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

We report cases of angina pectoris or minimal acute myocardial infarction accompanied by pulmonary edema, which were retrospectively studied with regard to their clinical characteristics, prognosis and treatment. Sixteen patients, 5 males and 11 females with a mean age of 72.6 years, admitted to the Cardiovascular Center of Sendai between January 1986 and June 1989, were studied. Ten had previous myocardial infarction. Hypertension, chronic renal failure and diabetes mellitus were found in 10, 7 and 7 patients, respectively. Electrocardiograms during cardiac ischemic attacks showed ST elevation in 8 and ST depression in the other 8 patients. Coronary arteriography which was performed in 6 patients revealed three-vessel disease in 5, and two-vessel disease in one. Mechanical ventilation was indicative of 7, and intraaortic balloon counterpulsation in 2 patients. Coronary artery bypass graft surgery was performed for 3 patients. All patients recovered from pulmonary edema and were discharged. During the mean 15-month-follow-up period, 8 patients died. The causes of death were sudden cardiac death in 3, acute myocardial infarction in one, congestive heart failure in one, post-surgical death in one, and non-cardiac death in 2.
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PMID:[Pulmonary edema caused by cardiac ischemic attacks in cases with or without minimal myocardial infarction]. 184 32

Patients undergoing peripheral vascular surgery are at increased risk of postoperative cardiac complications. To evaluate the role of dipyridamole echocardiography in predicting major cardiac events, 109 unselected patients undergoing elective peripheral vascular surgery were prospectively studied. Preoperative dipyridamole echocardiograms were interpreted by an echocardiographer unaware of all clinical data. Patients were followed up until hospital discharge by research physicians without knowledge of dipyridamole echocardiography results. Outcomes were classified using strict predefined criteria by reviewers unaware of other clinical and echocardiographic data. Of the 109 patients, 9 (8%) had positive studies defined as development of new regional wall motion abnormalities or worsening of preexistent wall motion abnormalities. Of these 9 patients, 7 had postoperative events, including 3 cardiac deaths, 1 nonfatal myocardial infarction, 2 with unstable angina, and 1 with pulmonary edema. Only 1 event occurred among the 100 patients with negative studies. The sensitivity and specificity of dipyridamole echocardiography for predicting cardiac events after vascular surgery were 88 and 98%, respectively; the positive and negative predictive values were 78 and 99%. The relative risk of having a cardiac event if dipyridamole echocardiography was abnormal was 78 (95% confidence interval, 11 to 564; p less than 0.0001). If these results are extended and confirmed by other investigators, preoperative dipyridamole echocardiography may be an important screening test for patients undergoing elective peripheral vascular surgery.
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PMID:Prediction of major cardiac events after peripheral vascular surgery using dipyridamole echocardiography. 187 77

Intravenous fluorescein angiography is a commonly performed and extraordinarily valuable diagnostic procedure. The frequency of adverse reactions after angiography has varied considerably in previous reports. In a prospective study of 2789 angiographic procedures in 2025 patients, the authors found that the percentage of adverse reactions depended strongly on the patient's angiographic history. Overall, adverse reactions followed 4.8% of the angiographic procedures. These reactions included nausea (2.9%), vomiting (1.2%), flushing/itching/hives (0.5%), and other reactions (dyspnea, syncope, excessive sneezing) (0.2%). No cases of anaphylaxis, myocardial infarction, pulmonary edema, or seizures occurred. The percentage of reactions was 1.8% for patients who had had previous angiography without ever having had an adverse reaction. In contrast, the percentage of reactions was 48.6% for patients who had had an adverse reaction to angiography previously.
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PMID:Frequency of adverse systemic reactions after fluorescein angiography. Results of a prospective study. 189 Dec 25

Diastolic function in coronary artery disease is modified to a variable extent. There are distinct abnormalities produced during acute ischemia, and following myocardial infarction. The pathophysiology of diastolic abnormalities in these two syndromes is reviewed. During acute ischemia filling pressures of the left ventricle are increased. Pulmonary edema may be produced. Silent ischemia causes less of an increase in filling pressures. The diastolic pressure-volume relation is shifted in an upward manner with a variable contribution from altered myocardial relaxation, increased muscle stiffness, acute pericardial restriction, ventricular interaction, and acute chamber dilatation. The impairment of myocardial relaxation plays a central role and has been quantified in multiple clinical and experimental studies. Filling of the left ventricle during ischemia is altered due to the factors which shift the pressure-volume relation. The acute increase in left atrial pressure may increase filling rates somewhat surprisingly, given the reduced left ventricular compliance. Myocardial fibrosis following infarction may elevate filling pressures, but the degree of elevation is closely tied to the intravascular volume status. Shifts in the diastolic pressure-volume relation reflect a loss of chamber compliance due to an increase in muscle stiffness. Increased amounts of extracellular matrix, specifically collagen, produce this permanent increase in muscle stiffness which is central to the diastolic abnormalities in chronic coronary artery disease.
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PMID:Diastolic function in coronary artery disease. 202 80

