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

The cause of death due to toxin F7, an angusticeps-type toxin, isolated from the venom of Dendroaspis angusticeps was studied in anesthetized mice. The carotid arterial blood pressure, the ECG and the respiratory movements were recorded. Within a few minutes after i.v. injection of F7 (1 mg/kg), both the rate and amplitude of the respiratory movements decreased and respiratory arrest took place within 15 min in most cases. Before respiratory arrest, marked bradycardia with various types of arrhythmia and oscillation of blood pressure were observed. Artificial ventilation could abolish these cardiovascular changes and maintain the blood pressure for a long period. Toxin F7 caused a transient and slight increase of arterial blood pressure which could be prevented by hexamethonium. Intracisternal application of F7 (1 mg/kg) caused a long-lasting hypertension and bradycardia and the respiratory arrest time was significantly longer than after i.v. injection. A large dose (50 mg/kg i.p.) of atropine, but not smaller doses (5-10 mg/kg), protected mice against respiratory failure induced by F7. In rats, the phrenic nerve discharge was prolonged during respiratory depression. Since F7 has a potent anticholinesterase activity, it is concluded that the respiratory failure induced by F7 is peripheral in origin, chiefly, if not entirely, due to its anticholinesterase activity.
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PMID:A study on the cause of death produced by angusticeps-type toxin F7 isolated from eastern green mamba venom. 395 63

Scorpion sting in children is a hazardous and potentially lethal condition. Fifty-one infants and children were admitted to the Pediatric Departments at the Hadassah-Hebrew University Hospitals in Jerusalem, during a 5-year period, following scorpion sting. Fifteen (29.4%) had severe systemic signs of envenomation and two (3.9%) died. Analysis of our data showed that patients with severe toxicity were brought to the hospital after a significantly longer time lapse than were the patients with mild-to-moderate symptoms. The current management of children with scorpion envenomation consists of administration of specific antivenom and close surveillance in an intensive care unit, where vital signs and continuous cardiac monitoring enable early initiation of therapy for life-threatening complications, such as cardiac and respiratory failure, convulsions, or hypertension.
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PMID:Scorpion sting in children. A review of 51 cases. 397 39

We administered 20 mg of isosorbide dinitrate sublingually to 16 patients with acute hypoxemic respiratory failure (ARF) complicated by pulmonary artery hypertension (PAH) and evaluated its effects 20 to 30 min later using a combination of invasively measured pressures and flows and ECG-gated cardiac scintigraphy. We measured the right and left ventricular ejection fractions and a simultaneous thermodilution stroke volume index; we then calculated respective end-diastolic (EDVI) and end-systolic (ESVI) volume indexes. An initially depressed mean right ventricular ejection fraction (RVEF) increased modestly after the administration of isosorbide dinitrate (35 +/- 10 to 41 +/- 10%; p less than 0.02), whereas both the mean right ventricular end-diastolic (-27 +/- 50 ml/M2; p less than 0.04) and end-systolic (-27 +/- 44 ml/M2; p less than 0.03) volume indexes fell. The RVEF increased in 11 of 16 patients: within this subgroup, a decrease in the RVEDVI and RVESVI was associated with a decrease in both cardiac index (delta 0.3 L/min/M2) and LVEDVI (delta -15 +/- 21 ml/M2; p less than 0.01); hence, O2 delivery also fell (delta -36 +/- 56 ml/min/M2; p less than 0.05). In some patients with ARF complicated by PAH, sublingually administered nitrates may improve right ventricular systolic function when globally depressed. However, left ventricular "pump" function appears to be depressed when a concurrent depression in right ventricular "pump" function ensues.
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PMID:The immediate effects of isosorbide dinitrate on right ventricular function in patients with acute hypoxemic respiratory failure. A combined invasive and radionuclide study. 400 37

