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

The ECG data are analyzed in the adolescents, aged 15-16, with arterial hypertension, revealed during the prospective examination. Th main group consisted of 238 adolescents with arterial hypertension, and the control group of 172 healthy adolescents. ECG recording was done in 12 conventional leads. ECG was assessed according to the Minnesota code. The data were compared with the criteria of the clinical electrocardiography. 1/3 of the adolescents had normal ECG. The duration of RQ interval, P wave, QRS complex and internal deviation time were within normal, as in the adults. The signs of the left ventricular hypertrophy were revealed in 11.3% of the adolescents of the main group. The sign RV5,6 + SV1 greater than 35 mm was the most typical one. The left ventricular electric prevalence by the position of the transitional zone was observed in 44.1% of the adolescents of the main group. Sinus tachycardia was detected in 14.7% of the cases.
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PMID:[ECG in arterial hypertension in 15 and 16-year-old adolescents]. 727 57

Some inflammatory processes of the 9th cranial nerve may provoke disturbances of the autonomic nervous system, with parasympathetic irritation. A unilateral intracranial lesion or section of the glossopharyngeus may produce adverse reactions such as sinus tachycardia and transitory hypertension, due to a cut-off in physiological feedback. The two cases presented developed acute hypertension after either lesion or section of the 9th cranial nerve. In one case the hypertension was of a few days duration only, while the second was rather unusual in that it was sustained over a four-month period. The physiopathologic mechanisms are described as well as the favorable response to treatment with drugs. The hypothesis that arterial hypertension is caused by an over-stimulation of the beta-adrenergic system, in particular in its effect on cardiac output is, at least in part, supported by the favorable response to propranolol. In order to either confirm or discard this hypothesis, the measurement of cardiac output in successive patients after lesion or section of the glossopharyngeus is considered to be of special interest.
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PMID:[Acute hypertension and sustained arterial hypertension after unilateral intracranial lesion or section of the glossopharyngeus (author's transl)]. 727 22

Twenty consecutive female patients (mean age 30.1 years) with Primary Antiphospholipid Syndrome (PAPS) were studied cardiologically through noninvasive methods and compared with 20 age-and sex-matched healthy subjects. On physical examination 13/20 patients (65%) with PAPS had a valvular abnormality. In 12/20 (60%) patients with PAPS the ECG was abnormal, mainly due to sinus tachycardia in 5 (25%) and acute myocardial infarction in 3 (15%). In 7/20 patients with PAPS (35%) abnormal pulmonary findings were detected by X-ray and in 6 (30%) they were related to dilated pulmonary arch and pulmonary hypertension. In 14/20 cases (70%) with PAPS, abnormal echocardiographic findings were present; 13/20 patients (65%) had valvular complications attributable to PAPS: mitral insufficiency in six cases; mitral valve prolapse in three and aortic insufficiency in three. Two had pulmonary artery hypertension and two, tricuspid regurgitation (one attributable to PAPS). All valve diseases were regurgitant with mild to moderate hemodynamic repercussion. No stenotic lesions were detected. The mean mitral thickness in patients with mitral valve involvement was 7.0 +/- 1.6 mm, compared to 2.8 +/- 0.7 mm in patients with normal valves and 3.1 +/- 0.9 mm in the control group (p < 0.001). The mean aortic valve thickness in patients with aortic valve involvement was 3.6 +/- 0.5 mm compared to 1.5 +/- 0.3 mm in patients with normal valves and 1.4 +/- 0.4 in the control group (p < 0.001). None of the patients from the control group had valve disease (p < 0.0001). Three cases (15%) had pericardial effusion diagnosed by echo. Two patients with PAPS died during the 4.7 +/- 1.2 years of cardiological follow up, due to acute myocardial infarction and embolic cerebrovascular accident, respectively. In conclusion, cardiologic complications are common in PAPS, including left side regurgitant lesions that might be hemodynamically significant, acute myocardial infarction, pericardial effusion and pulmonary hypertension.
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PMID:The heart in the primary antiphospholipid syndrome. 762 Feb 75

Amrinone and dobutamine compare favorably in the treatment of chronic congestive heart failure. There is increasing evidence that amrinone alone or in combination with a catecholamine may be used with considerable success in treating patients who are difficult to wean from cardiopulmonary bypass or who have a low cardiac output syndrome after coronary artery bypass grafting surgery. Amrinone increases intramyocardial cyclic adenosine monophosphate and exerts positive inotropic activity in addition to being a potent vasodilator. It may also improve diastolic function by increasing sarcoplasmic reticulum reuptake of calcium during diastole. It has been administered to patients prior to weaning from cardiopulmonary bypass and has improved hemodynamics and oxygen transport. When compared with dobutamine as primary treatment for depressed myocardial function in patients being weaned from cardiopulmonary bypass after coronary artery bypass grafting surgery, it was more effective in achieving primary treatment objectives. Patients given dobutamine had a higher incidence of myocardial infarction, ventricular fibrillation, supraventricular tachyarrhythmias, sinus tachycardia, and hypertension compared to those given amrinone. It is concluded that amrinone compares favorably with dobutamine and may even be superior when used as primary treatment for treating myocardial depression in patients having coronary artery surgery supported by cardiopulmonary bypass.
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PMID:The role of amrinone in treating heart failure during and after coronary artery surgery supported by cardiopulmonary bypass. 806 35

