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 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cardiac arrhythmias were studied in patients with essential hypertension in relation to their myocardial function. It was found that the arrhythmias occurring in the early period of the disease (borderline hypertension, Stage I hypertension) were primarily functional and affected the course of the disease and hemodynamics to a small degree. The life-threatening arrhythmias recorded in early hypertension were more commonly caused by mitral prolapse. The duration and severity of hypertension, development of left ventricular myocardial hypertrophy, myocardial fiber distension in relative heart failure play a decisive role in the development of cardiac arrhythmias in patients with Stage II hypertensive disease. It is essential to make comprehensive clinical and instrumental studies to clarify the genesis of the arrhythmic syndrome and to correctly choose the management policy in these patients.
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PMID:[Clinical significance of arrhythmia in patients with hypertension]. 206 87

We reported a patient with a brainstem ptosis (midbrain ptosis) associated with mesencephalic hemorrhage. A 57-year-old woman had the sudden onset of bilateral blepharoptosis and diplopia. On admission, computed tomography of the brain and magnetic resonance imaging disclosed a small hematoma in the left tegmentum of midbrain. She had no past history of hypertension of head trauma. Cerebral angiography gave no additional informations. The lesion involving the central caudal subnucleus of IIIrd nerve nucleus may be responsible for the bilateral ptosis, since this finding is consistent with current models of oculomotor organization in monkeys (Warwick 1953).
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PMID:[Brainstem ptosis (midbrain ptosis) associated with mesencephalic hemorrhage]. 224 38

A group of 22 adults with Turner's syndrome, mean age 29.6 years, was subjected to a careful examination by one-dimensional, two-dimensional, pulsed and coloured Doppler echocardiography. The purpose was to assess the incidence and character of congenital and acquired abnormalities of the cardiovascular system which occur within the framework of this defined genetic syndrome. A quite normal echocardiographic finding was recorded in 13 patients, i. e. in 59.1%. In the remainder a wide spectrum of abnormalities was found such as prolapse of the mitral valve (in 13.6%), bicuspid aortal valve with a medium regurgitation (4.5%), hypoplasia of the coronary cusp of the aortal valve (4.5%), dilatation of the ascending aorta with a residual significant stenosis at the site after operation of coarctation of the thoracic aorta (4.5%), subaortal defect of the interventricular septum (4.5%) and slight left ventricular hypertrophy in patients with arterial hypertension (9.1%). Echocardiographic examination in Turner's syndrome makes early diagnosis of abnormalities of the cardiovascular system possible, incl. quantification of the haemodynamic impact. Some of these pathological changes (bicuspid aortal valve, dilatation of the root of the aorta) are for a long time clinically silent but may be nevertheless associated with serious complications. An echographic diagnosis made in time may be of decisive importance for the prevention of complications.
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PMID:[Disorders of the cardiovascular system in Turner's syndrome]. 239 89

A 63-year-old white male with a 25-year history of hypertension experienced the onset of intermittent diplopia and gait disturbance 24 hours after a change in antihypertensive medication from atenolol 50 mg/d to enalapril 5 mg bid. Three weeks later, the patient was admitted with a worsening of symptoms. Cerebral arteriography revealed significant bilateral vertebral artery stenosis. Symptoms continued to progress in the hospital, and at the time of posterior circulation revascularization the patient had a persistent bilateral internuclear ophthalmoplegia and right ptosis. The need for a neurovascular workup and adjustment of therapy in patients with antihypertensive-associated cerebral ischemia is discussed.
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PMID:Hemodynamic vertebrobasilar insufficiency as an adverse effect of antihypertensive therapy. 254 68

This is the case of a 34-year-old woman with Ehlers-Danlos syndrome whose cardiopulmonary manifestations are the following: Prolapse of mitral and tricuspid valves. Aneurysmal dilatation of main arteries without aortic or pulmonary insufficiency. Disturbances in pulmonary function tests and pulmonary arterial hypertension. The diagnosis was verified by skin biopsy and an electron microscopic study. Due to the clinical and histopathological characteristics, we have considered this case to be a non-specified type of the 10 varieties described up to now, and have decided to report it also because of the interesting findings in the hemodynamic and pulmonary function tests.
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PMID:[Cardiovascular abnormalities in Ehlers-Danlos syndrome. Report of a case]. 278 94

The patient, a man aged 57, was admitted to our clinic on May 1, 1987, because of severe vertigo and unsteadiness in standing. Since the age of 55 he had been suffered from hypertension and atrial fibrillation. In September, 1986, he experienced vertigo but recovered soon without therapy. On April 25, 1987, while working, he noticed severe vertigo, nausea and vomiting. He was admitted to a hospital, and then transferred to our clinic. On admission, he was alert and the mentality was normal. Slight ptosis abducent nerve paresis, hypalgesia on the forehead, nose and cheek, facial paresis of peripheral type and hypacusis were detected on the left side. No anisocoria was observed. Sweating was impaired over the left side of the face. Elevation of the soft palate was limited on the left side and the tongue deviated to the left on protrusion. Dysarthria was detected. Though there was no muscular weakness in the extremities, incoordination and dysmetria were noted in the left arm and leg. He could not stand up because of vertigo and unsteadiness. There was no sensory disturbance in the trunk and extremities. Deep tendon reflexes were well elicited and no pathological reflex was observed. These clinical manifestations, except for the ipsilateral palatal and lingual disturbances, were typical of the lateral inferior pontine syndrome caused by occlusion of anterior inferior cerebellar artery, and the lesion was clearly demonstrated by horizontal and coronal MRI. The palatal and lingual disturbances might be due to the involvements of the corticobulbar tracts of the 10th and 12th nerves after the fibers had decussated.
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PMID:[Lateral inferior pontine syndrome: a case report]. 280 19

