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

The authors report a cause of acute cor pulmonale caused by Schistosoma mansoni bilharziosis. The clinical feature was a collapse with right ventricular failure following a delivery. The hemodynamic exploration showed a pre-capillary and supra-systemic pulmonary hypertension. The histopathologic study in post-mortem showed pulmonary lesions of fibrosis endarteritis with granulomatosis reaction round many eggs of Schistosoma mansoni. The authors discuss the frequency of various anatomic lesions (20, 30%), hemodynamic (20%) and clinical (2,5%) of the pulmonary bilharziosis. They recall the anatomical and histological mechanisms of the pulmonary artery hypertension in this disease. They emphasize the originality of this observation which is due to its super acute character and its Schistosoma mansoni bilharziosis etiology whereas pulmonary demonstrations are usually due to Schistosoma haematobium.
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PMID:[Acute bilharzial cor pulmonale due to Schistosoma mansoni]. 652 24

Two sisters who presented with diffuse hypoplasia of pulmonary arteries, relative hypoplasia of ascending aorta, obstructive uropathy, bilateral ureteral reflux, and hydronephrosis, are described. The subsequent course was characterized by progressive and gradual onset of right heart failure, failure to thrive, chronic malabsorption and systemic hypertension. The syndrome which appears to be transmitted by autosomal recessive inheritance can possibly represent a generalized hypoplasia and growth failure of a part or the entire arterial system. Peripheral pulmonary stenosis can occur as an isolated lesion or in association with other congenital cardiac anomalies, as well as in rubella syndrome and the syndrome of supravalvular aortic stenosis. This communication reports two siblings with a hitherto unreported combination of hypoplastic pulmonary arteries, and aorta with identical genito-urinary tract abnormalities.
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PMID:Hypoplastic pulmonary arteries and aorta with obstructive uropathy in 2 siblings. 671 10

On the basis of a personal observation and from a complete review of the existing literature, clinical and instrumental findings of right atrial myxoma are described. The clinical presentation appears to be rather characteristic. The presence of systemic symptoms, peripheral venous hypertension and/or right heart failure without apparent cause are a clue to the diagnosis especially in an adult woman. The presence of abnormal sounds and/or murmurs in the tricuspid area and intermittence of the signs of obstruction are further support to the diagnosis. The diagnosis can always be made non-invasively by echocardiography, though some pitfalls seem to be inherent to the M-mode technique. The accuracy of two-dimensional echocardiography in the diagnosis of the right atrial myxoma is such that no further investigations are necessary before surgery.
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PMID:[Right atrial myxoma. Review of the literature and a case report]. 676 70

The results of a series of 38 patients with a tricuspid valve prostheses (:76% Starr-Edwards ball valves) associated with correction of one or two left heart valvular lesions are presented. 24 patients underwent clinical and haemodynamic assessment on average 4,2 years after surgery. The conclusions were that signs of systemic venous hypertension were mainly related to residual right ventricular failure despite normal valve function and secondarily to the poor hemodynamic profile of these prostheses and their paradoxical motion. Using these results: 18% early mortality; 24% late mortality; 24% late thrombosis amongst survivors and 52% residual right ventricular failure; and 47,5% of excellent results. The clinical and haemodynamic profiles of the patients were analysed to determine the surgical indications. Apart from the correction of associated left heart valve lesions, it seems that the prognosis in tricuspid valve repair depends on the duration of tricuspid regurgitation and the severity of right ventricular myocardial disease. In elderly patients with chronic tricuspid regurgitation and severe right ventricular failure, long-term analysis showed 87,5% poor results, whilst in younger patients with a shorter history of tricuspid regurgitation and less severe right ventricular failure, there was 77,7% excellent long-term results. Semi circular annuloplasty is widely indicated in mild or severe functional tricuspid regurgitation. Tricuspid valve replacement, a much more serious operation, remains essential in chronic organic lesions and in some cases of massive functional tricuspid regurgitation. A regards the choice of prosthesis, the authors suggest the Hancock bioprosthesis as a logical choice in cases of severe right ventricular failure as they are less prone to thrombosis than mechanical prostheses and have good haemodynamic profiles. The evolution of the right ventricular failure even after correction of tricuspid regurgitation underlines the importance of preventative therapy by early correction of left heart lesions.
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PMID:[Long-term results of tricuspid prostheses]. 679 14

