Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An 82-year-old woman was admitted with severe chest pain and orthopnea on January 17, 1997. Physical examination revealed bilateral leg edema and cyanosis at the periphery of the extremities. The serum CK level was 488 IU/l on admission and increased to a maximum value of 4,866 IU/l 8 hours after admission. An echocardiogram demonstrated diffuse severe hypokinesis in the left ventricle. Serial electrocardiograms showed transient right bundle branch block, left bundle branch block, and normal sinus rhythm. The patient was diagnosed as having congestive heart failure. Artificial ventilation was performed, and furosemide, isosorbide dinitrate and dopamine were administered. A right ventricular endomyocardial biopsy performed on the 13th hospital day demonstrated moderate hypertrophy and disparity of cardiac myocytes and fibrosis around the myocytes, and few inflammatory cells in the specimens. This biopsy finding was not compatible with acute myocarditis but with the chronic stage of myocarditis. The patient was discharged on the 45th hospital day, but returned because of a recurrence of congestive heart failure. After an improvement of the heart failure, a coronary angiography was performed on the 20th hospital day. The coronary angiography revealed significant stenosis in three vessels. This elderly patient had congestive heart failure and triple-vessel coronary artery disease with transient alternating bundle branch blocks on serial electrocardiograms. Alternating bundle branch blocks and diffuse left ventricular dysfunction was considered to be induced by the aging process, postmyocarditic change of myocytes, and triple-vessel coronary artery disease in this case.
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PMID:[An elderly case of triple-vessel coronary artery disease with alternating bundle branch blocks in serial electrocardiograms]. 1061 29

We report here a case of Staphylococcus epidermidis endocarditis with bacterial vegetation which was suspected by intraoperative alternating pulse on arterial pressure monitoring. A 65-year-old man was diagnosed as lumbar spinal canal stenosis and scheduled for operation. Preoperatively, he had chronic renal failure, mild aortic valve stenosis, and moderate mitral valve regurgitation. Neither inflammatory signs nor vegetations on TEE were observed preoperatively. General anesthesia was induced with propofol and vecuronium, and maintained with oxygen (33%), nitrous oxide and sevoflurane. Two hours after the beginning of operation, alternating pulse was observed suddenly on arterial pressure waves without marked change in hemodynamic parameters. The operation was performed uneventfully and alternating pulse disappeared after changing from prone position to supine. Using a transesophageal echocardiography, large-sized bacterial vegetation (22 x 17 mm) was found in the left ventricle. Second operation was performed to remove vegetation at three weeks after first operation. Alternating pulse is generally considered as a sign of severe left ventricular dysfunction such as dilated cardiomyopathy and aortic stenosis. Therefore, we should be careful about pulse disorder during operation for the patient who is in the state of severe heart failure.
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PMID:[Case of Staphylococcus epidermidis endocarditis with a bacterial vegetation suspected by intraoperative alternating pulse]. 1910 98

Hyaluronan is an extracellular matrix component implicated in expansion of the extracellular space, organization of supramolecular architecture, cell motility, proliferation, tumour metastases and wound healing. Hyaluronan is highly expressed in the developing heart but it is only a minor component of the mature heart. The loss of hyaluronan synthase-2 (Has2) results in embryonic lethality with a phenotype remarkably similar to that of the versican-deficient heart defect mouse. Has2-deficient embryos lack hyaluronan-containing cardiac jelly, and at embryonic day 9.5 show arrested development, with an apparent absence of the right ventricle and underdevelopment of the conustruncus segment, and pericardial effusion consistent with heart failure. Cardiac cushions are totally absent, and endocardial cell migration over collagen gels is not detectable in Has2-deficient atrioventricular (AV) canal explants. Endothelial to mesenchymal transformation is also defective in AV explants from Has2-null embryos. The normal phenotype is restored in AV canal explants from Has2-deficient embryos by co-culture with wild type AV canal explants, with conditioned media from wild type AV explants or with exogenous hyaluronan. These results provide evidence for a direct role for hyaluronan during endocardial cushion and AV canal morphogenesis.
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PMID:Regulation of cardiac cushion development by hyaluronan. 2042 37