Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0034063 (pulmonary edema)
 10,665 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A patient experienced episodic pulmonary edema accompanying nocturnal angina pectoris. The symptoms were provoked at cardiac catheterization by atrial pacing. Simultaneous onset of chest pain, shortness of breath, and sudden appearance of a large V wave in the pulmonary artery wedge pressure contour confirmed acute mitral valve regurgitation. Rapid reversal of these changes after nitroglycerin administration supported "papillary muscle dysfunction" as the explanation for these hemodynamic changes.
 ...
PMID:Severe papillary muscle dysfunction substantiated by atrial pacing during cardiac catheterization. 40 54

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.
 ...
PMID:Cardiac risk factors and complications in non-cardiac surgery. 66 58

The effectiveness of Nitroglycerin and its derivates in angina pectoris is well-known. One of the main effects is the reduction of left ventricular filling pressure. Therefore in patients with left ventricular failure after acute myocardial infarction or with chronic coronary heart disease the indication for Nitroglycerin has to be proved. In 51 patients with 76 measurements Nitroglycerin sublingual, intravenous Nitroglycerin, Isosorbide-Dinitrate and Myocardon were investigated. All substances decreased pulmonary artery pressure especially left ventricular filling pressure. Cardiac output increased or decreased in dependence to the height of left ventricular enddiastolic pressure. In the patients with myocardial infarction and left ventricular failure with filling pressures over 20 mm Hg a significant increase in cardiac output was observed. On the contrary in patients without left ventricular failure cardiac output decreased slightly. Nitroglycerin sublingual is especially useful in the most severe form of left ventricular failure: in pulmonary oedema. 0.8 mg of Nitroglycerin 3 to 4 times in 5 to 10 minutes distance is necessary dependent on the severity of the pulmonary oedema and the height of the blood pressure. The permanent intravenous infusion of Nitroglycerin (3 to 6 mg per hour) is very efficient in the treatment of congestive failure in acute myocardial infarction. The left ventricular filling pressure decreased from 28 to 16 mm Hg with an increase in cardiac output from 3.5 to 4.01/min. The mean arterial pressure dropped about 10 mm Hg. Also with oral derivates of Nitroglycerin (Isosorbide-Dinitrate and Myocardon) an extensive decrease in left ventricular filling pressure and an increase in cardiac output has been observed in patients with left heart failure.
 ...
PMID:[New aspects of the treatment of left ventricular failure: Nitroglycerin (author's transl)]. 81 Jun 53

The results of aorto-coronary shunting in 36 patients with preinfarction angina and of urgent direct myocardial revascularization in 17 patients with acute myocardial infarction are presented. The surgical mortality comprised 28% in the group of patients with preinfarction angina. Twenty-two patients were followed-up for 8 months to 4 years. Good results were obtained in 9 patients, satisfactory--in 7, unsatisfactory--in 4. One patient died of cardiac insufficiency 1 1/2 year after surgery. The diagnosis of preinfarction angina is a direct indication for urgent coronary angiography and aorto-coronary shunting in case suitable coronary arteries are available for anastomosing. The indications for urgent revascularization of the myocardium in cases of infarction included the inefficacy of drug therapy within 2-3 hours of its onset, an unarrested pulmonary oedema and cardiogenic shock in cases of localized proximal occlusion of the coronaries revealed by elective or urgent coronary angiography. Four patients were operated on in the state of cardiogenic shock (one of them after reversing the state of clinical death), and two patients were operated on with pulmonary oedema. All these patients (with the exception of the one with pulmonary oedema) recovered. Four patients died. The follow-up covered a period of 9 months to 3 years. Good results were obtained in 4 patients, satisfactory--in 3, unsatisfactory--in 4. No late mortality cases were observed. The obtained results permit to analyse the preinfarction angina and acute myocardial infarction from the standpoint of modern coronary surgery.
 ...
PMID:[Preinfarct stenocardia and acute myocardial infarct from the viewpoint of modern coronary surgery]. 108 96

