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

The effect of ergotamine and ergometrine on the venous compliance of the forearm has been studied in normal persons. Ergotamine tartrate (0.25 mg. intravenously) led to a fall in venous compliance amounting to 49% on average, while ergometrine maleate (0.25 mg. intravenously) caused a reduction of 41%; these changes were statistically significant. The potent veno-constrictor action of these ergot alkaloids appears to be a major component of the circulatory response to small doses and may be important in provoking the harmfull cardiovascular side-effects (such as angina and pulmonary oedema) that are sometimes observed in patients with pre-existing heart disease.
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PMID:Effect of ergotamine and ergometrine on forearm venous compliance in man. 541 50

We describe seven years' experience with the University of Cape Town lenticular mitral valve prosthesis in 122 patients. All the patients had severe mitral valve disease. In 98 severe mitral stenosis was present with or without incompetence and in 24 the dominant or sole lesion was mitral incompetence. Other valves, particularly the tricuspid, were also frequently affected. The disability was severe or total in almost every patient. One hundred and five patients were discharged from hospital, and in 90 per cent of these the clinical improvement was most gratifying, with the disappearance of pulmonary oedema, paroxysmal dyspnoea, angina pectoris, and congestive cardiac failure. Return to full normal activity including physical work was the rule. The hospital mortality was 14 per cent and a further 38 per cent died during the follow-up period. The major post-operative complication was systemic embolism which could occur at any time after operation. The most important factor influencing the frequency of this complication was the nature of the valve seat. A bare steel seat was associated with a 100 per cent embolism, and a significant reduction occurred when a cloth-covered seat of Dacron-velour was introduced. Anticoagulant therapy appeared to prevent large or fresh clots but had no effect on the deposition of fibrin or platelet thrombi. The only other factor of importance was the age of the patient: after the age of 50 life expectancy and trouble-free long-term survival was reduced.
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PMID:Immediate and long-term results of mitral valve replacement with University of Cape Town mitral valve prosthesis. 544 May 20

Water intoxication from intravascular absorption of non-electrolyte irrigating fluid is a well-known and often serious complication of transurethral resection of the prostate. The amount of absorbed fluid depends on the duration of the operative procedure, the number of transected open venous sinuses and the hydrostatic pressure of the irrigating fluid. Arterial hypertension, bradycardia, mental agitation, confusion, headache, nausea, dyspnoea, convulsions and pulmonary edema are the typical syndromes. In this case, severe Angina Pectoris was the first alarming symptom.
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PMID:[Angina pectoris -- an early sign of water intoxication during transurethral prostatectomy (author's transl)]. 617 35

Approximately 50% of patients hospitalized with acute myocardial infarction have an uncomplicated course and an excellent prognosis. To be considered as having an uncomplicated course, patients should not have ventricular tachycardia or fibrillation, second or third degree atrioventricular block, pulmonary edema, cardiogenic shock, infarct extension, persistent hypotension, sinus tachycardia, or sustained supraventricular tachycardia occurring within the first 4 days of hospitalization. Patients with recurrent angina in the postinfarction period may also be at increased risk. Early and rapidly progressive rehabilitation programs permit the safe discharge of patients with an uncomplicated course after 7 days. Functional exercise testing before, or soon after, early discharge may identify high-risk patients and alter their management.
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PMID:Early discharge after acute myocardial infarction. 635 32

For an appraisal of effectiveness and limitation of the current coronary care unit (CCU) in treatment of patients with complications following acute myocardial infarction (MI), consecutive 557 patients hospitalized to our CCU during five years were studied. In order to assess the severity of complicating pump failure, patients were divided into four classes according to Killip's classification. Number of patients, total mortality (%) and mortality due to pump failure (%) were as follows; 333 (6%, 2%) in class I, 118 (17%, 8%) in class II, 42 (19%, 17%) in class III and 55 (84%, 80%) in class IV. Warning arrhythmias, cardiac rupture and interventricular septal perforation complicated in 184 patients, 11 and 10, respectively, and mortality due to these complications was 2%, 91% and 84% in the order. Right ventricular infarction complicated in 54 patients, but only one patient died from right heart failure. Post-MI angina manifested in 156 patients and six of them died postoperatively. Our data indicate that improvement in mortality due to pulmonary edema and arrhythmias and reduction in incidence of cardiac rupture are evident effectiveness of the CCU, and that there is no improvement in survival rate of patients with cardiogenic shock even under the use of newly introduced vasodilator and catecholamine therapy or intraaortic balloon pumping.
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PMID:Effectiveness and limitation of the current coronary care unit in treatment of patients with complications following acute myocardial infarction. 647 42

