Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twohundred and eighteen patients aged 13 years or more at operation for coarctation of the aorta were selected for a long-term postoperative follow-up study. The mean age of operation was 25,3 years, range 13 to 62 years, and the mean follow-up period was 13 years, range 2 to 28 years. The surgical mortality rate was 1.4%, all 3 patients being in their fourth decade. There were 35 late deaths (16,3%), 26 having cardiovascular disease as the causation; 3 patients developed a dissecting aneurysm of the ascending aorta, and 11 died suddenly of unknown cause. Persisting hypertension was found in approximately one third of the patients. A highly significant correlation was demonstrated between the systolic blood pressures before and after surgery. Aortic valve disease occurred in 31 patients (14,2%). Coarctation of the aorta should be operated on in childhood, and a close postoperative long-term follow-up in all patients is recommended.
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PMID:Coarctation of the aorta. Follow-up of 218 patients operated on after 13 years of age. 694 Apr 20

Drugs used to treat hypertensive emergencies should have the characteristics of rapid action, short duration, high potency, reversibility, a low toxic/therapeutic ratio, no association tachyphylaxis, and a specific action on the cardiovascular system. Of the three mentioned only SNP fulfills all of the requirements. SNP is used, with few exceptions, to treat hypertensive crisis. Trimethaphan camsylate is useful in preventing hemorrhage secondary to a dissecting aneurysm; the other drugs may worsen the tear. Diazoxide is good when no prolonged monitoring is available, since the drug is administered as a bolus rather than an infusion. Side effects, contraindications, and drug interactions are important points to remember during administration of these medications. Care is directed toward limiting or avoiding side effects by titrating the drug and by close observation of the patient. Concurrent maintenance therapy must be initiated to prevent a recurrence of hypertension upon discontinuance of the acute drug protocol.
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PMID:Intravenous drugs used in treating hypertensive emergencies. 702 3

This paper presents a review of the principal cardiovascular conditions which are associated with or cause certain neurological lesions. Included are conditions such as rheumatic and coronary heart disease, bacterial and non-bacterial endocarditis, dissecting aneurysm of the aorta, cardiac arrhythmias, hypertension, congenital heart disease, mitral valve prolapse, and carotid sinus hypersensitivity. The purpose of the review is to call attention to the neurological complications which may confront the physician in treating the patient who presents with any of the entities listed above, and to indicate the type of management which is currently favored for the complications.
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PMID:Cardiovascular diseases and their neurological complications. 705 1

A 54 year old man without pathologic past history but mild hypertension, obesity and gastric ulcer, presented with a syndrome of Wallenberg. He had complained for five days of progressive and diffuse headache. The neurological condition improved initially, but the patient died suddenly two weeks later. Pathological examination showed no significant alteration except for left ventricular enlargement and mild arteriosclerosis. There was a hemodissection (dissecting aneurysm) of the left vertebral artery next to the inferior oliva. It induced a lateral infarct and a limited dorsal infarct at the middle third level of medulla oblongata. Although the location of the arterial changes is usual, their nature is exceptional. The cause of the arterial hemodissection could not be ascertained: fibrous arterial dysplasia, atherosclerosis or congenital abnormalities of internal elastic layer may be discussed. But no definite conclusion can be reached.
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PMID:[Wallenberg's syndrome due to a dissecting aneurysm of the vertebral artery]. 713 26

Two cases of leakage of an aortic dissecting aneurysm into the pericardial cavity presenting as acute pericarditis are reported. In both cases the existence of risk factors (hypertension and coarctation of the aorta) suggested the correct diagnosis. Echocardiography showed enlargement of the ascending aorta and thickening of vascular wall in the two cases, furthermore it suggested the presence of aortic insufficiency in one case. The definite diagnosis was made by means of aortography. One patient died after surgery, while the other was successfully treated with hypotensive drugs. Dissecting aneurysm of the aorta may present atypical clinical manifestations; in these circumstances a great suspicion index is the basis for a correct diagnosis. The importance of an early diagnosis by means of aortography and echocardiography is emphasized.
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PMID:[Dissecting aneurysm of the aorta presenting as acute pericarditis (author's transl)]. 740 37

A case of acute dissecting aneurysm of the aorta in a seriously hypertensive woman was treated for 9 days with continuously infused labetalol hydrochloride, initially at 1 mg/min and later at 125 mg/min. Continuous, invasive monitoring of arterial pressure showed values to be within present safety limits, even though the treatment was first supplemented with furosemide and then with clonidine. The use of labetalol in hypertension emergencies offers and alternative to the employment of dangerous drugs that have a transient effect, or are even unadvisable for treatments lasting longer than two days.
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PMID:[Use of labetalol hydrochloride by continuous infusion in managing the hypertensive state; a clinical case]. 744 61

