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

Pulmonary emboli seldom recur, and when recurrence does occur it is not associated with permanent sequelae unless there is progressive pulmonary arterial hypertension. Five patients with clinical and perfusion lung scan evidence of recurrent pulmonary embolism presented with abnormal cardiac rhythms without evidence of progressive pulmonary hypertension. Twenty-four-hour ambulatory electrocardiographic monitoring was valuable in diagnosis and in assessing the effectiveness of treatment. Although palpitation was the main complaint, other symptoms included tiredness, mild exertional dyspnoea, and chest discomfort unrelated to effort. Symptomatic improvement coincided with objective evidence of improvement from repeat lung scans and 24-hour ECG records. Antiarrhythmic agents controlled the arrhythmias but were subsequently withdrawn without the return of symptoms. Four of the five patients continued to take anticoagulants for two years. We believe that these five patients represent a group of patients with recurrent pulmonary emboli and a recognisable clinical picture dominated by arrhythmias unrelated to progressive pulmonary arterial hypertension. Long-term anticoagulant treatment was associated with clinical improvement.
Thorax 1979 Jun
PMID:Recurrent pulmonary thromboembolism presenting with cardiac arrhythmias. 48 14

Degradation of prostaglandins (PGs) during passage through the human pulmonary circulation was investigated by measuring the transpulmonary plasma PGF2 alpha difference during continuous intravenous infusion of PGF2 alpha (5-10 mug/min). Seven patients with cardiological disorders and two patients with extensive pulmonary abnormalities were investigated during diagnostic cardiac catheterization. PGF2 alpha levels were measured by radioimmunoassay. The seven cardiac patients were found to have transpulmonary PGF2 alpha differences of 47-88%, indicating metabolism of the PG in the lungs. A patient with extensive bronchiectasis had an apparently normal transpulmonary PGF2alpha difference despite gross abnormalities in routine lung function tests. A patient with primary pulmonary arterial hypertension showed no metabolism of PGF2alpha in the pulmonary circulation. The results show that PG degradation is an aspect of normal lung function and suggest that it becomes imparied when extensive pulmonary vascular damage exists.
Thorax 1976 Dec
PMID:Degradation of porstaglandin F2alpha in the human pulmonary circulation. 101 42

Pulsed Doppler echocardiography of the inferior vena cava is an accurate method for the diagnosis of tricuspid regurgitation and impaired right ventricular compliance, two features of pulmonary hypertension. The purpose of this study was to assess the value of Doppler echocardiography of the inferior vena cava for the detection of pulmonary arterial hypertension in patients with chronic obstructive lung disease. Pulse Doppler echocardiography of the inferior vena cava and right heart catheterisation were performed in 29 patients with severe chronic obstructive lung disease. The mean pulmonary arterial pressure was 27 (10) mm Hg for the entire group; 62% of patients (18/29) had pulmonary arterial hypertension (mean pulmonary arterial pressure greater than 20 mm Hg). An adequate Doppler signal could be obtained in 25 of the 29 patients (86%). Pulsed Doppler echocardiography of the inferior vena cava gave normal results in 10 patients and disclosed tricuspid regurgitation in seven patients, impaired right ventricular compliance in seven patients, and both of these abnormalities in one patient. An abnormal Doppler echocardiogram of the inferior vena cava (tricuspid regurgitation or impaired right ventricular compliance, or both) predicted the presence of pulmonary arterial hypertension with a sensitivity of 87% and a specificity of 80%. These results suggest that pulsed Doppler echocardiography of the inferior vena cava may be a useful though imperfect method of detecting pulmonary arterial hypertension in patients with chronic obstructive lung disease.
Thorax 1989 May
PMID:Detection of pulmonary hypertension by Doppler echocardiography of the inferior vena cava in chronic airflow obstruction. 276 38

From March 1967 to February 1985 91 patients aged from 11 months to 53 years underwent surgical treatment of isolated coarctation of the aorta. The surgical procedures in descending order of frequency, were: resection with end to end anastomosis, resection with replacement by a tube graft, patch aortoplasty, and bypass graft. Resection with end to end anastomosis was achieved mainly in younger patients. The number of patients needing other procedures increased with advancing age. Eighty six patients have been followed up (mean 10 years). There were no hospital or late deaths and none of the patients suffered from spinal cord injury. There were three recurrences of the coarctation, all in patients who had had primary reconstruction below the age of one year. The patients were divided into three groups by age: group 1, 0-5 years; group 2, 6-15 years; and group 3, over 15 years. It was found that there was no late hypertension in group 1 while hypertension persisted in 7% of group 2 and in 28% of group 3. Fifty per cent of the patients with persistent hypertension were above the age of 20 years at the time of operation and had resection with replacement by a tube graft. It is recommended that elective surgery for coarctation of the aorta should be performed at the age of 3-5 years to avoid both recurrence of stenosis and persistent hypertension.
Thorax 1987 Apr
PMID:Surgical treatment of isolated coarctation of the aorta: 18 years' experience. 361 90