This study describes the case of a 58 year old man who presented with an episode of acute respiratory failure and right heart decompensation. After recovery from the acute illness, hypoxaemia, hypercapnia and pulmonary arterial hypertension remained, the causes of which were not known. There was no airway obstruction, only a moderate restrictive ventilatory defect, a little weight increase and a unilateral diaphragmatic paralysis. Obstructive sleep apnoea was finally suspected and confirmed by sleep recording. The obstructive sleep apnoea probably explained the respiratory insufficiency and the pulmonary hypertension. Loss of weight was associated with the disappearance of hypercapnia and pulmonary hypertension. As a result of this study, the value of sleep recording is emphasized. When respiratory failure or pulmonary hypertension seem unexplained, think of obstructive sleep apnoea.
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PMID:[Value of sleep polygraph examination in the etiological diagnosis of apparently inexplicable respiratory insufficiency]. 404 63

The physiopathology of chronic bronchitis consists of sequential reactions which progressively result in respiratory failure, blood gas abnormalities and finally, post-hypoxia cor pulmonale. Airway obstruction produces maldistribution of inspired gas and starts off a series of compensatory mechanisms with increased resting lung volume and prolonged expiration time resulting in diminution of tidal volume. Abnormal ventilation/perfusion ratios result in shunt and dead space effects, determine blood gas disorders and hypoxia due to reflex vasoconstriction and ultimately lead to pulmonary arterial hypertension with elevated cardiac output and increased vascular resistances. These physiopathological chain-mechanisms account for the clinical symptoms observed, including dyspnoea, episodes of acute bronchitis and in the end, signs of chronic cor pulmonale. They also indicate that the primary objective of treatment is to correct hypoxaemia. This can be achieved by continuous low flow rate oxygen therapy, by drugs capable of redistributing more evenly the ventilation/perfusion ratios and, accessorily, by respiratory analeptic agents. As regards the treatment of pulmonary arterial hypertension, one must admit that many uncertainties are still surrounding the use of vasodilators.
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PMID:[Physiopathology of chronic bronchitis]. 614 30

This review evaluates noninvasive techniques for assessing cardiovascular performance in acute and chronic respiratory failure. Radiographic, radionuclide, and echocardiographic methods for determining ventricular volumes, right (RV) and left ventricular (LV) ejection fractions, and pulmonary artery pressure (PAP) are emphasized. These methods include plain chest radiography, radionuclide angiocardiography, thallium-201 myocardial imaging, and M mode and 2-dimensional echocardiography, which have recently been applied in patients to detect pulmonary artery hypertension (PAH), right ventricular enlargement, and occult ventricular performance abnormalities at rest or exercise. Moreover, radionuclide angiocardiography has proven useful in combination with hemodynamic measurements, for evaluating the short-and long-term cardiovascular effects of therapeutic agents, such as oxygen, digitalis, theophylline, beta-adrenergic agents, and vasodilators.
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PMID:Noninvasive assessment of right and left ventricular function in acute and chronic respiratory failure. 634 Sep 61

The orally active angiotensin-converting enzyme inhibitor captopril was administered for up to 11 weeks to three patients with progressive systemic sclerosis presenting with hypertension and plasma creatinine levels of 3.1, 7.2 and 10.4 mg/100 ml. Only one patient had malignant phase hypertension. In this patient a diuretic had to be added to captopril in order to keep blood pressure under control. Despite sustained blood pressure control during captopril administration, renal function deteriorated and hemodialysis treatment had to be started in all patients. Up to that time no substantial improvement in skin lesions was observed. During the period of dialysis, blood pressure was normal in all patients even though administration of captopril was discontinued. All three patients died of respiratory failure while on chronic hemodialysis for 3 to 4 weeks. These observations confirm that angiotensin-converting enzyme inhibition may be helpful in controlling blood pressure of patients with scleroderma. However, in contrast to some earlier reports, they also indicate that converting enzyme inhibition does not always prevent the multivisceral vascular lesions of scleroderma.
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PMID:Deterioration of renal function in hypertensive patients with scleroderma despite blood pressure normalization with captopril. 638 62

