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

Closed-chest trauma in a young man was followed by rupture of a right ventricular papillary muscle and bifascicular block. This produced signs and symptoms of tricuspid regurgitation and recurrent syncope. Treatment by valve replacement and pacemaker implantation was successful. Review of 30 cases of traumatic tricuspid regurgitation reveals that this patient had characteristic findings: adult onset of isolated tricuspid regurgitation, a history of trauma, right bundle branch block, and cardiomegaly without signs of left ventricular failure. In addition, right atrial hypertension of longstanding may produce cyanosis because of right-left shunting through a patent foramen ovale.
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PMID:Chronic tricuspid regurgitation and bifascicular block due to blunt chest trauma. 394 68

The case report of a fatal result in an abortion requested because X-ray diagnostic studies of the gallbladder and intestine had been made during an undiagnosed early pregnancy is presented. A uterine vacuum aspirator had not been purchased by the hospital. A portable laboratory vacuum pump with an appropriate suction trap was used. The apparatus had been used previously in several abortion cases. After dilatation of the cervix and insertion of the aspirating cannula, the pump was turned on. A sudden massive effusion of bloody froth issued from around the cannula. The cannula was removed immediately. It was found that the tubing had been incorrectly connected. The aspirator tube was connected with the pressure outlet of the pump. The tubing was then correctly placed and the uterus emptied. The patient was given succinyl choline, intubated, placed in the Trendelenburg position, and monitored cardiographically. About 30 seconds after the uterine insufflation blood pressure became unobtainable. The pulse slowed to 50 beats/minute and respiration diminished. Cardiac ausculation revealed no sounds. Respiration was maintained using oxygen through an endoctracheal tube. The pulse was still palpable and the EKG showed abnormal QRS complexes. Cyanosis then became evident. Closed chest cardiac massage was used for 1 minute but the patient became pulseless and QRS complexes were bizarre. Then the chest was opened and each ventricle was needled. From each ventricle of the distended heart air hissed under pressure through the needle vent site. The ascending aorta was needled and air escaped under pressure. Cardiac color and action improved when aided by massage. Iv isoproterenol and intracardiac epinephrine were given. An electric defibrillator converted the cardiac rhythm to a sinus rhythm. Norepinephirne brought about hypertension. Blood and albumin were given iv. The patient never regained consciousness. Tracheostomy and a feeding gastrostomy were required. Urinary and respiratory infections followed and the patient died after 2 1/2 months. Autopsy revealed tracheobronchitis, bronchopneumonia, and pulmonary edema. The brain showed extensive cerebral cortical necrosis. The heart was normal. This maternal death was preventable.
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PMID:Air embolism and maternal death from therapeutic abortion. 502 50

A patient with acute necrosis of the intestinal mucosa and high serum diamine oxidase activity is described. The 71-year-old woman, with a history of hypertension and cardiovascular and peripheral arteriosclerotic disease, presented with acute epigastric pain, vomiting, and a deteriorating hemodynamic condition. Serum level of the intestinal enzyme diamine oxidase (DAO) obtained on admission, approximately 24 hr after the onset of symptoms, was 7.4 times above the normal value. An exploratory laparotomy performed 6 hr later revealed cyanosis and areas of transmural necrosis involving the entire small bowel. The bowel was not resected because of the extent of lesion. Thirty hours after the first sample was taken and 2 hr before death, the serum DAO level was only slightly above normal. It is suggested that this biochemical marker could provide a valuable tool for the early diagnosis of intestinal ischemia.
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PMID:Acute necrosis of the intestinal mucosa with high serum levels of diamine oxidase. 643 1