A group of 1592 male Croatian soldiers (average age 32 +/- 9, ranging from 19 to 54) were examined by an internist at the war hospital. Elevated blood pressure was found in 80 men (5%); 61 of them had no history of hypertension (Group A), while in 19 patients hypertensive disease had been diagnosed before (Group B). In group A, systolic blood pressure (BPS in mm Hg), diastolic blood pressure (BPD in mm Hg) and heart rate (HR) were 182 +/- 13, 111 +/- 10, and 115 +/- 9; in group B, the values were 184 +/- 12, 108 +/- 8, 85 +/- 11. Electrocardiograms (ECG) and thorax roentgenograms of group A did not reveal any hypertension-caused signs, neither did the examination of the fundus, nor the serum creatinine values yield any abnormal results. The ECG test showed sinus tachycardia (heart rate > 100/min) but an otherwise normal function in group A. In group B, at least one of the laboratory examinations confirmed the previously diagnosed hypertension. Group A was treated with the cardioselective beta-blocker Atenolol (100 mg daily), while in group B, the previous antihypertensive medication was modified and/or increased. All patients were sent back to the front-line. Three days later, blood pressure and heart rate in group A were: BPS 139 +/- 9, BPD 87 +/- 6 and HR 77 +/- 8; and in group B: 156 +/- 11, 95 +/- 8, 75 +/- 7. A significant decrease in systolic and diastolic blood pressure (p < 0.0001) was found in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Hyperdynamic beta-adrenergic syndrome among Croatian soldiers engaged in battle. 831 Jul 2

To study acute organophosphorus (OP) poisoning cases, 190 OP-intoxicated cases admitted to Civil Hospital, Ahmedabad, were investigated in depth. The group consisted of subjects ranging from 11 to 60 years of age, with the maximum number of cases in the age group 21-30 years and a male-to-female ratio of 2.1:1. Most of the subjects (71.61%) were partially educated, 24.2% of the cases were illiterate, and only 4.2% of the cases were highly educated. Socioeconomically, 21.1% of the subjects were of low economic status, 52.6% were low middle class, 16.8% were upper middle class, and only 9.5% were upper class. With regard to marital status of the subjects, 98 cases were married and 92 were unmarried. About 67.4% of the cases had the intention of committing suicide, 16.8% of the cases were the result of occupational exposure, and 15.8% of the cases were from accidental poisoning. Social and domestic problems (37.5%), marital friction (15.6%), financial stress (15.6%), love affairs (14.1%), job problems (10.9%), chronic illness (4.7%), and failure in examination (1.6%) were observed as the precipitating factors. Muscarinic manifestations such as vomiting (96.8%), nausea (82.1%), miosis (64.2%), excessive salivation (61.1%), and blurred vision (54.7%) and CNS manifestations such as giddiness (93.7%), headache (84.2%), disturbances of consciousness (44.2%), and typical pungent odor from mouth and clothes (77.9%) were the main presenting symptoms. Cardiac manifestations such as sinus tachycardia (25.3%), sinus bradycardia (6.3%), and depression of ST segments with T-wave inversion (6.3%) were observed electrocardiographically, with hypertension (10.5%) and muscular twitching in some (2.1%) cases. Biochemical changes such as albuminuria (12.6%) and azotemia (18.9%) with inhibition of acetylcholinesterase enzyme activity in blood were recorded in 78.9% of the cases. About 89.5% of the cases recovered completely, 4.2% of the cases absconded after partial recovery, and 6.3% of the cases died. The mortality rate (6.3%) depended on various factors such as the organophosphorus compound consumed, the amount ingested, the time interval for hospitalization, and the general health of the patient. Chances of recovery were higher when the patient was hospitalized at the earliest indication.
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PMID:A clinical, biochemical, neurobehavioral, and sociopsychological study of 190 patients admitted to hospital as a result of acute organophosphorus poisoning. 832 67

