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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The indirect arterial blood pressure in 50 cases of catheter-proven aortic stenosis without significant incompetence was examined. Defining the upper limit of normal blood pressure as 140/90mmHg, 14 percent had borderline, 18 percent had mild and 8 percent had severe hypertension. There was a significant positive correlation of systolic and diastolic blood pressure with age; ie pressures rose with age. The rate of increase was virtually identical with that of the normal population except for those over 70. Hypertension interferes with reliable clinical and haemodynamic quantitation of the valve lesion. The two lesions summate to increase the systolic burden on left ventricle.
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PMID:Hypertension in valvar aortic stenosis. 28 5

Little is known of the clinical significance of myocardial bridges, which may be recognized angiographically as systolic coronary artery narrowing (SCAN). A retrospective review of a 1 year's experience (313 consecutive coronary arteriograms) revealed 5 patients with SCAN, an incidence of 1.6%. SCAN involved the proximal and/or middle segments of the left anterior descending coronary artery in all patients. It is of particular note that the administration of nitroglycerin noticeably accentuated the SCAN phenomenon in each of 3 patients to whom it was administered. Four of the 5 patients had left ventricular hypertrophy due to hypertrophic cardiomyopathy (2), aortic stenosis (1), and hypertension (1). All 5 patients with the SCAN phenomenon had anginal chest pains, and critical obstructive coronary atherosclerosis was observed in only 2 cases. The other 3 patients showed, otherwise normal coronary arteriograms. Thus, myocardial bridges appear to be angiographically manifest predominantly in patients with cardiac hypertrophy. Nitroglycerin, which accentuates SCAN, might be useful as a provocative test to enhance the angiographic recognition of this phenomenon. The possible role of myocardial bridges in the production of myocardial ischemia warrants further investigation.
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PMID:Myocardial bridges in man: clinical correlations and angiographic accentuation with nitroglycerin. 40 19

The diastolic characteristics of the left ventricle with special reference to the patterns of left ventricular filling and diastolic posterior wall movement were studied echocardiographically in 95 patients with various cardiac conditions including constrictive pericarditis, idiopathic cardiomyopathy (CCM, HCM), valvular aortic stenosis (AS), mitral stenosis (MS), hypertension (HT), aortic insufficiency (AI), mitral insufficiency (MI), and in 20 normal subjects. 1. Various types and severities of LV diastolic abnormalities were revealed by analyzing the patterns of posterior wall movement and LV filling in three diastolic phases--rapid filling period, slow filling period, and atrial filling period, respectively. 2. Disturbances of posterior wall distension and LV filling during the rapid filling period with a compensatory augmentation of atrial contribution to LV filling were observed in most patients. These patients also showed a markedly decreased posterior wall velocity and LV filling rate during rapid filling period. 3. E-F slope was significantly decrease in patients with MS, AS, and HCM. E-F slope correlated well with DPWV and RFR in most patients. In MS, however, DDR decreased to a disproportionate degree with a decrease in DPWV and RFR, probably due to the structural changes and decreased mobility of the mitral valve. From this study, we conclude that the patterns of the left ventricular filling and posterior wall movement during three phases of diastole obtained by echocardiography is useful in detecting left ventricular diastolic abnormalities.
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PMID:Echocardiographic study on diastolic posterior wall movement and left ventricular filling by disease category. 45 17

Nineteen planimetric indices of 110 cardiac healthy subjects, 141 patient with left ventricle loading and 136 patients with right ventricle loading are analyzed. On the base of the variation analysis and determination of statistically significant differences, it was established that in right-ventricular loading the following indices deviate from the norm: ASX, AQZ, AQRSX, AQRSz, SAQRSx, SAQRSy, SAQRSz, SAS, SAQRSg, whereas in left-ventricular loading -- ARx, ARz, AQRSx, AQRSz, SAQRx, SAQRSy, SAQRz, SAR, SAQRSg. At a second stage, the sensitivity of the separate indices from the groups with left ventricular and right-ventricular loading was amalyzed, as well as the separate subgroups (pulmonary stenosis, aortic stenosis, mitral stenosis, interauricular defect, arterial hypertension, mitral or aortic insufficiency. The results were compared with those of axial indices, obtained from another investigation of the authors. The planimetric analysis was established to be more complex than the axial and the index SAQRSg to be with the best sensitivity in the cases with hemodynamically lightly loaded musculature.
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PMID:[Planimetric analysis of ventricular depolarization on Frank's corrected orthogonal electrocardiogram in healthy hearts and in patients with ventricular loading]. 52 72

This case report documents the co-existence of valvar aortic stenosis and hypertrophic obstructive cardiomyopathy with systemic hypertension and calcific mitral annulus, a combination which has not hitherto been reported. It is the purpose of this paper to help assess the true incidence of the co-existence of aortic stenosis and hypertrophic cardiomyopathy.
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PMID:Valvar aortic stenosis with unusual features. 56 Jun 91