Non-inflammatory calcific disease of the mitral valve apparatus is a common finding in elderly patients. This study describes the incidence, clinical findings and location of mitral calcium deposits detected by 2D-echocardiography in an unselected series of patients referred for echocardiography to a general hospital. In addition, valvular function was assessed by Doppler sonography. In 48 out of 217 consecutive patients, 2D-echocardiography showed mitral calcium deposits. The mean age of this patient group was 72 +/- 11 years. Clinical histories and findings in most patients indicated an association between calcium deposits and increased tension of valve structures by left ventricular pressure overload (i.e., hypertension, aortic stenosis), dilatative cardiomyopathy or valve prolapse. Calcific deposits were located predominantly at the posterior mitral ring, but in 48% of our patients calcification of mitral chordae was also seen. Mitral regurgitation was detected by Doppler sonography in 52% of the patient group, in 25% at least moderate mitral regurgitation could be demonstrated. The presence of valve incompetence was not dependent on the location of calcium deposits. Mitral valve area, as assessed by Doppler, ranged from 2.1 to 6.7 cm2.
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PMID:[Calcinosis of the mitral valve system and its effect on valve function. A Doppler echocardiography study]. 319 74

The clinical, hemodynamic and pathological findings of 13 patients with aortic regurgitation due to aortic valve prolapse caused by advanced myxomatous degeneration were evaluated. Eleven patients showed a favorable outcome with no complications resulting from surgery. One patient died from aortic dissection, and another died suddenly from an unknown cause. Five patients had mitral valve prolapse as a complication. Ten patients (77%) had a long-standing history of hypertension. Twelve patients (92%) were male. None of the patients had the stigmata of Marfan's syndrome. All patients had marked myxomatous degeneration of the aortic valves without any inflammatory changes. Two patients showed microcalcification; 7 demonstrated moderate fibrosis. Five patients showed severe fragility of the cusps which appeared redundant, gelatinous and softened by degenerative changes. Myxomatous degeneration of the aortic valve is not rare, and, in fact, it may be one of the most common pathologic and clinical entities associated with pure aortic insufficiency.
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PMID:Results of surgery for aortic regurgitation due to aortic valve prolapse. 323 39

An open-label study was undertaken to assess the clinical impact of multiple doses of intacervical prostaglandin E2 (0.5mg) gel administered at 6-hour intervals. 50 women in Canada with low Bishop scores requiring induction of labor were recruited. The prestudy mean Bishop score was 2.3 +or-1.1 and changed significantly with 1 (p 0.001), 2 (p 0.001), and 3 (p 0.002) doses. The mean gestational age of patients receiving 3 doses was significantly less than that of patients receiving 1 dose, (38.5 versus 40.1 weeks, p 0.005). Prostaglandin E2 gel induced labor in 55% of patients, but 14% required subsequent oxytocin (Syntocinon) augmentation. Cesarean section was performed in 6% of patients. No deleterious fetal, neonatal, or maternal effects occurred. 80% of the study group fell into the categories of postmaturity, pregnancy-induced hypertension, and intrauterine growth retardation. There appeared to be a trend toward a higher mean change in Bishop score from 6 to 12 hours in the primiparous women, but a statistically significant difference was not achieved. Surgical amniotomy was performed in 25 patients after labor was established. 47 of the patients achieved vaginal delivery. 3 Cesarean sections were performed because of cord prolapse, fetal distress, and failure to progress. Postpartum hemorrhage occurred in 3 patients.
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PMID:Clinical utility of multiple-dose administration of prostaglandin E2 gel. 346 15

The influence of antenatal and intrapartum events and the route of delivery on Apgar scores and short-term outcome was studied in 359 singleton very low birth-weight infants who were resuscitated adequately at birth and had no lethal congenital anomalies. When stratified according to gestation the occurrence of antepartum haemorrhage, pregnancy-induced hypertension and amnionitis had no influence on the outcome while cord prolapse in infants less than 26 weeks resulted in 100% mortality. Prolonged rupture of membranes significantly improved the chances of their survival. The route of delivery did not influence survival, but greater numbers of babies between 27 and 30 weeks delivered by the breech had lower Apgar scores both at 1 and 5 minutes. Survival was dependent on gestational age and the condition at birth among this group of very low birth-weight infants.
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PMID:Antenatal and intrapartum events influencing outcome in very low birth-weight infants. 346 91


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