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

The product of minimal transit time (MTT) and heart frequency (HF) defines the number of heart beats which are necessary to transport the blood in a determined region of the circulatory system. According to own studies in physiological (stress) and pharmacological conditions this product is constant, independent from body size, length, age etc. In proportion to the degree of heart failure the MTT X HF increases. Measuring appropriate regions of the circulatory system, right and left heart failure can easily be determined. The method has the advantage of a noninvasive procedure and gives exact quantitive accessment of the pump performance of the heart. In view of the increasing use of radio-nuclides this procedure can be recommended because of its good reliability causing little or no discomfort to the patient, and making it applicable, even under extreme conditions, for instance in a CCU.
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PMID:[The definition of heart failure with the product of minimal transit time and heart frequency (author's transl)]. 79 64

A 59-year-old man developed red, swollen and warm feet accompanied by intermittent burning pain during treatment for cardiac failure and arrhythmias with several drugs including verapamil. The condition gradually worsened until there was persistent disabling burning pain and severe erythema and swelling of the feet. Aspirin and other analgesics were ineffective in relieving the discomfort. Histopathology of punch biopsies showed a mild perivascular mononuclear infiltrate and moderate perivascular oedema. Within 2 weeks of stopping verapamil the burning pain, erythema, and swelling of the feet had resolved. The clinical features and subsequent course are consistent with a diagnosis of erythermalgia secondary to verapamil.
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PMID:Verapamil-induced secondary erythermalgia. 139 Jan 76

Adenosine has recently become widely available for the treatment of paroxysmal supraventricular tachycardia. In order to evaluate its role in the management of arrhythmias, we have reviewed the literature on the cellular mechanisms, metabolism, potential for adverse effects, and clinical experience of the efficacy and safety of intravenous adenosine. Adenosine produces transient atrioventricular nodal block when injected as an intravenous bolus. This is of therapeutic value in the conversion to sinus rhythm of the majority of paroxysmal supraventricular tachycardias, which involve the atrioventricular node in a re-entrant circuit. The mean success rate was 93% from over 600 reported episodes. Compared with other antiarrhythmic agents, adenosine is remarkable for its rapid metabolism and brevity of action, with a half-life of a few seconds. It commonly produces subjective symptoms, particularly chest discomfort, dyspnea, and flushing, which are of short duration only. No serious adverse effect has been reported. Arrhythmias may recur within minutes in a minority of patients. Comparative studies have shown that adenosine is as effective as verapamil in the treatment of supraventricular tachycardia, and has less potential for adverse effects. Patients with supraventricular tachycardia should initially be treated using vagotonic physical maneuvers. Immediate electrical cardioversion is indicated if the arrhythmia is associated with hemodynamic collapse. Adenosine is the preferred drug in those patients in whom verapamil has failed or may cause adverse effects, such as those with heart failure or wide-complex tachycardia. The safety profile of adenosine suggests that it should be the drug of first choice for the treatment of supraventricular tachycardia, but only limited comparative data to support this view are available at present.
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PMID:Adenosine and the treatment of supraventricular tachycardia. 160 47

A pair of 37-year-old identical twins with diabetes mellitus are described. One of the brothers was admitted for heart failure without pain, and autonomic neuropathy was found. The clinical diagnosis was inferior myocardial infarction with anteroseptal healed myocardial infarction. Cardiac catheterization revealed triple coronary vessel involvement. The diagnosis was confirmed at autopsy after sudden death. The other brother was also examined by cardiac catheterization, which revealed total right coronary occlusion and hypokinesis of the wall. There had been no previous pain nor upper body discomfort until that time in either twin. Thus, genetic factors should possibly be considered in the genesis of asymptomatic or silent myocardial infarction.
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PMID:Painless myocardial infarction in identical diabetic twins. 186 90

Exercise tolerance is one of the most important factors when evaluating patients with heart failure, because it is closely related to their symptoms, Treadmill or ergometer test is usually used to evaluate exercise tolerance. But these tests are painful and sometimes dangerous to the seriously-ill patients. Further exercise tolerance tests reflect the exercise capacity under unusual conditions, which differs greatly from daily activities. So it is very questionable whether we can evaluate actual exercise capacity by exercise tolerance tests. Therefore I devised my own exercise tolerance classification, with 10 Grades according to the symptoms felt during walking. I used this classification for patients with heart failure, and investigated its utility. I studied the correlation between the new classification and the symptom-limited exercise duration in 18 patients, and between the classification and anaerobic threshold in 12 patients. I got good correlation in each of them; (r = 0.842,p less than 0.001) and (r = 0.806, p less than 0.01). The classification also correlated with pulmonary wedge pressure (r = -0.778, p less than 0.05), but it had no correlation with other hemodynamic and morphological parameters. The classification also reflected therapeutic efficacy of heart failure. These results indicate that the new classification is useful in evaluating exercise tolerance without imposing any discomfort on patients with heart failure.
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PMID:[Evaluation of patient-oriented exercise tolerance based on symptoms of patients with heart failure]. 206 Sep 3

