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

In 305 patients operated upon for symptomatic ischaemic heart disease, a series of resting electrocardiograms, obtained during the first days after operation, was evaluated. A new Q wave was found in 10% of the patients. The genesis of this EGG change had not correlation with the patients' age and sex, presence of hypertension and diabetes mellitus, tobacco smoking, blood cholesterol level, functional calss of angina pectoris, previous myocardial infarction, the number of affected coronary arteries, duration of extracorporeal circulation or anoxic circulatory arrest, and peroperatively measured graft blood flow. A new Q wave after revascularization occurred more frequently in patients with multiple venous aortocoronary bypasses. The new Q wave is an EGG manifestation of myocardial necrosis with subsequent local disturbance of left ventricular function.
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PMID:A new Q wave in the electrocardiogram in patients operated upon for ischaemic heart disease. 53 2

Situations requiring immediate lowering of systemic blood pressure are infrequent. Certain clinical syndromes resulting from or complicated by severe hypertension demand vigorous, usually parenteral, antihypertensive therapy. Such syndromes include (1) diastolic hypertension accompanied by sudden disruption of cerebral function, (2) dissecting or leaking aortic aneurysm; (3) accelerated or malignant hypertension, (4) toxemia of pregnancy when either the fetus' or the mother's life is immediately threatened, (5) some instances of diastolic hypertension and acute left ventricular failure, (6) uncontrolled hypertension in the patient who requires emergency surgery, (7) refractory elevation of the diastolic pressure in the kidney transplant patient, and (8) refractory hypertension complicating myocardial infarction or angina. Drugs useful in acutely lowering blood pressure include diazoxide, sodium nitroprusside, methyldopa intravenously, reserpine intramuscularly, and trimethaphan camsylate intravenously. Use of furosemide reinforces the hypotensive effect of these agents. Theoretical advantages and disadvantages of these agents are not always encountered in clinical use.
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PMID:Hypertension crisis. Recognition and management. 57 54

The factors adversely affecting long-term prognosis differed from those affecting outcome of acute infarction. Individual factors were previous history of infarction or hypertension, tachycardia, cardiac arrest, ventricular arrhythmia, atrial fibrillation, 3rd heart sound, raised venous pressure, and pulmonary crepitations. Multivariate analysis reduced these to 6--previous infarct or hypertension, sinus tachycardia, cardiac arrest, ventricular arrhythmia, and artial fibrillation. Of those who survived 5 years, approximately half had angina. Two-thirds of the under 60 survivors were at their normal work.
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PMID:Prognosis of patients with acute myocardial infarction admitted to a coronary care unit. II. Survival after hospital discharge. 58 71

With 218 postinfarction patients under 40 years of age who all underwent coronary angiography, the question in priority is: Can myocardial infarction in young age be characterized by special constellation of risk factors and by specific coronary morphology? Compared with results from literature the risk factors hypertension and diabetes seem to be of less importance than in older patients, smoking on the other hand seems to be more significant: 90.5% of postinfarction patients under 40 years of age were smoking regularly. Coronary angiography proved a pre-domination of 1-vessel disease: 72% showed 1-vessel, 17.9% 2-vessel and 10.1% 3-vessel disease. These findings and those from literature show that the majority of patients with myocardial infarction in young age have the following characteristics: In connection with the risk factor smoking the sclerotic coronary vessel process is developing rapidly, very often at a single spot. Since no longterm gradual occlusion process occurs, no prolonged period of angina pectoris precedes the infarction. There is no time for the development of an adequate collateral circulation; it follows that the infarction is a large one. After the acute infarction there is no angina pectoris.
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PMID:[Riskfactors and coronary morphology in 218 patients with myocardial infarction under 40 years of age (author's transl)]. 60 50

A population of 199 patients from Rochester, MN, was followed from the time of their first carotid or vertebral-basilar transient ischemic attack (TIA). Patients treated with anticoagulants had no significant difference in survival from untreated patients. Among patients with carotid TIA who received anticoagulants, the net probability of stroke was slightly but not significantly lower than in untreated patients. The difference favoring treated patients with vertebral-basilar TIA was significant starting at three months. The rate of intracranial hemorrhage was higher higher among all patients receiving anticoagulant treatment than among untreated patients and was significantly higher among those 55 to 74 years old. Almost all the hemorrhages occurred after a year or more of anticoagulant treatment and in patients more than 65 years old. Patients with high diastolic blood pressure had a significantly higher net probability of stroke than did patients with lower blood pressure and those receiving antihypertensive drugs. By implication, treatment of hypertension was effective in preventing stroke in patients with TIA. Linear discriminant analysis and actuarial analysis indicated that diastolic blood pressure and anticoagulant therapy were the only factors that influenced stroke occurrence. There was no suggestion that previous myocardial infarction, angina pectoris, valvular heart disease, cardiac arrhythmia, or congestive heart failure--individually or in combination--influenced the occurrence of stroke or survival.
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PMID:Carotid and vertebral-basilar transient ischemic attacks: effect of anticoagulants, hypertension, and cardiac disorders on survival and stroke occurrence--a population study. 65 61