A patient with pronounced dyspnoea and cyanosis was found to have severe hypoxaemia with normal spirographic values. His past history included arterial hypertension, myocardial infarction and phlebitis of the lower limb. Airways resistance was normal, but maximal expiratory flow rates at low lung volume (Flow-volume curves) were reduced, suggesting "peripheral" airways obstruction. This was confirmed by the presence of pulmonary hyperinflation and mechanical non-homogeneity accompanied by unevenly distributed ventilation, as shown by alveolar nitrogen gradient. There was marked hyperventilation with hypocapnia. Since transfer values (measured by the CO single-breath method) and lung distensibility values were normal, emphysema could be ruled out as a cause of obstruction. Analysis of pressure-flow relationship confirmed that the obstruction of peripheral airways was "intrinsic" in character. It could be due to an increase in lung extravascular fluid (interstitial oedema due to left cardiac failure), or to repeated micro-emboli in the lungs, or to hypocapnia, these three mechanisms possibly being associated.
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PMID:[Peripheral airway obstruction involving cardiovascular factors. A case report (author's transl)]. 677 51

Patients with congenital cardiac shunts in whom marked functional disability, cyanosis and pulmonary arterial hypertension develop have been considered inoperable or at exceedingly high risk. Three adult patients, 2 with atrial septal defect (ASD) and 1 with patent ductus arteriosus (PDA), presented with New York Heart Association class IV symptoms, bidirectional shunting with cyanosis, polycythemia, severe pulmonary hypertension, and increased pulmonary vascular resistance. Pulmonary arterial pressure did not decrease in response to administration of 100% oxygen in any patient, and 2 had lung biopsy results showing advanced pulmonary vascular obstruction. While a right-to-left shunt caused cyanosis in all patients, the net shunt was left to right (Qp/Qs greater than 1) and the resistance ratio (Rp/Rs) less than 0.5. All 3 patients survived operation, became acyanotic with normal hematocrit, and are in functional class I or II a mean of 36 months postoperatively. At repeat cardiac catheterization, pulmonary arterial pressure and resistance had decreased substantially. This high-risk group of patients with bidirectional shunts, in whom cyanosis due to pulmonary vascular obstruction and polycythemia develop and who appear to be at very high operative risk, should still be considered for surgical correction if the usual criteria for operability exist: net left-to-right Qp/Qs and Rp/Rs less than 0.50.
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PMID:Management of adults with congenital bidirectional cardiac shunts, cyanosis, and pulmonary vascular obstruction: successful operative repair in 3 patients. 684 83

Total anomalous pulmonary venous drainage is one of the cardiac malformations requiring early surgical correction. In our series of nine cases, 89% were under three months of age and none above six months. Clinically, two types were present: without obstruction and with obstruction to the pulmonary venous flow. In the non obstructive group, all had mild cyanosis, heart failure, cardiomegaly and systolic murmur. In the obstructive group, they had severe cyanosis, heart failure, small heart and pulmonary fields with a "ground glass" or mottled appearance on chest X-ray due to hypertension and edema. The second heart found was split in both groups. An increased right sided O2 saturation and pulmonary hypertension are due to the total anomalous pulmonary venous connection to the right atrium. Right atrium pressures were superior than left atrium pressures in two patients, requiring atrioseptostomy in one patient. Total surgical correction was performed in three patients, with one patient surviving; this patient is well one year after operation. It is noteworthy in our series the early symptomatology. Symptoms begun at birth in 77% of the cases. It was striking as well the absence of cases with drainage to the right atrium or the coronary sinus.
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PMID:[Total anomalous pulmonary venous drainage. Nine case reports (author's transl)]. 721 68

A 10 years old school boy, who had been known to have a small ventricular septal defect from 2 months after birth, was admitted to us with a diagnosis of subarachnoid hemorrhage on October 24, 1978. On admission, neurological examination revealed mild right hemiparesis and miotic pupils in semicomatose state, and thrilling, that was equivalent to Levine III, pansystolic murmur and cyanosis of nails were noticed. By CT scan, intraventricular hemorrhage originated from hemorrhage in the basal ganglia was shown and the left CAG revealed an arteriovenous malformation in the left basal ganglia. Electrocardiogram showed mild cardiac failure and chest x-ray showed pulmonary congestion. Neurological symptoms and abnormal cardiopulmonary changes made well manageable after bilateral ventricular drainage. Twenty four cases of arteriovenous malformation associated with congenital heart disease were reviewed in the reported literature, and 20 cases were found to combine with Galenic aneurysm with congenital heart disease. All of those cases had been in a little pause after the birth and the most of congenital heart diseases were of patient ductus arteriosus. The rest of cases including our present case were 4 cases, who had rather small arteriovenous malformation, and the severity of the congenital heart disease was attributable to the patients mortality. In all of the report at present only our case was the single survival. Embryological investigation on arteriovenous malformation of the brain and congenital heart disease indicated that association of both conditions could be attributable to the vascular malformation in a very limited gestational stage, and that the incidence should be much less than reported. Our case showed the intracranial hypertension was found to create serious cardio-pulmonary dysfunction when congenital heart disease being accompanied, and it was presumably relating to the relatively higher incidence of Galenic aneurysm associated with ductus arteriosus.
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PMID:[Arteriovenous malformation associated with congenital heart disease, with a remark on accompanying cardiopulmonary dysfunction (author's transl)]. 724 22