Between April 1985 and July 1989, 125 cases with pleural effusion were admitted to our department. The causes of pleural effusion were carcinomatous pleurisy in 47 cases, infection without tuberculosis in 34 cases, tuberculous pleurisy in 17 cases, cardiac insufficiency and hypoproteinemia in 11 cases, trauma and pneumothorax in nine cases, collagen disease in two cases and unknown origin in five cases. Carcinomatous pleurisy and tuberculous pleurisy, the differential diagnosis of which is very important, comprised 37% and 14% of all cases, respectively. These diseases can be definitively diagnosed by pleural biopsy, effusion cytology and/or effusion culture. In July 1987, we introduced thoracoscopy to improve the ratio of definitive diagnoses. The ratio for carcinomatous pleurisy in the previous term, when thoracoscopy was not being used, was 59%, while that in the latter term, when it was used, was 73%. The ratio for all cases with tuberculous pleurisy was 47%. Prior to June 1987, pleural biopsies in our department were performed with a Cope needle. Using that procedure, a low positive ratio of 50% was obtained. For thoracoscopic pleural biopsies, a high positive ratio of 84% was achieved (in carcinomatous pleurisy, 13 out of 15 cases; in tuberculous pleurisy, three out of four cases). This procedure was performed with minimal patient discomfort and no serious complications. Therefore, thoracoscopic pleural biopsy is recommended as a diagnostic procedure for cases with pleural effusion.
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PMID:[The role of thoracoscopy in pleural biopsy in cases with pleural effusion]. 221 27

Collective studies offer experimental and clinical evidence for the advantages of the low osmolality agents in cardiac radiology. These agents cause less subjective discomfort, less hemodynamic and biochemical effects, and less blood pressure and rhythm disturbance in coronary angiography. The reduction of adverse effects with low osmolality media is of particular benefit to children, patients with cardiac failure, those at risk from systemic hypotension, and other high risk groups. Some coronary angiography patients and those undergoing angioplasty are probably at less risk if these media are used. No measurable clinical disadvantage in diagnostic or therapeutic cardiac radiology has been found with low osmolality contrast media.
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PMID:Low-osmolality contrast media in cardiac radiology. 639 57

Clinical details of two cases of arteriovenous angioma of the vein of Galen are presented. In one case a diffuse meningo-cerebral angiodysplasia was found at necropsy. Due to a large arteriovenous shunt both cases became apparent in the neonatal period by progressive and fatal heart failure as the main clinical feature. Increased head circumference and a loud cranial bruit suggested the final diagnosis. Improvement of diagnostic work-up by computerized axial tomography and two-dimensional ultrasound with less discomfort to the patient is emphasized.
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PMID:Arteriovenous angioma of the vein of Galen causing cardiac failure in the neonate. Report on clinical and pathological findings in two cases. 662 11

Cardiac involvement in pulmonary sarcoidosis was found in a higher percentage than formerly reported, by careful observation. In a retrospective analysis of 1 236 patients with pulmonary sarcoidosis we found a possible cardiac involvement in 15.1%. In cases of pulmonary sarcoidosis or lymph node sarcoidosis combined with sarcoid lesions in other organs (liver, eyes, skin etc.) cardiac involvement is possible. Heart sarcoidosis was found in all roentgenographic stages and without sex difference. Patients with possible heart sarcoidosis suffer from dyspnoe , thoracical pain, heart discomfort, or angina pectoris in a higher part than without it. Enlargement of the heart and/or cardiac failure are signs of sarcoid involvement in patient with sarcoidosis, also in elderly patients. There are some difficulties in differential diagnosis of sarcoid cardiac involvement and ischaemic heart disease.
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PMID:[Retrospective evaluation of sarcoidosis patients 1970-1979 at the Bad Berka Central Clinic for Heart and Lung Diseases for the detection of possible heart involvement]. 674 Nov 71

More than 1200 patients who received pindolol for the treatment of hypertension, angina pectoris, and various arrhythmias in studies conducted in the United States were included in the New Drug Application submitted to the FDA. Nearly 1000 of these patients received pindolol as monotherapy. The side effects reported were generally transient and of mild or moderate severity. The most frequently reported side effects seen after pindolol administration, compared to those seen after placebo, were in decreasing order of incidence: headache, dizziness, insomnia, muscle pain, fatigue, weakness, nervousness, joint pain, edema, nausea, and muscle cramps. Other side effects that occurred more frequently with pindolol than with placebo but at a rather low incidence induced weight gain, bizarre dreams, visual disturbances, lethargy, and diarrhea. Nasal congestion, throat discomfort, nocturia, impotence, pruritus, anxiety, hypotension, bradycardia, and heart failure occurred only rarely. Of the 323 patients who received pindolol alone for the treatment of mild to moderate hypertension, only 20 (6.2%) were withdrawn from the study because of side effects. Overall, 3.4% of the patients treated with pindolol were withdrawn because of side effects, most of which involved the central nervous system, that is, insomnia, anxiety, dizziness, and headache. However, a few patients manifested some edema and weight gain while receiving pindolol alone. Review of the side effects data did not reveal a tendency for the incidence of side effects to be dose related. One placebo-controlled, double-blind study designed to evaluate the fixed dosages of 15, 30, and 60 mg in the treatment of mild to moderate hypertension suggested that only the incidences of insomnia and nervousness increased with increasing doses. However, these side effects were generally transient and of mild or moderate severity. The evidence indicates that pindolol has an acceptable safety profile and that any side effects that appear are generally well tolerated and disappear with continued treatment.
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PMID:Adverse reactions to pindolol administration. 704 82


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