The cardiac profile of 38 patients readmitted to the hospital with the clinical and radiologic findings of pulmonary artery hypertension and right ventricular failure 2 months after ingestion of toxic rapeseed oil was determined with M-mode and two-dimensional echocardiography, pulsed Doppler flow studies and right and left heart catheterization and ventriculography. The echocardiogram and pulsed Doppler recordings revealed right ventricular enlargement in 84% of the patients, indirect evidence of pulmonary artery hypertension in 76% and tricuspid insufficiency in 13%. At cardiac catheterization (n = 11) the mean (+/- standard deviation) pulmonary artery pressure was 40 +/- 9 mm Hg, mean pulmonary systemic vascular resistance ratio was 0.45 +/- 0.12 and mean right ventricular end-diastolic pressure was 13 +/- 4 mm Hg. Pulmonary artery hypertension was sustained after the acute administration of 100% oxygen and persisted in six patients who were restudied within 6 months. Cardiac index and left heart pressures were normal in all but one patient. The contrast ventriculographic studies revealed right ventricular dilation in all patients, tricuspid regurgitation in three patients and a normal left ventricular contraction pattern in all but one patient. The data confirm that symptomatic pulmonary artery hypertension and associated right ventricular dysfunction can complicate toxic rapeseed oil ingestion and that these findings persist for at least 6 months.
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PMID:An epidemic of pulmonary hypertension after toxic rapeseed oil ingestion in Spain. 683 63

Pressure in the right ventricle (RV) as well as the right atrium (RA) and pulmonary artery (PA) were measured in 80 patients with catheter-tip micromanometers and evaluated to determine if the pressures are compatible with the concept of RV diastolic suction. In 40 patients with normal PA pressure, minimal RV diastolic pressure that occurred during early filling, was negative (-2 +/- 0.3 mm Hg) (mean +/- SEM). In 29 patients with PA hypertension, minimal RV diastolic pressure during expiration also was negative (-2 +/- 0.7 mm Hg). In 11 patients with right ventricular failure, however, minimal RV diastolic pressure was positive (9 +/- 2 mm Hg). These results indicate that the human right ventricle, in the absence of failure, has a negative early diastolic pressure, which may reflect RV diastolic suction.
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PMID:Can the human right ventricle create a negative diastolic pressure suggestive of suction? 728 4

The maximal rate of fall in right ventricular pressure (negative dp/dt) was evaluated in 34 patients. Eight had normal pulmonary arterial pressure. Seventeen had pulmonary arterial hypertension, and nine had pulmonary arterial hypertension with right ventricular failure. The right ventricular maximal negative dp/dt in patients with normal pulmonary arterial pressure was 170 +/- 20 mm Hg/sec. In patients with pulmonary arterial hypertension not accompanied by right ventricular failure, this value was 670 +/- 60 mm Hg/sec; and in patients with right ventricular failure, it was also 670 +/- 60 mm Hg/sec. This was higher than in control subjects (P less than 0.001). The maximal positive dp/dt was also higher in patients with pulmonary hypertension, regardless of the presence of right ventricular failure. Right ventricular maximal negative dp/dt correlated with right ventricular maximal positive dp/dt (r = 0.72). Right ventricular maximal negative dp/dt in patients who were not in right ventricular failure correlated linearly with pulmonary arterial systolic pressure (r = 0.83) and pulmonary arterial diastolic pressure (r = 0.83). At any level of pulmonary arterial systolic pressure, right ventricular maximal negative dp/dt in patients with right ventricular failure was lower than in patients with the same level of pulmonary arterial hypertension who were not in failure. These observations indicate that right ventricular maximal negative dp/dt is dependent on load. Even in the presence of right ventricular failure, right ventricular maximal negative dp/dt exceeded values in control subjects.
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PMID:Effect of chronic pressure overload on the maximal rate of pressure fall of the right ventricle. 747 26

