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

A retrospective analysis of records from an outpatient medical practice was undertaken to determine the incidence and features of cough resulting from the use of enalapril maleate. Of 209 patients taking enalapril, 22 (10.5%) required discontinuation of therapy because of an intractable, dry cough. Cough was more than twice as common in women; 16 (14.6%) of 109 women and 6 (6%) of 100 men stopped taking enalapril because of cough. The cough resolved in 21 of 22 patients within 2 weeks of discontinuation of enalapril therapy. When the patients with cough were compared with the others, there was no significant difference in age, smoking status, creatinine levels, enalapril dosage, associated cardiopulmonary disease, or concomitant administration of medications. Among the 187 study patients who did not discontinue taking enalapril because of cough, many developed a persistent, dry cough that to date has not been severe enough to require discontinuation of therapy, after a mean follow-up period of 16 months. The enalapril-induced cough is insidious, dry, persistent, benign, and reversible on discontinuation of therapy. It is important to distinguish enalapril-induced cough from cough resulting from acute illness, reactive airway disease, and congestive heart failure. Optimal clinical application of enalapril in the treatment of hypertension and congestive heart failure will require increased awareness of this incessant cough, which requires discontinuation of the therapy in about 10% of patients.
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PMID:Enalapril-induced cough. 255 77

New data on the pathogenesis of chronic cor pulmonale were obtained. The reduction of pulmonary capillaries at the site of the tuberculosis process beyond this site was found to contribute much to the development of pulmonary artery hypertension. Irreversible injuries to the vessels are due to both the pneumosclerotic changes and the specific circulating immune complexes (CIC) effects. Acting on the peripheral veins (in Koch's test), CICs influence the central hemodynamics, decreasing circulating blood volume by 30-40% and reducing cardiac output, thus resulting in deficit of the blood inflow to the right compartments of the heart. In this case the atrium functions at a higher load, like a suction pump, thus leading to cardiac hypertrophy. Peripheral vasodilators (apressin, nitrong) combined with cardiac glycosides (digoxin), favorably influencing the central hemodynamics, are recommended for the prevention and treatment of chronic cor pulmonale.
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PMID:[Chronic cor pulmonale in pulmonary tuberculosis and its treatment]. 261 39

Short and long term administration of vasodilator drugs to patients with pulmonary artery hypertension (PAP) effects small falls of PAP and larger reductions of pulmonary vascular resistance due to increases of cardiac output. Side effects of systemic hypotension are sometimes troublesome. Improvement of survival has not yet been demonstrated. It is likely that any treatments capable of sustained clinical benefit in hypoxic cor pulmonale will have to arrest or reverse pathology in the airway and pulmonary vessel. There is no evidence that pulmonary vasodilator drugs will do this. Their clinical place is in doubt.
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PMID:Vasodilator drugs in chronic obstructive airways disease. 267 15

Twenty-six episodes of Pseudomonas aeruginosa bacteremia treated with intravenous ceftazidime, 4-6 g/day were evaluated. Treatment was begun within the first 24 hours after the isolation of the microorganism and was maintained for 10-12 days. In two patients with neutropenia amikacin was added during the initial 48-72 hours until the susceptibility to ceftazidime was known. All isolates were sensitive to ceftazidime. The most common underlying diseases were neoplasia (12), diabetes with stroke (4), neurosurgical and vascular procedures (4), rheumatoid arthritis (2), burns (2), cor pulmonale (1), and hypertension (1). The origins of bacteremia were urinary (12), pulmonary (9), and unknown (5). The infection was hospital-acquired in 77% and community-acquired in 23%. A critical clinical status and the presence of complications were significantly (p less than 0.01) associated with an increased mortality rate. Clinical outcome was good in 18/26 (70%), with a 30% mortality rate. The microbiological evolution showed 14 eradications, 6 persistences, 3 relapses and 3 colonizations. Resistance did not develop during therapy. Ceftazidime may be a good alternative therapy for these severe infections, although wider comparative studies are required for a better evaluation.
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PMID:[Evaluation of ceftazidime monotherapy in Pseudomonas aeruginosa bacteremias. Prospective study]. 268 60

Standard biplane chest X-rays were tested for the validity of morphometric criteria in the diagnosis of pulmonary artery hypertension. Twenty-seven patients suffering from chronic obstructive lung disease were examined and compared with a control group without cardiopulmonary disease. The diameter of the right and left pulmonary artery, pulmonary conus and the hilar-to-thoracic ratio were significantly increased in patients with chronic obstructive lung disease (p less than 0,0001). Measurement of the right pulmonary artery was 19.7 +/- 3.9 mm compared to 13.6 +/- 1.2 mm of the control group; mean hilar thoracic index was 0.35 compared to 0.31. Thus if the width of the descending branch of the right pulmonary artery was above 16 mm, pulmonary arterial hypertension was suggested, with a specificity of almost 100%, although the sensitivity of the diagnosis was only 59%. The mean pulmonary arterial pressure obtained by right heart catheterization correlated poorly with the morphometric criteria obtained.
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PMID:[Pulmonary artery hypertension in chronic obstructive lung disease. The place of morphometric studies in thoracic radiography]. 274 Apr 90