We experienced a case of myocardial infarction associated with pulmonary edema in a patient with hydatidiform mole probably due to methylergometrin and prostaglandin F2 alpha (PGF2 alpha) administered during the operation. A 26-year-old woman was scheduled to have curettage for hydatidiform mole under general anesthesia. She had no previous history of cardiopulmonary disease. During the operation, 0.4 mg of methylergometrin was administered intravenously to induce uterine contraction. Because the contraction was not sufficient, 2 mg of PGF2 alpha was given into the uterine muscle. A few minutes later blood pressure and heart rate increased abruptly and arterial blood gas analysis showed hypoxia and respiratory acidosis. Pulmonary edema was confirmed by chest X-P. After ordinary treatment for pulmonary edema, she was transferred to ICU. Postoperative examinations of ECG, serum enzymes and echocardiography revealed anterior subendocardial infarction. About one month later, methylergometrin test was performed during coronary angiography and this induced coronary vasospasm. PGF2 alpha is also known to cause peripheral as well as pulmonary vasoconstriction. Acute myocardial infarction induced by methylergometrin and PGF2 alpha may be a possible cause of this episode.
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PMID:[A case of myocardial infarction associated with pulmonary edema during curettage for hydatidiform mole]. 205 64

A study is presented of 103 patients with myocardial infarction (age: from 23 to 41 years) and 100 patients over 55 years-old. The younger patients showed rarely stenocardia in the preinfarction period, macrofocal lesions prevailed, more pronounced were leucocytosis, hyperenzymemia, hyperlipidemia and hyperthermia, rarely cardiogenic shock, cardiac asthma, pulmonary edema and complex rhythm disorders. Diagnostic errors were observed in 48.5% at the prehospital stage in the younger patients. The most frequent causes of errors were awareness of the physician for coronary pathology in the young, inadequate anamnesis screening and examination of patients.
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PMID:[The diagnosis of myocardial infarct at a young age in the prehospital stage]. 208 89

Four patients developed an acute respiratory distress syndrome characterised by clinical and radiological signs of pulmonary oedema, a protein-rich oedema, severe hypoxemia refractory to oxygen therapy, contrasting with normal left ventricular filling pressures and indicating increased permeability of the alveolo-capillary membrane, 24 to 72 hours after the onset of acute myocardial infarction. After having excluded the usual causes of the acute respiratory distress syndrome, the authors suggest that acute myocardial infarction, especially when extensive, may cause a lesion of the alveolo-capillary membrane by an unknown mechanism. Treatment consisted in mechanical ventilation with positive expiratory pressures in 3 cases and with continuous positive pressure during spontaneous respiration in the third patient and in relay with controlled ventilation in the other two. These techniques of ventilation improved the hypoxemia and led to complete cure in all cases without evolution to pulmonary fibrosis. In addition to mechanical ventilation, all patients were given systematic antibiotic therapy because of the possibility of an infectious etiology while waiting for the results of microbiological and serological testing and because of the high risk of superinfection which plays an essential part in the outcome of the condition. The immediate response to treatment was favourable in all cases. One patient died suddenly of cardiogenic shock two weeks after this episode. The other patients are still alive 39, 38 and 20 months after infarction. The importance of the diagnosis of the acute respiratory distress syndrome in the acute phase of myocardial infarction resides in its therapeutic implications which are quite different to those of cardiogenic shock.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Acute respiratory distress syndrome in the initial phase of myocardial infarction in adults]. 212 17

We report the case of a 37 years old woman with pheochromocytoma of the adrenal gland, with acute circulatory failure and pulmonary oedema. Its originality lies, besides the rare circumstances of diagnosis, in the echographic aspect of the left ventricle with an apical myocardial infarction with both severe apical hypokinesia and compensating basal hyperkinesia. In the literature the most frequent aspect of catecholamine cardiomyopathy is a large uniform dilatation of the left ventricle with often wall hypertrophy. After surgical ablation of the left adrenal gland tumor, we observe quickly a complete normalisation of the picture and especially the echocardiogram. The cardiomyopathy and the pulmonary oedema can result from the specific action of the excess catecholamines on the myocardial cells and the pulmonary capillaries.
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PMID:[A rare cause of acute circulatory failure with pulmonary edema: catecholergic cardiomyopathy of pheochromocytoma]. 226 6

The case of a 68 year old man in whom hydrochlorothiazide induced pulmonary oedema with hypovolaemic shock is presented. The condition was misdiagnosed as myocardial infarction until an early echocardiogram excluded a cardiac cause. The diagnosis was confirmed by an oral challenge.
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PMID:Pulmonary oedema with shock induced by hydrochlorothiazide: a rare side effect mimicking myocardial infarction. 232 72

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


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