Type A aortic dissection still presents an emergency situation in cardiac surgery that is associated with high morbidity and mortality rates. There has been a significant improvement in the surgical outcome since the introduction of deep hypothermia and circulatory arrest. In this study, we discuss our results after operative repair of ascending aortic dissections, using deep hypothermia and circulatory arrest. This study presents the results of 67 patients (43 men, 24 women) from 18 through 81 years of age (mean, 54 years) who underwent surgery for type A dissecting aneurysm over a period of 4 years. Type A dissection (52 acute and 15 chronic cases) was due to Marfan syndrome in 12 patients, to atherosclerotic disease of the aorta in 27 patients, and to traumatic injury in 1 patient. Hypertension as the only pathologic finding was observed in 27 patients. Deep hypothermia (confirmed by isoelectric electroencephalogram) and circulatory arrest were induced in all patients. Two patients died intraoperatively due to massive bleeding (intraoperative mortality, 3%). The 30-day mortality rate was 30% (n = 20). Causes of perioperative deaths in order of frequency were multi-organ failure (n = 11), myocardial infarction (n = 2), postoperative bleeding (n = 2), cerebrovascular insult (n = 2), and sepsis (n = 1). The mean intensive care unit stay of the surviving 47 patients (72%) was 8 days, followed by a mean of 21 additional days in the hospital. Our experience with profound hypothermia and circulatory arrest, used in combination with coated grafts, supports our conviction that this is the method of choice for the treatment of type A dissecting aneurysm.
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PMID:Surgical treatment of type A aortic dissections. Results with profound hypothermia and circulatory arrest. 868 Feb 82

Persistent inappropriate blood pressure elevation leads to the development of left ventricular hypertrophy, progressive atherosclerosis, and structural changes in the arterial tree. These changes result in clinical manifestations such as ischemic cardiac and cerebral events, congestive heart failure, renal failure, and peripheral vascular insufficiency. This article reviews the 5-year course of 439 patients with primary hypertension who were seen at a time (1946-1953) when potent antihypertensive therapy was not widely used. At the end of 5 years, 55% of the men (78 of 143) and 28% of the women (83 of 296) were dead. The principal causes of death were coronary insufficiency, congestive heart failure, cerebral infarction and hemorrhage, accelerated hypertension, renal failure, and dissecting aneurysm of the aorta. Coronary insufficiency and accelerated hypertension predominated in men, whereas women died principally of cerebral events and congestive heart failure. The 439 patients were stratified according to the level of their office blood pressure on the first visit, the severity of the changes in the optic fundi, the degree of left ventricular hypertrophy determined by electrocardiogram, cardiac enlargement determined by roentgenogram and their renal function, as measures of end-organ damage. Patients who had higher initial blood pressures showed more evidence of end-organ damage than patients with lower initial pressures. The higher the initial blood pressure or the more advanced the evidence of end-organ damage, the greater was the 5-year mortality. The mortality was particularly high in patients who had already sustained a clinical cardiovascular event before entry into the study and in those with malignant hypertension or gross cardiomegaly.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Retrospective and prospective research on hypertension-related end-organ damage. 760 71

Fifty-three-year-old woman was admitted to hospital with tetraplegia symptoms and died two hours later. Clinical diagnosis was: cerebral stroke, hypertension in anamnesis. Postmortem examination showed ruptured dissecting aneurysm of thoracic and abdominal segment of aorta, meningioma of right pontocerebellar angle and saccular aneurysm of left inferior, posterior cerebellar artery. The diagnostic difficulties and hypotheses of formation of multifocal of different changes are discussed.
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PMID:[A case of coexistence of meningioma with intracranial aneurysm in a patient with ruptured aortal aneurysm]. 786 44

Arterial dissection occurs when an intimal tear allows blood to enter the arterial wall, potentially compromising the lumen and reducing blood flow. Carotid and vertebral artery dissections typically occur after major trauma, although they also can arise spontaneously or after trivial injury. Arterial dissection has been associated with a variety of factors, including hypertension, fibromuscular dysplasia, Marfan syndrome, cystic medial necrosis, oral contraceptives, drug abuse (sympathomimetics), and infection [1-8]. It is important to recognize arterial dissection early so that prompt treatment can be initiated to prevent ischemic complications [1]. In this essay, we illustrate the use of MR angiography in the diagnosis of carotid and vertebral artery dissection.
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PMID:Dissection of the carotid and vertebral arteries: imaging with MR angiography. 786 92


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