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Query: UMLS:C0034063 (pulmonary edema)
 10,665 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We tried to make an estimate of how pleural effusion occur in congestive heart failure, using right atrial pressure (RA) and pulmonary arterial wedge pressure (PAW) as variables. We calculated the following equation by quoting the data in the past. RA greater than -0.02 x PAW + 13.3. We speculated that when this relationship is satisfied, pleural effusion will appear. We also studied the patients with severe congestive heart failure, dividing them into 2 groups, ie the pleural effusion group (EF) and pulmonary edema group (ED). Compared with ED, EF has a significantly higher RA (RA = 6.1 +/- 1.33 mmHg in EF and 13.3 +/- 2.21 mmHg in ED, mean +/- SE, p less than 0.02) and a significantly lower cardiac index (3.17 +/- 0.26 l/min/m2 vs 2.23 +/- 0.16 l/min/m2, mean +/- SE, p less than 0.01). Therefore, we thought that it was adequate to treat RA and PAW as independent variables. These equations appear to be useful in predicting the development of pleural effusion that's based in the plots of our patients on RA-PAW plane and their relationship to our equations.
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PMID:[Role of systemic and pulmonary hemodynamics in genesis pleural effusion in congestive heart failure]. 226 73

Although treatment with ribavirin has been known to be associated with a decreased mortality in infants with congenital heart disease (CHD) who have respiratory syncytial virus (RSV), few data are available regarding morbidity. We reviewed records of 10 consecutively hospitalized infants with CHD during a recent RSV epidemic. Despite the presence of left-to-right shunt in each patient, symptoms of RSV were respiratory at presentation. After ribavirin, decreased respiratory symptoms were found in 8 infants but in 2 assisted ventilation were required 1 and 3 days after admission. Congestive heart failure worsened in 8 patients, 6 of whom had improved respiratory status after ribavirin. Of the 8 patients with worse CHF (pulmonary edema), 3 responded to medical management but 5 were refractory and 4 required surgical repair of CHD. One patient died of pulmonary hemorrhage. Medically refractory CHF may develop in infants with CHD who become infected with RSV and are treated with ribavirin. Further studies are needed to determine whether the pulmonary edema is caused by RSV, ribavirin, or combination of effects on pulmonary capillary function or some other unrecognized mechanism.
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PMID:Refractory congestive heart failure after ribavirin in infants with heart disease and respiratory syncytial virus. 230 58

A case of right ventricular assistance required after emergency heart transplantation is reported. The patient was a 62 year-old man with terminal congestive heart failure due to ischaemic cardiomyopathy. Preoperatively, this patient had a cardiac index of 1.93 1.min-1.m-2, moderate pulmonary hypertension (mean Ppa: 34 mmHg) and pulmonary arteriolar resistances at 440 dyn.s.cm-5; clinical examination revealed pulmonary oedema, cardiac liver and oliguria with renal failure. Cardio-pulmonary bypass lasted 145 min, including 50 min of assistance after graft reperfusion. Despite postoperative dopamine and dobutamine treatment, oliguria and central venous pressure increased, and higher doses of catecholamines (adrenaline, noradrenaline) and pulmonary intraarterial prostaglandin E1 infusions were required. Despite these agents and haemofiltration, mechanical assistance was needed and a centrifugal pump set up. Diuresis and haemodynamic parameters improved. The patient was weaned from this assistance after 102 h. A satisfactory haemodynamic status was then maintained, but still required 1.4 micrograms.kg-1.min-1 noradrenaline and 0.02 microgram.kg-1.min-1 prostaglandin E1. Six days later, the patient was weaned from the ventilator, but he rapidly developed fatal aspergillus septicaemia. This case demonstrates that temporary mechanical assistance can be useful for treating right ventricular failure occurring after transplantation.
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PMID:[Right ventricular assistance using a centrifugal pump after heart transplantation]. 233 Oct 86