A study was made of pulmonary artery pressure in 16 chronic bronchitics with severe respiratory failure, who were treated with continuous oxygen therapy at home. At the beginning of the study these patients presented with a pure and severe obstructive syndrome with marked hypoxaemia at rest (mean PaO2 = 6.8 kPa), had a suitable interval from a recent exacerbation, in a stable clinical and functional respiratory state. The duration of longterm oxygen therapy was controlled, as the efficacy of the blood gases (PaO2 of O2 greater than or equal to 8 kPa). The pulmonary artery pressure was measured using a microcatheter, at the beginning, and for most of the 18 months breathing ambient air in a stable state. At the end of this time a significant diminution of the FEV1 (VEMS) (a mean of 100 ml, p less than 0.01). This was evidence of the deterioration in the ventilatory state which contrasted with the improvement in the diminution of pulmonary artery hypertension (HTAP) from 3.43 to 2.97 kPa (p less than 0.05) without the deterioration in the other values. The good result above in chronic bronchitics contrasts with a stable or deteriorating pulmonary arterial pressure in a group of emphysematous (n = 6) and bronchiectatic subjects (n = 4) with somewhat similar functional characteristics but in whom the effect was too small to allow for any statistical comparison. Our results are compared with those in the literature much of which applies to only a few patients and for the great part revealed only haemodynamic stability of oxygen therapy. Possible reasons for these discordant findings are discussed.
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PMID:[Pulmonary arterial pressure in chronic bronchitis with respiratory insufficiency on long-term oxygen therapy. Outcome of 16 patients with review of the literature]. 646 53

The haemodynamic definition of chronic cor pulmonale is precapillary pulmonary artery hypertension (P.A.H.T.), which determines the long term prognosis of chronic respiratory failure (C.R.F.) due to chronic obstructive airways disease (C.O.A.D.). The essential element of the various causes for an increase in pulmonary arterial pressure (PAP) is an increase in pulmonary arterial resistance secondary to alveolar hypoxia. At the present time, only long term oxygen therapy at home seems capable of limiting the progression of P.A.H.T., with a favourable influence on survival as demonstrated by two recent Anglo-Saxon multicenter surveys. The value of new drugs which have been proposed as a complement to or even a replacement for oxygen therapy, such as Almitrine dimesylate and Nifedipine, is currently being evaluated.
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PMID:[Effect of oxygen therapy on chronic pulmonary artery hypertension]. 646 2

Renal biopsies were carried out in 29 patients with scleroderma to study the early vascular lesions and their eventual clinical significance. Haemolytic acute renal failure was present in 9 patients. The biopsies showed early vascular lesions on interlobar arteries. The main biological change was proliferative or fibrous endarteritis. Mucoid infiltration was found in 3 biopsies. The arterioles were spared or only slightly affected without major fibrinoid necrosis. These lesions were therefore distinct from those of malignant hypertension. However, at autopsy of 2 of these cases, the vascular lesions were undistinguishable from those of malignant hypertension. The biopsies in 13 out of 14 patients with scleroderma without obvious renal involvement (9 cases) or with moderate proteinuria and/or hypertension without renal failure (5 cases) showed interlobar endarteritis with associated mucoid infiltration in 3 patients. This lesion was isolated but sometimes extensive even in young patients without hypertension. One patient died within one year, of disseminated colonic carcinoma, and 4 of cardio-respiratory failure due to scleroderma without hypertension, renal failure or proteinuria. Eight of the 9 remaining patients were traced 6 to 16 years after biopsy. Two were moderately hypertensive but none had renal failure. Cutaneous and internal organ scleroderma had regressed in the majority and proteinuria had disappeared in 3 cases.
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PMID:[Renal involvement in scleroderma]. 652 54


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