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

Intraparenchymal renal aneurysms have been reported with increasing frequency; yet, to our knowledge, this subject has not been reviewed in radiologic literature. The spectrum of such aneurysms includes congenital aneurysms, those secondary to disease usually affecting the main renal arteries, those associated with renal masses, microaneurysms, and false or pseudo aneurysms. Seemingly unrelated conditions, such as atherosclerosis, bacterial endocarditis, and trauma, can all produce similar radiographic appearance of aneurysmal dilatation within the kidney, albeit through differing mechanisms. In addition, there are several etiologies for renal microaneurysms, even though this finding has been considered specific for polyarteritis in the past. Although there were a few guidelines for recognizing certain specific etiologies based solely on the angiographic appearance, it must be appreciated that many of these conditions may be indistinguishable. The possibility of hemorrhage from such intrarenal aneurysms, and the question of whether such lesions are responsible for renovascular hypertension are also discussed.
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PMID:Intrarenal arterial aneurysms. 1 Jan 34

The case files of 4,456 medical admissions in 1975--1976 at Ahmadu Bello University Teaching Hospital, Kaduna, Nigeria, included 354 cardiovascular patients. The most common causes were hypertension (45.5%), cardiomyopathy (20.6%) and chronic rheumatic heart disease (14.4%). The mean age of hypertensive and cardiovascular patients was lower than in Europe. The majority of hypertensive patients suffer from essential hypertension. Congestive cardiac failure is the commonest complication of hypertension and cardiomyopathy. Rheumatic valvular disease with mitral incompetence is frequent and sometimes severe in young people. Other cardiovascular diseases included pericardial disease, bacterial endocarditis, cor pulmonale, anaemic heart failure, congenital and syphilitic heart disease. Coronary heart disease was only encountered in non-Africans. Cardiovascular mortality in hospital was high (20%).
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PMID:Cardiovascular disease in Northern Nigeria. 31 94

Conclusions drawn from the post-mortem examination of 226 subjects who died of cerebral haemorrhage are presented. There were slightly more women than men (53%) in the series. Arterial hypertension (68%) was the main cause of death, while renal disease, leukaemia, angioma of the pons, and embolism due to bacterial endocarditis were also observed. The most frequently noted sites are listed. Since cerebral haemorrhage follows the rupture of one or more already damaged deep arteries, as assessment was made of the part played by vascular lesions. 13 cases due to leukaemia and 35 to rupture of aneurysms of the polygon of Willis were discarded. In only 20 cases out of 138 in which convincing microscopic evidence of the vascular situation could be obtained was there an absence of significant alterations. The remaining cases consisted of serious hyalinosis (56%), fibrinoid necrosis (13%), and siderocalciosis (12%). An account is also given of the special pathogenetic conditions applicable to cerebral haemorrhage associated wtih serious gastrointestinal haemorrhage or recent myocardial infarct.
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PMID:[Pathogenesis of cerebral hemorrhage considered in the light of objective lesions in the arteries of the brain (in 226 cases studied by autopsy)]. 119 33

Calcific emboli from a calcific aortic stenosis is an uncommon event, usually following local trauma, as from cardiac surgery or left heart catheterization or as a sequel to bacterial endocarditis. We report what we believe to be the first case of a spontaneous calcareous emboli demonstrated by cranial computed tomography. In this patient, systemic hypertension and mild aortic insufficiency may have caused increasing mechanical forces acting on the aortic cusps and may have precipitated embolism.
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PMID:Spontaneous calcific cerebral embolus from a calcific aortic stenosis in a middle cerebral artery infarct. 265 88

Thirteen patients developed a renal disease after using heroin alone or in combination with other drugs, for a period of 3 to 12 years. Eleven were IV drug addicts, 2 were sniffers. Six patients had acute tubular necrosis, due to rhabdomyolysis in 5 and to prolonged gentamicin therapy for bacterial endocarditis in 1. Five patients manifested a nephrotic syndrome, and renal biopsy showed various types of glomerulonephritis (GN) without glomerular sclerosis. The two last patients had hypertension with intrarenal vascular lesions and HBsAg was present in their serum. Chronic hemodialysis and/or renal transplantation were required in 2 cases with GN; all other patients recovered normal serum creatinine. There was no specific pathologic picture of heroin abuse in this series.
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PMID:[Renal disease associated with heroin abuse]. 321 43

We report two patients with Turner syndrome who had aortic dissection and rupture, one with prior repair of coarctation. We also note the high incidence (8.8%) of unrecognized aortic root dilation in a group of 57 patients with Turner syndrome whom we prospectively evaluated by echocardiography. Our analysis and review of previously reported cases suggests that multiple risk factors may exist for aortic dissection, including coarctation, bicuspid aortic valve, and systemic hypertension, but that these need not be present. Aortic root dilation may be an additional finding that suggests the patient with Turner syndrome is also at risk. When it is present, magnetic resonance imaging visualizes the entire aorta and allows quantification of the site and degree of dilation. In patients with dissection, the aorta often exhibits pathologic evidence of cystic medial necrosis similar to the finding in patients with Marfan syndrome. Therapeutic methods to decrease risk, such as those directed toward prevention of bacterial endocarditis, blood pressure control, and perhaps prophylactic beta blockade or surgical reconstruction, may need to be considered. Patients with Turner syndrome, their families, and the physicians who care for them should be aware of the significance of unexplained chest pain, dyspnea, or hypotension as potential manifestations of aortic dissection or rupture.
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PMID:Aortic dilation, dissection, and rupture in patients with Turner syndrome. 377 61