The clinical features of 304 patients with acute myocardial infarction with and without hypertension were studied retrospectively. This inner city population consisted of 172 (57%) males and 132 (43%) females; 155 (51%) patients were black, 88 (29%) Hispanic, and 61 (20%) white by self-identification. Hypertension (greater than or equal to 160/95 mmHg) was present on admission in 46% (139) of patients. Typical ischaemic chest pain was the most common presenting symptom and occurred with a similar frequency in patients with and without hypertension. However, the group with hypertension consisted of proportionately more females than males, more frequently had previously diagnosed hypertension and congestive heart failure, and more often presented with shortness of breath and pulmonary oedema. The racial distribution, mean ages, prevalence of angina, previous myocardial infarction, diabetes, smoking, family history of cardiovascular disease, type of myocardial infarction, peak creatinine phosphokinase, plasma cholesterol, and mortality rates were similar in both groups. Thus, female sex, history of hypertension, history of congestive heart failure, and pulmonary oedema characterised patients with compared to those without hypertension. These findings suggest that the higher mortality rate observed in hypertensives during follow-up after myocardial infarction may be due, at least in part, to more severe underlying left ventricular dysfunction.
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PMID:Atypical myocardial infarction and hypertension: an inner city experience. 233 76

We showed that normovolaemic induced hypertension therapy was effective in reducing ischaemic symptoms attributed to cerebral vasospasm in 41 patients after subarachnoid haemorrhage. By inducing hypertension to 25% to 50% above normal systolic arterial blood pressure, we observed that in 17 of 24 cases (71%) neurological deficits improved. In four cases of haemorrhagic infarction, the blood pressure rose to over 50% of systolic arterial pressure, and a low density area was confirmed on computerized tomography (CT) scan prior to vasospasm. Induced hypertension was therefore not considered when a low density area was revealed on CT scan. Restriction of fluid input is usually a factor in producing hypovolaemia after a neurosurgical operation. Intravascular volume expansion has been reported effective in reversing ischaemic deficits. However, according to Poiseuille's equation, increasing blood volume to a state of hypervolaemia can not enhance flow. The cerebral blood flow (CBF) was raised by increasing perfusion pressure, reducing viscosity, or increasing blood vessel diameter. Intravascular volume expansion elevates not only systemic arterial pressure, but also pulmonary artery wedge pressure over 18 mmHg and cardiac index over 2.2. Since pulmonary oedema and congestive heart failure may develop, one should monitor haemodynamic parameters with the Swan-Ganz catheter as a preventive measure. We emphasize that normovolaemic induced hypertension, maintaining haemodynamics subset 1 of the comparable haemodynamic subsets, is effective in raising perfusion pressure of CBF.
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PMID:Normovolaemic induced hypertension therapy for cerebral vasospasm after subarachnoid haemorrhage. 236 Apr 62

The pregnancy of a patient with myotonic dystrophy and heart failure due to cardiac involvement is described. Endomyocardial biopsy was performed at 32 weeks' gestation with echocardiographic guidance to establish the diagnosis. Severe congestive heart failure, refractory to conventional therapy, was encountered. Continuous arteriovenous hemofiltration was used to relieve pulmonary edema before cesarean delivery.
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PMID:Severe congestive heart failure and cardiomyopathy as a complication of myotonic dystrophy in pregnancy. 238 31

Nitroglycerin and its derivatives have become widely used agents in the treatment of severe forms of heart failure. Their beneficial effects in this disease results from their ability to reduce preload and afterload of the heart muscle leading to an increase of cardiac index, a decrease in mean pulmonary artery and wedge pressures as well as pulmonary and peripheral vascular resistances. This is associated with reducing the patients' complaints. Intravenous nitrates are used in the treatment of myocardial infarction complicated by an increased left ventricular filling pressure as well as in various forms of acute and worsening left ventricular failure, mainly in pulmonary edema. Oral and transdermal nitrates are administered in chronic congestive heart failure NYHA class III and IV.
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PMID:[Use of nitroglycerin in the treatment of congestive heart failure]. 251 63