During the years 1974 and 1975 at our institution, 587 patients who had suffered previous myocardial infarctions underwent anesthesia and surgery. Thirty-six (6.1%) had a reinfarction and 25 (69%) died. Patients operated on within three months of the previous infarction had a 27% reinfarction rate. This decreased to 11% if the infarct had occurred three to six months previously and stabilized at 4% to 5% if the interval was more than six months. Risk factors associated with significantly increased reinfarction rates included preoperative hypertension, intraoperative hypotensive episodes, and noncardiac thoracic or upper abdominal operations of more than three hours' duration. Time under anesthesia was strikingly correlated with reinfarction rates in the entire group. Postoperative intensive care unit admission did not significantly affect the reinfarction rate, nor did diabetes, angina, patient age or sex, or site of the previous myocardial infarction.
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PMID:Myocardial reinfarction after anesthesia and surgery. 66 Jul 89

In an attempt to assess cardiac risk in non-cardiac surgery, 1001 patients over 40 years of age who underwent major operative procedures were examined preoperatively, observed through surgery, studied with at least one postoperative electrocardiogram, and followed until hospital discharge or death. Documented postoperative myocardial infarction occurred in only 18 patients; though most of these patients had some pre-existing heart disease, there were few preoperative factors which were statistically correlated with postoperative infarction. Postoperative pulmonary edema was strongly correlated with preoperative heart failure, but 21 of the 36 patients who developed pulmonary edema did not have any prior history of heart failure. Nearly all of these 21 patients were elderly, had abnormal preoperative electrocardiograms, and had intraabdominal or intrathoracic surgery. In the absence of an acute infarction, bifascicular conduction defects, with or without PR interval prolongation, never progressed to complete heart block. Spinal anesthesia protected against postoperative heart failure but not against other cardiac complication. By multivariate regression analysis, postoperative cardiac death was significantly correlated with (a) myocardial infarction in the previous 6 months; (b) third heart sound or jugular venous distention immediately preoperatively; (c) more than five premature ventricular contractions per minute documented at any time preoperatively; (d) rhythm other than sinus, or premature atrial contractions on preoperative electrocardiogram; (e) age over 70 years; (f) significant valvular aortic stenosis; (g) emergency operation; (h) a 33% or greater fall in systolic blood pressure for more than 10 minutes intraoperatively. Notably unimportant factors included smoking, glucose intolerance, hyperlipidemia, hypertension, peripheral atherosclerotic vascular disease, angina, and distant myocardial infarction.
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PMID:Cardiac risk factors and complications in non-cardiac surgery. 66 58

Twenty four cases with myocardial rupture among 259 patients with autopsy after death due to myocardial infarction, were compared with patients with acute myocardial infarction and death secondary to other causes. Myocardial rupture occured during the first 72 hours in 58% of the patients and all cases within the first five days. Two thirds of the patients were males and 46% were 70 years of age. There were 24 myocardial ruptures (9.5%). Previous history of arterial hypertension and un-remittent anginal pain were predisposing factors for rupture (p=0.05). Other previously reported bad prognostic factors such as persistent hipertension after acute infarction, severe exercise before infarction and history of Diabetes Mellitus were not statistically significant in this study. Ruptured myocardium was not influenced by a previous history of myocardial infarction, hospitalization delay in the C.C.U., administration of anticoagulants, digitalis or pressor amines. There was no significant difference among the groups compared in enzyme curves or magnitude of leucocytosis. Electromechanic dissociation, sinus bradycardia, nodal rhythm followed by idioventricular rhythm and asystole, were observed following myocardial rupture.
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PMID:[Rupture of the free wall of the heart as cause of death in acute myocardial infarct]. 66 44

The most important factors in the prognosis of coronary artery disease are the number of arteries severly obstructed, significant involvement of the left main coronary artery, and generalized impairment of left ventricular function or ventricular aneurysm. Other prognostic influences at least partially independent of these factors are the severity of functional impairment imposed by angina pectoris, electrocardiographic evidence of left ventricular hypertrophy or conduction defects, hypertension, and diabetes. Candidates for bypass operation have a better prognosis than noncandidates, but difference in left ventricular function is responsible. Refinement of prognostic precision will depend largely on future improvement in measurement of obstructive disease and left ventricular function serially and better knowledge of the cause or causes of coronary artery disease.
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PMID:Natural history of obstructive coronary artery disease: ten-year study of 601 nonsurgical cases. 67 85

The present work allows us to draw a psychological profile of patients suffering from hypertension, tachycardia and angina pectoris. It confirms the fact that patients affected by cardiovascular symptoms are not relevant to one and the same structure of personality. It lays stress on the necessity to differentiate the studied symptoms and to homogenize the cardiovascular samples.
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PMID:[Validation of a psychological questionnaire to differentiate subjects with propensities for hypertension, tachycardia or angor from normal subjects (author's transl)]. 67 78


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