A case of combined hypertrophic obstructive cardiomyopathy and mitral annular calcification is reported. The characteristic features of both entities were clearly demonstrated by thorough noninvasive examinations. It is proposed that the association of the two conditions is not coincidental but that mitral annular calcification, by narrowing of the left ventricular outflow tract, can result in the development of hypertrophic obstructive cardiomyopathy. Mitral annular calcification should possibly be added to the other causes of pressure overload of the left ventricle--such as hypertension and valvular or discrete subvalvular aortic stenosis--as a potential etiology of secondary hypertrophic obstructive cardiomyopathy.
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PMID:Coexistence of hypertrophic obstructive cardiomyopathy and mitral annular calcification: proposed etiologic relationship. 57 64

Among 119 cases of fatal dissecting aneurysm of the aorta, exclusive of those iatrogenically caused or associated with arachnodactyly or aortic stenosis, there were observed 11 cases of congenital bicuspid aortic valve (9%). The ages ranged from 17 to 69 years, five of the patients being 29 years old or younger. Among the latter, three had coarctation of the aorta and one had Turner's syndrome without coarctation. In one of the older patients, aortic insufficiency was present. Hypertension was either established or inferred from cardiac weight in 73% of the cases. In each case, cystic medial necrosis of the aorta was present. Prolapse of valves other than the aortic was observed in 45% of the cases with bicuspid aortic valve. Compared to an estimated incidence of bicuspid aortic valve of about 1 to 2% in the population, the high incidence among subjects with dissecting aneurysm suggests a causative relationship between bicuspid aortic valve and aortic dissecting aneurysm.
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PMID:Dissecting aortic aneurysm associated with congenital bicuspid aortic valve. 63 1

In an attempt to assess cardiac risk in non-cardiac surgery, 1001 patients over 40 years of age who underwent major operative procedures were examined preoperatively, observed through surgery, studied with at least one postoperative electrocardiogram, and followed until hospital discharge or death. Documented postoperative myocardial infarction occurred in only 18 patients; though most of these patients had some pre-existing heart disease, there were few preoperative factors which were statistically correlated with postoperative infarction. Postoperative pulmonary edema was strongly correlated with preoperative heart failure, but 21 of the 36 patients who developed pulmonary edema did not have any prior history of heart failure. Nearly all of these 21 patients were elderly, had abnormal preoperative electrocardiograms, and had intraabdominal or intrathoracic surgery. In the absence of an acute infarction, bifascicular conduction defects, with or without PR interval prolongation, never progressed to complete heart block. Spinal anesthesia protected against postoperative heart failure but not against other cardiac complication. By multivariate regression analysis, postoperative cardiac death was significantly correlated with (a) myocardial infarction in the previous 6 months; (b) third heart sound or jugular venous distention immediately preoperatively; (c) more than five premature ventricular contractions per minute documented at any time preoperatively; (d) rhythm other than sinus, or premature atrial contractions on preoperative electrocardiogram; (e) age over 70 years; (f) significant valvular aortic stenosis; (g) emergency operation; (h) a 33% or greater fall in systolic blood pressure for more than 10 minutes intraoperatively. Notably unimportant factors included smoking, glucose intolerance, hyperlipidemia, hypertension, peripheral atherosclerotic vascular disease, angina, and distant myocardial infarction.
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PMID:Cardiac risk factors and complications in non-cardiac surgery. 66 58

A study of the fourth sound was conducted on 100 normal subjects (ages 1-88 years) and 42 clinical cases with either aortic stenosis, systemic hypertension or coronary heart disease. This study was based on the graphic recognition of a presystolic sound when the tracing was taken with the use of one or more of 5 different high pass filters. Attention was paid to the existence of the fourth sound, its magnitude, and its vibrational frequency. In general it was accepted that a magnitude of 1/2 of the first heart sound or a frequency of 30 Hz denoted a pathologic fourth sound. However, exceptions were found among normal subjects, so that only the combination of the two criteria could be considered highly significant for a pathologic phenomenon (gallop). Patients with aortic stenosis presented an increase in magnitude of the fourth sound but incidence and vibrational frequency were similar to those of controls. Patients with hypertension had a greater incidence of fourth sounds, especially in middle age (100%); middle age patients usually had a greater magnitude while older patients had more often an increase in vibrational frequency. Patients with coronary heart disease (evidence of old infarcts) had an increase in the incidence, magnitude, and vibrational frequency in comparison with controls. These data and the cause of the fourth sound are discussed. The fourth sound has been repeatedly studied in the past, both as an auscultatory finding and a graphic phenomenon. Attempts were made for separating the normal fourth sound from that denoting a pathological phenomenon but, so far, no clear cut criteria for the differentiation have been obtained. We thought, therefore, that a new study was indicated.
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PMID:When does a fourth sound become an atrial gallop? 105 54

In nine of ten hypertensive patients with "atypical" suprarenal aortic stenosis (aged 20 to 51 years, mean 28.5 years), operative treatment of the stenosis reduced blood pressure to normal. In the tenth patient, combined vascular and reno-parenchymal hypertension was effectively treated by drugs, the dosage of which could be reduced after resection. Aorto-aortic bypass was the operative procedure of choice because of its lower risk and better results than other methods. In a review of 346 cases of atypical coarcation reported in the literature, two-thirds were found to be located above or at the level of the renal arteries, causing marked hypertension. Surgical procedures and results in 136 operated cases are tabulated and discussed.
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PMID:[Atypical suprarenal aortic stenosis as a cause of hypertension in young people (author's transl)]. 112 11


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