The pathology and clinical features of 258 cases of mitral ring calcification were reviewed. The overall incidence in patients over 50 years of age was 8.5%; it was more than twice as high in women (11.5%) as in men (4.5%) and rose sharply with age. Cardiac failure and systolic murmurs were each noted in over half the patients. Hypertension was slightly commoner than in age- and sex-matched groups without ring calcification, although the difference was not statistically significant. Small nodules of calcification were more frequent in men and heavy deposits in women. Distortion and atrial displacement of the posterior mitral cusp was present in 26% of the hearts with early ring calcification, in 56% of the hearts with moderate, and in almost all hearts with marked changes. Systolic murmurs had been heard in 73% of these cases. ;Caseation' of the calcified ring was seen in seven hearts and haemorrhagic valvulitis in three. Calcium had ulcerated through the cusp in 12 cases, with thrombotic and/or bacterial endocarditis in five. Aortic valve calcification was present in 36% of men and was quantitatively related to the severity of mitral ring calcification. In women the incidence was 30% and there was no corresponding quantitative relationship. Microscopy showed nonspecific chronic inflammatory changes adjacent to calcium in about half the cases in both sexes, with foreign body type giant cells in 6%. Similar inflammatory changes in the valve cusp were almost twice as common in women as in men. There was no evidence that previous endocarditis was responsible for mitral ring calcification, neither did parity influence its incidence. Severe coronary atherosclerosis was unrelated but severe aortic atherosclerosis was commoner in patients with calcified mitral rings. The difference, in women, was statistically significant. The higher incidence of severe degrees of ring calcification, complications, and valvular inflammation in women suggests a sex-determined difference in tissue response in the mitral area. Possible provoking factors apply to both sexes and both left side valves, and such a difference would account for the relative frequency and sex incidence of mitral ring calcification.
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PMID:Pathological and clinical study of calcification of the mitral valve ring. 543 Apr 24

The chest X-ray films of 251 patients with cardiovascular lesions, collected in the major hospitals of Papua New Guinea, were reviewed. Cor pulmonale (18%) and rheumatic heart disease (16%) were the predominant cardiac disorders, and cor pulmonale was the most common cause of cardiac failure (58%). Cardiomegaly or cardiac failure of unknown cause, possibly due to cardiomyopathy or myocarditis, made up 9% of the group and may be more important than has been thought previously. Aortic-arch calcification typical of atheroma was present in 21% of the patients, and is thus quite common, even though ischaemic heart disease remains very rare (1%). More than half of the patients with aortic atheroma had chronic lung disease, and though this could be explained by the coincidental frequency of both conditions, the possibility of an association or link in pathogenesis between them deserves further consideration. Anaemia was a common cause of cardiac enlargement (14%), and sometimes led to cardiac failure. Only 16 patients had hypertension (essential in 10 patients and renal in six), and this may indicate a change from the previously reported predominance of renal hypertension in Papua New Guinea towards a more equal incidence of the two conditions. Aneurysms of unknown cause were encountered in three fairly young patients. They had some resemblance to the aneurysms in arteritis of obscure origin described in Africa. There were also two dissecting aneurysms and one syphilitic aneurysm of the aorta. Congenital lesions (8%), pericarditis due to various causes (including tuberculosis), bacterial endocarditis (in four patients with rheumatic heart disease), and miscellaneous conditions made up the remainder of the series.
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PMID:Cardiovascular disease in Papua New Guinea. 644 34

A 7-year-old boy with bacterial endocarditis developed renal artery mycotic aneurysm and diffuse distal occlusions of the renal branches. Blood pressure in the patient returned to normal after obliteration of flow to the left kidney with Gelfoam, Ivalon, and a Gianturco coil. An end loop of the coil used for embolization remained in the lumen of the aorta against its lateral side. Improper coil placement did not result in complications; the boy later died due to neurologic and pulmonary complications. We discuss the therapeutic potential of renal embolization, as well as the risks of particulate and ethanol embolization, in the treatment of renal vascular hypertension from mycotic aneurysms.
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PMID:Total therapeutic embolization of the kidney for hypertension in a child with a mycotic aneurysm. 668 57

Based on the study of the materials of 13,000 autopsies made in 1962--1979 at the Pathology Department of the Chair of Pathological Anatomy of the I. M. Sechenov First Medical Institute, an increase in the rate of thromboembolic complications (TEC) was established predominantly in diseases of the cardiovascular system (atherosclerosis, hypertension, ischemic heart disease, rheumatic disease, protracted bacterial endocarditis). The analysis of 8157 autopsies with TEC revealed general regularities of changes in TEC structure in different diseases irrespective of their pathogenetic differences: predominance in the last two decades of venous thrombs, thromboemboly of the pulmonary artery and pulmonary infarction; prevalence of senescent and senile people among patients with TEC, and women among them (with the exception of protracted bacterial endocarditis).
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PMID:[Structure of thromboembolic complications (based on prosection data of the Department of Pathological Anatomy of the I. M. Sechenov I Moscow Medical Institute from 1962 to 1979)]. 696 51


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