 iTGV with exclusion of Raw. Analysis after dividing study group into 3 subgroups with increasing airway function disturbances (from predicted to hyperreactivity and obstruction) was also performed. The improvement in airways function was noticed only in 6 patient (20% studied). In patients with mitral valve disease airway function disturbances as obstruction and bronchial hyperreactivity persist in long term follow-up after mitral valve replacement.
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PMID:[Airway function disturbances reversibility after mitral valve replacement]. 1192 57

Two patients, a 72-year-old man and a 34-year-old woman, presented with severe pain in the lower back and abdomen, respectively, accompanied by acute dyspnoea. One patient presented additionally with a palpable pulsatile abdominal mass and a continuous harsh bruit. He subsequently developed massive haemoptysis and went into deep shock. The second patient presented with peripheral cyanosis and a loud systolic heart murmur. She developed increasing respiratory distress and was maximally supported in the intensive care unit. Further investigation revealed acute left-to-right shunting based on rupture of an aortic aneurysm into the venous system in both patients; in the first this was into the V. cava inferior and in the second this was into the right atrium. In both patients, high-output heart failure was present. Acute right heart failure due to a fistula between the aorta and the venous system is a life-threatening and rapidly worsening haemodynamic disturbance. The diagnosis is not difficult but the condition is rare. In some cases, the patient's survival can be achieved by prompt diagnosis followed by operative closure of the fistula.
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PMID:[Acute right heart failure due to aortic aneurysm: 2 patients with an aortocaval shunt]. 1223 63

Pulmonary Embolism (PE) poses an important diagnostic problem in patients with chronic obstructive pulmonary disease (COPD). Indeed PE may aggravate the already precarious respiratory state of these fragile patients. Moreover, these two conditions share common symptoms: dyspnoea, wheezing, pleural pain, haemoptysis, palpitations and signs of right cardiac insufficiency. In two studies, one retrospective and the other prospective, we investigated the incidence of PE in patients with non-infective exacerbations of their COPD. The retrospective study was carried out over two years and involved 50 COPD patients with non-infective respiratory exacerbations. In this population, 10 patients out of 50 (20%) had a documented PE. No predictive factor was identified. The prospective study was conducted over one year and COPD patients admitted to hospital with exacerbations were included in the study if they had a positive D-dimer blood test and no evidence of acute respiratory infection. 31 patients were studied with Doppler ultra-sound examination of the legs and a lung perfusion scan. The presence or absence of PE was determined and the two groups were compared. 9 patients out of 31 (29%) had a documented PE. Six of these nine patients had a deep venous thrombosis (DVT). Two predictive factors of PE were identified: existence of a DVT and a significant fall in PaO(2) from baseline state (DeltaPaO(2) > 22 mmHg). We conclude that PE is a frequent (20 to 30%) of non-infective respiratory decompensation in COPD patients. Faced with an unexplained respiratory exacerbation in these patients, a lung perfusion scan should be routinely undertaken to rule out a PE when the D-dimers are positive.
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PMID:[Pulmonary embolism and sibilant types of chronic obstructive pulmonary disease decompensations]. 1241 52

A 49-year-old female was admitted to our hospital because of worsening of congestive heart failure on November 2000 in a state after insertion of permanent pacemaker for complete atrioventricular block in 1986, followed by a clinical history of chronic heart failure due to dilated cardiomyopathy. After admission, her general condition had been improved, but, she had massive hemoptysis suddenly and died on February 2001. At autopsy, noncaseating granulomas were observed scattering in lungs, liver and spleen, not associated with any infectious lesions, therefore indicating systemic sarcoidosis. In lungs, granulomatous arteritis in small- and medium-sized muscular arteries associated with disputation of the media and elastic laminae were observed, suggesting the direct cause of hemoptysis. This is the extremely rare case of pulmonary arteritis with systemic sarcoidosis resulting the death from massive hemoptysis.
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PMID:[An autopsy case of massive hemoptysis in systemic sarcoidosis with pulmonary granulomatous arteritis]. 1246 21

We describe a 15-year-old asymptomatic girl with multiple pulmonary nodules which turned out to be cavernous hemangiomas. The radiological findings of other organs revealed no abnormalities, excluding the liver, where multiple low-density areas were located. Thoracoscopy and laparoscopy revealed cavernous hemangiomas of the lung and liver. While liver cavernous hemangiomas are common, pulmonary hemangiomas are fairly rare. Although cavernous hemangiomas are classified as malformations, some of these lesions have been reported to grow. In pulmonary hemangiomas, some cases have an inexorable clinical course with hemoptysis, respiratory distress, and heart failure. In our case, the lesions have not remarkably progressed under observation for more than 2 years.
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PMID:Cavernous hemangiomas of lungs and liver in an asymptomatic girl. 1473 99

A 55-year-old man had undiagnosed tetralogy of Fallot with the complications of decompensated heart failure and infective endocarditis, as well as pulmonic involvement secondary to the endocarditis. The patient had a massive hemoptysis and died. This case is a rare insight into the late outcome of this congenital heart disease.
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PMID:Cyanotic tetralogy of fallot with its infective endocarditis complication on the tricuspid and pulmonary. 1474 57


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