There are significant differences between functioning of transplanted and healthy hearts. Assessment of such a heart and therapeutic possibilities in heart recipients require understanding of these differences. Vegetative denervation of heart increases its sensitivity to the circulation humoral substances, especially catecholamines. In the early postoperative period, filling pressures of the right and left ventricle are elevated. An increase in pulmonary resistance accompany noted pulmonary hypertension, leading subsequently to the right ventricular failure and mitral valve insufficiency. Normalization of these disorders begins in the majority of cases about 4 months following heart transplantation. A type of immunosuppression has an important effect on circulatory hemodynamics. A systemic blood hypertension is a frequent complication of immunosuppression with cyclosporine A in heart recipients. Heart contraction frequency is usually higher in heart recipients than that in control group, and its resting mean value is 90 beats per minute. Moreover, a mild circadian changes in this frequency by about 20% is noted in heart recipients. Cardiac arrhythmias following heart transplantation are associated with the degree of denervated heart transplant to arrhythmia is rather improbable. Cardiac drugs acting with mediation of vegetation system have no effect on the transplanted heart. Heart transplant is fully capable to maintain proper body functioning.
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PMID:[Functioning of the transplanted heart]. 765 17

The use of tailored acquisition spiral CT protocols together with standardized contrast medium injections result in a detailed visualization of the pulmonary arteries. Since spiral CT is a quick and noninvasive imaging modality, it is especially suited for severely ill patients suspected to be suffering from acute pulmonary embolism. In contrast to perfusion scintigraphy, spiral CT will directly visualize the emboli, and should be performed if scintigraphy is not conclusive before the patient is referred to angiography. In cases of chronic pulmonary embolism spiral CT will directly visualize thromboemboli, consecutive wall thickening, pulmonary infarctions, and relative hyperperfusion as well as signs of pulmonary arterial hypertension and right heart failure. Acquisition protocols, diagnostic criteria, and clinical value of spiral CT are presented.
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PMID:[Spiral computerized tomography of the pulmonary arteries: diagnosis of acute and chronic lung embolism]. 775 67

Development of acute lung injury (ALI) in the critically ill is associated with an array of abnormal interactions between the heart and lungs. Of these abnormalities, increased pulmonary vascular resistance (PVR) is common and seems to indicate a worse prognosis than when PVR is normal. Increased pulmonary artery pressure, which follows ALI in humans, has been attributed to many factors. Early in ALI, pulmonary artery hypertension (PAH) is secondary to an imbalance between the release of vasoactive mediators derived from arachidonic acid, endothelium-derived relaxing factor, and other metabolites. As ALI progresses, the combination of mechanical obstruction and severe regional hypoxic pulmonary artery vasoconstriction probably becomes the main factor responsible for PAH. In addition to these elements, in situ and peripherally derived thromboemboli can be seen in ALI, owing to diverse disturbances in the coagulation and fibrinolytic processes. The result is increased workload of the right ventricle which is caused by increased afterload and may induce hemodynamic disturbances that culminate in overt right ventricular failure. However, epidemiologic studies have demonstrated that death following ALI is more often the result of respiratory failure or sepsis. The absence of effective therapy for PAH in ALI might be explained by the pathophysiological and clinical course of the disease. A reasonable conclusion from the contributing elements cited above is that PAH complicating sepsis and trauma is simply a marker of the gravity of the systemic insult that leads to the development of ALI and probably not a separate process.
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PMID:Cardiopulmonary interactions in acute lung injury: clinical and prognostic importance of pulmonary hypertension. 780 95


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