It was shown that the high-altitude conditions of the Pamirs and Tien Shan (2800-3600 m above the sea-level) modified the clinicofunctional signs and a course of the cor pulmonale (CP) in chronic bronchitis. CP was detected in the examined patients with chronic bronchitis. As compared to the conditions of foothills (760 m) CP in mountain-dwellers was more noticeable in terms of the signs of pulmonary arterial hypertension, right ventricular hypertrophy developed in them 5 years earlier. The first obvious signs of cardiac decompensation developed in the presence of moderate (noticeable at the foothills) right ventricular hypertrophy and were often (51.5% of the patients against 21.6% under the foothills conditions) accompanied by disturbance of cardiac rhythm and conduction.
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PMID:[Clinico-functional characteristics of pulmonary heart disease developing at high altitude as a result of chronic bronchitis]. 294 41

We describe the electrical signs due to the positional changes of the heart and those related to hypertrophy and dilatation of the right heart chambers in subjects with chronic cor pulmonale. The positional changes mainly reflect the vertical position of the heart, which is almost constantly associated with some degree of clockwise rotation, because of the descent of the diaphragm and increase of lung volume owing to chronic emphysema. The electrovectorcardiographic alterations observed in right ventricular hypertrophy owing to permanent pulmonary arterial hypertension differ depending on the type of hypertrophy: global or segmentary. The first is generally observed in the chronic hypertensive pulmonary cardiopathy of vascular origin and produces an increase in the magnitude and manifestation of all the principal vectors of right ventricular activation. The second is frequently present in the chronic hypertensive pulmonary cardiopathy of bronchial origin and increases only the magnitude and manifestation of the right basal vector. The progressive dilatation of the right heart chambers evident during the evolution of the chronic hypertensive pulmonary cardiopathy toward the congestive heart failure produces SAQRS rotation to the right, downward and forward or backward. During acute intercurrent bronchopulmonary infection or embolia, transient electrical signs of right cardiac chambers dilatation are present.
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PMID:[Electro-vectorcardiographic examination in cardiopathy of pulmonary origin]. 295 64

Two females patients with CREST syndrome associated with cardiac involvement are reported. One of them has pericardial effusion just shown by echocardiography with patterns of cardiomyopathy of ventricular cavities, the latter as primary myocardial involvement, in the absence of pulmonary or systemic hypertension. The second patient has chronic cor pulmonale secondary to pulmonary hypertension verified by electrocardiography and echocardiography. It is emphasized the utility of the echocardiography and the importance of those anomalies that can lead to the patient's death, transforming the CREST towards a syndrome with potentially but late, severe systemic involvement.
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PMID:[Cardiac repercussions in the CREST syndrome]. 296 63

The histories and the results of the postmortem examinations of 507 patients with chronic pulmonary heart disease were studied. In 62.6% of them left ventricular hypertrophy was found. As probable causes for this left ventricular hypertrophy are suggested: arterial hypertension, ischemic heart disease, hypoxemia, hypercapnia, heart failure, diabetes mellitus. The weight measurement correlations between the left and the right heart ventricles were studied in: "normal hearts", hearts with right ventricular, hypertrophy only, hypertrophy of both ventricles, left ventricular hypertrophy only. A correlation between the mass increase and the wall thickness of the ventricles was established. In the patients with chronic pulmonary heart disease and hypertrophy of both ventricles the mass and the wall thickness of the ventricles increase simultaneously. The possible pathogenetic mechanisms of the left ventricular involvement in patients with chronic pulmonary heart disease are discussed.
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PMID:[Left heart ventricle in chronic cor pulmonale patients. Etiological, pathomorphological and organ weight measurement studies]. 296 38

A case is reported of bronchial stenosis due to a vascular cause in a patient with chronic obstructive lung disease, cor pulmonale and pulmonary arterial hypertension. This led to right lower lobe atelectasis and acute respiratory failure (pHa 7.24; PaCO2 85 mmHg; PaO2 44 mmHg) with important right-to-left shunting. This diagnosis was only suggested on day 7 by fibreoptic bronchoscopy and confirmed a week later by tomography and digital angiography. Nifedipine, used to reduce the pulmonary arterial hypertension, increased the cardiac index (31.min-1.m-2 to 3.3.1.min-1.m-2) and oxygen transport (488 ml.min-1.m-2 to 554 ml.min-1.m-2), despite increasing the shunt effect (Qs/QT: 26% to 31%). This and the antiinflammatory action of methylprednisolone were probably responsible for the favourable outcome.
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PMID:[Bronchial stenosis of vascular origin in pulmonary arterial hypertension]. 304 7


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