Between 1961 and 1977, 51 patients underwent operations for coarctation of the aorta. The average age of presentation of these cases was higher than in other series. Only three were asymptomatic, a finding which is not seen in reports from the West. Operative procedures included resection and graft interposition, resection and end-to-end anastomosis, and bypass grafting. However, the technique of patch angioplasty, routinely performed in the last three years of this review, seemed by far the most satisfactory procedure. The overall operative mortality was 9.8%. Hypertension did not regress in some cases in spite of a successful operation. Recoarctation was not seen in this series. Associated defects influenced results adversely. The overall results of operation for coarctation of the aorta have been very satisfactory and comparable with those in other recorded series.
Thorax 1980 Dec
PMID:Experience with the surgical treatment of coarctation of the aorta in India. 726 73

Despite intensive hydatid control measures in New Zealand, hepatopulmonary fistula resulting from infection by the echinococcus granulosus still occurs. Although the patients may quickly become debilitated from coughing bile and pus and associated septic complications, appropriate surgical therapy is usually effective. The exact diagnosis may be obscure, but it is helped by a high index of suspicion. A retrospective study of eight patients seen over a 27-year period is presented, and principles of management are outlined. Where biliary hypertension is not present adequate evacuation of the intrahepatic cysts, obliteration of the cyst space, freeing of the adherent lung, and closure of the pulmonary fistula(e) usually give satisfactory long-term results. Pulmonary lobectomy or segmental resection is seldom required.
Thorax 1981 Jan
PMID:Hepatobronchial fistula caused by hydatid disease. The Dunedin experience 1952-79. 729 77

One hundred and sixty-five patients had their aortic valve replaced with antibiotic-sterilised homograft. In all cases, a two-layered freehand technique of valve implantation was used. Tailoring (narrowing) of the annulus was required in 29 cases, and an aortic root gusset was used to enlarge the non-coronary sinus in 68 cases. There was an early mortality of 1.8% and late mortality of 2.4%. The actuarial survival rate was 95% at a maximum follow-up of seven years. The incidence of valvar regurgitation (early diastolic murmur) was 11.5% up to six months after operation and an additional 7.2% subsequent to this. Overall, it was trivial in 10.3%, mild in 7.8%, and moderate in 0.6%. Most valve regurgitation was non-progressive and actuarial analysis showed 74% regurgitation-free valves at the end of seven years. The age of the donor and the valve storage time showed some relationship to valve deterioration. Special attention has been paid to the control of hypertension to prevent accelerated graft degeneration. The results suggest that this has been successful. Anticoagulant therapy was not used and thromboembolism has not been seen in patients undergoing isolated aortic valve replacement. There was one case of miliary tuberculosis after homograft valve replacement but no pyogenic or fungal endocarditis occurred. No haemolysis, calcification, or valvar stenosis were observed. This series, followed for a maximum of seven years, shows excellent sustained valve performance and a very low incidence of important postoperative regurgitation, with 91.8% of the survivors symptom-free.
Thorax 1981 May
PMID:Homograft aortic valve replacement: seven years' experience with antibiotic-treated valves. 731

Dexfenfluramine associated pulmonary arterial hypertension occurring in a patient with hereditary haemorrhagic telangiectasia related to a mutation within the endoglin gene is described. This report highlights the critical role of the TGF-beta signalling pathway in this condition.
Thorax 2004 May
PMID:Endoglin germline mutation in a patient with hereditary haemorrhagic telangiectasia and dexfenfluramine associated pulmonary arterial hypertension. 1511 79

The use of CPAP to control excessive daytime sleepiness in OSAHS probably also produces a substantial reduction in vascular risk. This is reviewed with particular reference to hypertension.
Thorax 2004 Dec
PMID:Sleep . 6: obstructive sleep apnoea/hypopnoea syndrome and hypertension. 1556 10

A patient with Klippel-Trenaunay syndrome and pulmonary arterial hypertension not associated with chronic thrombo-embolic pulmonary hypertension is described. It is hypothesised that pulmonary arterial hypertension is another complication associated with the Klippel-Trenaunay syndrome, possibly due to haemodynamic changes of small vessel abnormalities.
Thorax 2005 Nov
PMID:Klippel-Trenaunay syndrome with small vessel pulmonary arterial hypertension. 1626 52


1 2 Next >>