The clinical features of an inner-city population of 304 patients presenting with acute myocardial infarction (MI) with and without typical chest pain, were studied retrospectively. This population consisted of 172 men and 132 women; 155 (51%) were black, 88 (29%) hispanic, and 61 (20%) white, by self-identification. Typical ischemic chest pain was the presenting symptom in 85% (258); 15% (46) presented with nonchest symptoms, most frequently shortness of breath, abdominal pain, and dizziness. But the frequency of such nonchest symptoms was similar in both groups. When patients were grouped by the presence or absence of chest pain, the proportions of those without chest pain were significantly higher for blacks (22.7%) than hispanics (9.1%, P = 0.001) or whites (4.9%, P less than 0.01). Patients without chest pain also had higher admission systolic (P less than 0.01) and diastolic (P less than 0.01) blood pressures and more frequent histories of congestive heart failure (P less than 0.05), and more often presented with pulmonary edema (P = 0.001) than those with chest pain. Both groups were similar in age, sex, history of hypertension, and presence of hypertension on admission, defined as greater than or equal to 160/95 mmHg, prevalence of diabetes, history of smoking, previous MI, type of MI, history of angina, and mortality rates. Patients without chest pain were characterized by black race, history of congestive heart failure, elevated blood pressure and pulmonary edema than those with typical ischemic chest pain. Thus significant delays in the diagnosis and treatment of this important clinical entity may be reduced by alerting clinicians to these features and by educating selected patient groups.
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PMID:Clinical features of patients with acute myocardial infarction presenting with and without typical chest pain: an inner city experience. 252 Aug 50

The effect of cold and/or a raised partial pressure of oxygen was examined in eleven people with no demonstrable cardiac abnormality but who had pulmonary oedema when scuba diving or surface swimming, and in ten normal divers. These stimuli induced pathological vasoconstriction in the pulmonary oedema group, nine of whom also showed signs of cardiac decompensation when so stimulated. The pulmonary oedema patients have been followed-up for an average of 8 years. Seven have become hypertensive. Except for the onset of lone atrial fibrillation in one normotensive female diver and development of Raynaud's phenomenon in a normotensive man, there have been no cardiovascular events and no deaths.
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PMID:Cold-induced pulmonary oedema in scuba divers and swimmers and subsequent development of hypertension. 256 80

The Xe-133 ventilation pattern in congestive heart failure (CHF) was assessed using 24 inpatient ventilation/perfusion studies performed to rule out pulmonary embolism. Patients with histories of CHF, myocardial infarction (MI), and cardiomyopathy were included in the study. Frank pulmonary edema, pulmonary embolism, and other known lung diseases such as chronic obstructive lung disease, tumor, and pneumonia were excluded. Fifteen of the 24 patients had abnormal ventilation scans. Twelve of the 15 showed bilateral basal Xe-133 retention on washout; the remaining 3 showed diffuse, posterior regional retention. On perfusion scans, 14 of the 15 abnormal ventilation patients showed evidence of CHF such as inverted perfusion gradient, enlarged cardiac silhouette, or patchy perfusion, and all of them had a history of CHF or cardiac disease. Nine of the 24 patients had normal ventilation scans, including normal washout patterns. Seven of the nine had normal perfusion (p less than 0.01). Four of the nine normal ventilation patients had a history of cardiac disease or CHF but no recent acute MI. Bilateral basal regional Xe-133 retention, coupled with perfusion scan evidence of CHF such as inverted perfusion gradient, enlarged cardiac silhouette, and patchy perfusion pattern, appears to be a sensitive and characteristic ventilation/perfusion finding in mild or subclinical CHF.
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PMID:Bilateral basal Xe-133 retention and ventilation/perfusion patterns in mild and subclinical congestive heart failure. 260 44


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