In intensive therapy units, especially in guarded wards for coronary diseases, the lethality in acute myocardial infarction could be reduced by ca. 50%. However, these favourable results are nowadays of importance for the patients concerned only then, when the diagnosis myocardial infarction or the tentative diagnosis infarction are made in a short period and already prehospitally adequate measures are begun. The following measures are in the centre of prehospital care: Immediate home visit when a suspicion of infarction is present, immediate hospitalisation into an in-patient facility, alleviation of pain, immediate treatment of complications (disturbances of cardiac rhythm, shock, pulmonary oedema, cardiac arrest), prevention of disturbances of the cardiac rhythm. According to the modern knowledge is to be assumed that about 50% of the patients with infarction undergo a premonitory stage which lasts for hours, days or weeks. It is possible that here develop concrete approaches to an infarction prophylaxis. In the first place there are an increase of frequency, intensity and duration of the attacks of angina pectoris, insufficient responsiveness to nitrangin, provocation of the attacks by slight causes and changes of the ECG as they are typical for the inner layer and outer layer ischaemia and the so-called rudimentary infarction. The treatment of the preinfarction process should immediately be begun, at best under clinical conditions.
 ...
PMID:[Preinfarct and prehospital care of myocardial infarction]. 121 38

Epidemiologic investigations have provided a portrait of the potential candidate for coronary heart disease. This is important because studies of the evolution of coronary disease in the general population reveal that it is a common disease that frequently attacks without warning, can be silent in its most dangerous form and can present with sudden death as the first symptom. Progress in identifyin- persons in jeopardy and the factors needing correction makes it theoretically possible to interrupt the chain of factors that eventuate in this disease. Coronary disease does not really begin with crushing chest pain, pulmonary edema, shock, angina or ventricular fibrillation, but rather with more subtle signs like a poor coronary risk profile. The risk factors can be treated quantitatively as ingredients of a cardiovascular risk profile and their joint effect estimated. An efficient practicable set of variables for this purpose is a casual blood test for cholesterol and sugar, a blood pressure determination, an electrocardiogram and a cigarette smoking history. With this set of variables the risk of coronary heart diseases can be estimated over a 30-fold range and 10 percent of the asymptomatic population identified in whom 25 percent of the coronary disease, 40 percent of the occlusive peripheral arterial disease and 50 percent of the strokes and congestive heart failure will evolve. The periodic use of the electrocardiogram at rest and after exercise in persons with a poor risk profile can demonstrate persons with asymptomatic ischemic cardiomyopathy due to advanced coronary artery disease. Most cases of angina pectoris or myocardial infarction represent medical failures; the conditions should have been detected years earlier for preventive management. About 30 percent of patients with infraction will shortly experience new angina, have an annual death rate of 4 percent and a fourfold increased risk of sudden death. Reinfarction will occur at an annual rate of 6 percent, and half the recurrences will be fatal. Congestive heart failure must be expected at 10 times and strokes at 5 times the rate found in the general population. Although no major innovations are required to identify candidates for coronary disease and to estimate their risk, we have much to learn about motivating changes in behavior to control risk factors. Approaches to prevention of coronary heart disease include public health measures to alter the ecology in favor of cardiovascular health, preventive medicine directed at highly vulnerable candidates and hygienic measures initiated by an informed public in its own behalf.
 ...
PMID:Some lessons in cardiovascular epidemiology from Framingham. 124 56

Surgery has become an accepted method of treatment for coronary artery disease and its complications. Revascularization results in significant improvement in symptoms for patients with angina pectoris. Occasionally, patients requiring surgery for angina pectoris will sustain reversible ischemic damage during operation; such patients can be successfully weaned from cardiopulmonary bypass with full recovery when intra-aortic balloon counterpulsation is used. Arrhythmias associated with ischemic damage to the myocardium also can be controlled when IABCP is used for physiologic assistance. Patients in cardiogenicshock of pulmonary edema after acute myocardial infarction have an ominous prognosis. When decompensation occurs, IABCP may be used to stabilize the patient and to allow study and corrective surgery if possible. The prognosis is better for patients with ventricular septal defect, although selected patients without a mechanical defect of the myocardium can be salvaged if the response to IABCP is favorable. Counterpulsation has also been shown to be useful in achieving pulsatile cardiopulmonary bypass and in assisting high-risk patients through operation. External pressure circulatory assist (EPCA) is less effective than IABCP in assisting the failing myocardium; however, the external device is noninvasive and may be a useful adjunct in situations where IABCP is not feasible.
 ...
PMID:Mechanical circulatory assistance for the treatment of complications of coronary artery disease. 125 7