The effects of a 60-minute IV infusion of histamine (0.5 mg of histamine base/minute) on the systemic, pulmonary, and digital vasculature were investigated in mature ponies. Immediately after the start of histamine infusion, there were a transient decrease in systemic pressure lasting less than 1 minute and then a brief period of systemic hypertension. Systemic pressure then returned to preinfusion levels for the remainder of the infusion period. Pulmonary arterial pressure increased transiently coincident with systemic hypotension. Histamine increased cardiac output and decreased both total peripheral and pulmonary vascular resistances. In the digit, blood flow increased for the duration of the systemic hypertension, but was otherwise unchanged. Digital lymph flow and protein concentration were unchanged by histamine. Hematocrit increased significantly after 60 minutes of histamine infusion, but plasma and blood volumes were unchanged. Histamine caused cyanosis, hyperpnea, and sweating in all ponies. The effects of histamine given IV do not mimic the systemic and digital vascular effects of acute alimentary laminitis.
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PMID:Systemic and digital vascular effects of intravenous histamine in the pony. 725 69

The influence of previous job on health at the age of 70 has been investigated in two representative contrast groups belonging to the population study "70-year-olds in Gothenburg". Anamnestic information, clinical and laboratory data were compared in probands with sedentary work and with arduous manual work. An increased incidence of traumatic injury and an inability to hear whispering at a distance of 5 meters were observed among the heavy workers. In this group, there was also a statistically significantly increased frequency of cyanosis, dyspnea, and post-inflammatory sequelae found on X-ray examination, even if an association between facial cyanosis and exposure to wide ranging atmospheric temperatures and ultraviolet irradiation must be considered. Although the blood pressure levels were almost identical the comparison between the two contrast groups showed an increased incidence of hypertension configuration of the heart and an elongation of the aorta among the manual workers. Thus, the main differences indicated that arduous work was associated with increased risk of traumatic injury, impaired hearing and a certain pulmonary dysfunction, whereas no difference was found in the prevalence of circulatory diseases and diseases of the back and peripheral joints, for example. A very generalized conclusion might be that in the group of elderly people having survived to the age of 70 previous job had not markedly influenced their state of health.
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PMID:Previous job and health at the age of 70. 732 91

Ten cases with pumonary atresia with intact interventricular septum were studied; they were divided in type I (6 cases) and type II (4 cases). In the cases with necropsy no distinct characteristics were observed in comparison to those reported in the literature. Cyanosis, heart failure, cardiomegaly and pulmonary oligohaemia were present in all cases. No correlation was found neither between right atrial middle pressure and the P wave amplitude (r = 0.014), nor between the AQRS and the right ventricular systolic pressure (r = 0.039). All the cases from type II showed hypertrophy of the two ventricles and only one case from type I showed right ventricular hypertrophy. In nine cases right ventricular hypertension was registered. Right atrial middle pressure and right ventricular telediastolic pressure were found increased in nine cases; the other one showed normal values (type II). The angiocardiographic study is a necessary diagnostic procedure. By means of it is possible to determine the ventricular cavity size, the right ventricular infundibulum characteristics and the atresic segment size.
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PMID:[Pulmonary atresia with intact interventricular septum]. 741 70


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