The postoperative arrhythmias (exclusive of sinus tachycardia) was reviewed in 77 patients (male: 69, female: 8, mean age: 63.9 years) who underwent esophagectomy for esophageal carcinoma. The results were as follows: 1. The incidence of postoperative arrhythmias in all patients but seven who had preoperative chronic atrial fibrillation (af) or pacemaker rhythm was 47.1%, and af was observed most frequently (45.5%). Postoperative arrhythmias occurred in patients with abnormal preoperative electrocardiographic findings more often than in those with normal preoperative electrocardiographic findings (53% vs 41%). The incidence of postoperative arrhythmias in aged patients (> or = 66 years old) was significantly higher than that in younger patients (< or = 65 years old) (64% vs 35%, p < 0.05). Other risk factors for postoperative arrhythmias were sex and history of hypertension. 2. Postoperative arrhythmias occurred more often in patients who underwent blunt dissection of the thoracic esophagus and reconstruction using the whole stomach via the posterior mediastinal route than in those who underwent esophagectomy with right thoracotomy and reconstruction using the gastric tube via the poststernal route (60.0% vs 45.0%). 3. Most supraventricular premature contractions and ventricular premature contractions occurred immediately after surgery or on the first postoperative day, and af often occurred during the first postoperative night or the second postoperative day. 4. For treatment, various antiarrhythmic agents were administered according to the patient's condition. Glucose-insulin-kalium therapy was especially effective (63%). None of the arrhythmias was fatal.
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PMID:[Postoperative arrhythmia after operation of esophageal cancer]. 845 44

Anger is the affective state most commonly associated with myocardial ischemia and life-threatening arrhythmias. The scope of the problem is sizeable-at least 36,000 (2.4% of 1.5 million) heart attacks are precipitated annually in the United States by anger. The lethal cardiovascular consequences in ischemic heart disease are attributable to the unique physiology of this state, which activates high-gain central neurocircuitry and the sympathetic nervous system, leading to acute sinus tachycardia, hypertension, impaired myocardial perfusion, and a high degree of cardiac electrical instability. Exciting new tools have emerged from the fields of epidemiology, behavioral medicine, and cardiovascular physiology that offer considerable promise in accelerating our understanding of the pathophysiology of anger and in developing means to sever the link between anger and its life-threatening consequences.
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PMID:Life-threatening cardiovascular consequences of anger in patients with coronary heart disease. 872 60

Cyclobenzaprine (CBP) has a cyclic structure similar to amitriptyline. In overdose, CBP has been suggested to produce the cardiovascular and neurologic toxicity found with the cyclic antidepressants. To examine this possibility, a retrospective chart review of all cases of CBP exposure reported to five regional poison centers was performed for the years 1989-93. There were a total of 750 charts identified for CBP exposure, of which 523 had data sufficient for evaluation. There were 121 polydrug ingestions leaving 402 pure CBP ingestions. Ages ranged from 7 mo to 77 yrs, with a mean of 20 yrs; 26% were 6 yrs or less. Females comprised 63% of the patient group. No deaths occurred. Dysrhythmias beyond sinus tachycardia were infrequent, and none were life-threatening. No seizures occurred. Common effects were lethargy, sinus tachycardia, and agitation, and both hypertension and hypotension were seen. All symptomatic cases with a known time of ingestion were symptomatic within 4 h of ingestion. Doses ingested ranged from 5-1000 mg, with a mean of 133 mg. Asymptomatic and symptomatic patients had a mean dose ingested of 45 mg and 183 mg, respectively. Treatment was primarily gastrointestinal (GI) decontamination and supportive care. Other therapies required were mechanical ventilation, dopamine, fluid bolus, sedation, and foley catheter. Symptoms requiring treatment beyond GI decontamination did not occur with ingestions less than 100 mg. In conclusion, cyclobenzaprine does not appear to produce the life-threatening cardiovascular or neurologic effects of the cyclic antidepressants in doses less than 1 g. Lethargy and anticholinergic effects are prominent, though serious toxicity is infrequent.
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PMID:Five-year multicenter retrospective review of cyclobenzaprine toxicity. 874 27

Jimson weed (Datura stramonium, a member of the Belladonna alkyloid family) is a plant growing naturally in West Virginia and has been used as a home remedy since colonial times. Due to its easy availability and strong anticholinergic properties, teens are using Jimson weed as a drug. Plant parts can be brewed as a tea or chewed, and seed pods, commonly known as "pods" or "thorn apples," can be eaten. Side effects from ingesting jimson weed include tachycardia, dry mouth, dilated pupils, blurred vision, hallucinations, confusion, combative behavior, and difficulty urinating. Severe toxicity has been associated with coma and seizures, although death is rare. Treatment consists of activated charcoal and gastric lavage. Esmolol or other beta-blocker may be indicated to reduce severe sinus tachycardia. Seizures, severe hypertension, severe hallucinations, and life-threatening arrhythmias are indicators for the use of the anticholinesterase inhibitor, Physostigmine. This article reviews the cases of nine teenagers who were treated in hospitals in the Kanawha Valley after ingesting jimson weed. We hope this article will help alert primary care physicians about the abuse of jimson weed and inform health officials about the need to educate teens about the dangers of this plant.
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PMID:The dangers of jimson weed and its abuse by teenagers in the Kanawha Valley of West Virginia. 927 42


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