Over the span of two or three days in August, 1972, in two separate communities in eastern Massachusetts two men, one aged 39, the other 66, each without previous overt heart disease, were stung by wasps. Each went into shock rapidly after an interval of over a half-hour developed chest pain and, later, sequential electrocardiographic changes diagnostic of acute myocardial infarction. Each survived; each had normal electrocardiograms before the sting. Though preexistent coronary artery disease can be excluded in neither, the view is favored that acute myocardial infarction in each was caused by deficient coronary perfusion secondary to anaphylactic shock induced by the wasp stings. An intriguing case was just recently reported58 of a 62-year-old man with previous angina who developed pulmonary edema but no chest pain following wasp sting and went on to show rapidly reversed electrocardiographic changes attributable to subendocardial ischemia or infarction. In a sense, this sequence fills the gap as an intermediate phase between the normal and the two individuals described here who developed pain after anaphylactic shock, then proceeded, perhaps through this phase, to develop transmural infarction.
 ...
PMID:Acute myocardial infarction following wasp sting. Report of two cases and critical survey of the literature. 125 36

The observation was conducted in 96 patients with micro-focal myocardial infarction who developed recurrences within the acute or subacute period (up to 2 months). In 47 patients the secondary infarction was of a micro-focal nature, in 49 -- macro-focal. Recurrence of micro-focal infarctions was observed predominantly in aged patients with a long history of angina pectoris who have had repeated myocardial infarctions earlier. Recurrent macro-focal myocardial infarctions were more often noted in younger patients with a brief coronary history, their primary infarction having been of a micro-focal nature. In both groups of patients congestive cardiac insufficiency and pulmonary oedema were often noted. Cardiogenic shock was mainly seen in those with relapses of macro-focal myocardial infarction. Recurrent microfocal myocardial infarction was often characterized by the development of rhythm and conductivity disorders and high mortality rate, especially when the recurrence was of a macro-focal type.
 ...
PMID:[Micro-focal myocardial infarct with a relapsing course]. 127 27

Forty three men and 3 women, with an average age of 59 years (13 to 78 years) underwent aorto-coronary bypass surgery despite severe left ventricular dysfunction (ejection fraction < 35%); 96% of the patients had previous infarction; 60% (N = 28) had unstable angina, 52% (N = 24) had had pulmonary oedema or an episode of congestive cardiac failure. The average ejection fraction was 29 +/- 4%, range 17 to 35%. Thirteen patients had ventricular aneurysms, 4 had grade 3 or 4 mitral regurgitation. The coronary lesions were usually multivessel left main coronary (6), triple vessel disease (27), double vessel disease (12), single vessel disease (1). The average number of bypass grafts per patient was 2.3. The average aorting clamping time was 63 minutes (range 26 to 133 minutes). There were 4 mitral valve replacements, 4 resections of ventricular aneurysms and 1 double procedure (aneurysmectomy and valve replacement). The operative mortality was 2.1% (1 death). During an average follow-up period of 27 months (range 3 to 90 months), there were: 2 recurrent infarctions, 13 episodes of cardiac failure and 8 cardiac deaths (cardiac failure: 5, sudden death: 2, recurrent infarction: 1). Two patients underwent cardiac transplantation. The regression of angina (90% of operated patients were asymptomatic) and the low operative risk, justify aortocoronary bypass surgery despite left ventricular dysfunction in patients with severe symptoms (unstable angina, chronic, invalidating angina). The medium-term results indicate a high risk of cardiac failure which is partially responsible for the secondary mortality rate of 17% at 2 years.
 ...
PMID:[Can patients with severe left ventricular dysfunction be treated by coronary artery bypass surgery?]. 130 Sep 51


1 2 3 4 5 6 7 8 9 10 Next >>