Diameters of the small arterial and venous pulmonary vessels were studied in 17 patients, using selective pulmonary angiography. The majority had coronary heart disease. Pulmonary and systemic hemodynamics were also evaluated. In 11 patients, these procedures were repeated 3 minutes after the sublingual administration of 1.6 mg of nitroglycerin (Group I). The remaining 6 patients served as controls (Group II). In Group I, pulmonary circulatory pressures, left ventricular filling pressure, and pulmonary vascular resistance declined significantly compared with Group II. The diameters of the small pulmonary veins declined by more than 10 percent in Group I while remaining constant in Group II. Differences between the two groups in terms of the response of the small arterial vessels was less evident. Increases in vessel cross-sectional area were observed despite considerably reduced intravascular pressure. The increase in elasticity and capacitance of the pulmonary vessels following nitroglycerin is more pronounced on the venous than on the arterial side. These findings suggest that the pulmonary vascular bed contributes significantly to the therapeutically important pooling effect caused by nitroglycerin in the treatment of angina pectoris and pulmonary edema.
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PMID:[Changes in diameters of small pulmonary venous and arterial vessels after nitroglycerin (author's transl)]. 679 96

To assess the prognostic importance of resting left ventricular function in survivors of acute myocardial infarction with pulmonary edema, we retrospectively identified 39 consecutive patients who presented with acute pulmonary edema and myocardial infarction. Sixteen patients had radionuclide ejection fractions 10 +/- 2 days postinfarction of greater than 0.45 (group A, mean 0.55 +/- 0.06), and 23 patients had ejection fractions less than or equal to 0.45 (group B, 0.32 +/- 0.06). There were no significant differences between the two groups for age or sex, but group A patients had a significantly greater incidence of first myocardial infarction predominantly inferior in location. The calculated stroke work index during the acute event was significantly greater in group A than in group B (33.4 +/- 2.4 vs 23.4 +/- 2.0) (p less than 0.05). During a follow-up of 9 +/- 3 months, mortality was not significantly different between the two groups: Four (25%) died in group A and seven (30%) died in group B. In addition, eight patients (50%) in group A were hospitalized for recurrent angina, new myocardial infarction or recurrent pulmonary edema, compared with 11 (48%) in group B (NS). Three deaths in group A were preceded by infarction of the anterior wall of the left ventricle, confirmed at autopsy, and two nonfatal infarctions were anterior by electrocardiography. Four patients in group A had coronary arteriography performed during the follow-up period because of unstable angina, and all had significant (greater than or equal to 70% stenosis) three-vessel disease and two had left main coronary artery disease. Therefore, the predischarge ejection fraction did not predict prognosis for this group of patients. Patients with acute pulmonary edema in the course of myocardial infarction form a high-risk group despite good resting left ventricular function at discharge. They have a significant incidence of recurrent myocardial infarction and death and, because they have good residual left ventricular function, are excellent candidates for surgical intervention.
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PMID:Prognosis of patients with acute pulmonary edema and normal ejection fraction after acute myocardial infarction. 684 21

Among 854 coronary angiograms, we found the following abnormalities of the coronary arteries. Three cases had nonatherosclerotic coronary artery aneurysms. One case, a 27-year-old man with a diffuse lesion, expired after two episodes of myocardial infarction. In 2 other cases the lesions were localized and the patients underwent successful coronary bypass surgery. In 2 cases, a small vascular network was found: a 23-year-old man with pheochromocytoma who also had myocardial injury and pulmonary edema, and a case with contusio cordis who had angina pectoris but had normal coronary arteries. In 3 cases the coronary arteries originated abnormally from the aorta. A congenital right coronary artery-right ventricular fistula was detected in a 17-year-old female with multiple cardiac abnormalities. Abnormally wide coronary arteries were also found in 17 cases with apical hypertrophy, a form of hypertrophic nonobstructive cardiomyopathy.
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PMID:A survey of uncommon forms of coronary arteries. 717 81

Radioimmunological determination of serum myoglobin in 115 patients is reported. Frankly pathological values were noted in 45/55 subjects with a diagnosis of acute myocardial infarct, whereas 7 displayed only a slight rise, and the remaining 3 proved to be false negatives. Pathological values were observed only 2 hr after the commencement of pain, with maxima after 6-20 hr (mean 10 hr). Values returned tonormal 37 hr after the onset of pain. In patients with angina pectoris, myocardial ischaemia, and pulmonary oedema not due to acute infarct, there was only a slight increase in serum levels, while pathological values were never noted in patients with precordial pain of non-cardiac origin.
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PMID:[Diagnostic value of serum myoglobin]. 743 69

Previous studies have reported conflicting results on gender differences in the management of acute myocardial infarction (AMI) and have not evaluated hospital length of stay or costs. To determine gender-based differences in presentation, management, length of stay, costs, and prognosis after AMI, we studied 561 patients with AMI. Women were older, had systemic hypertension, diabetes mellitus, and a non-Q-wave AMI more frequently, whereas more men smoked cigarettes. Predictors of coronary angiography were: male gender (RR 1.9; 95% CI 1.2 to 3.1), chest pain at presentation (RR 1.8; 95% CI 1.0 to 3.3), recurrent angina (RR 4.1; 95% CI 2.5 to 6.8), admission via the emergency room (RR 0.2; 95% CI 0.1 to 0.3), and younger age. Gender did not predict mortality. Among presenting features, the predictors of length of stay were diabetes, prior coronary bypass and prior coronary angioplasty in men, and age alone in women. Pulmonary edema and need for coronary bypass during the hospital course were predictors of length of stay in men only. Among presenting features, predictors of cost were diabetes in men and congestive heart failure in women. Predictors of cost during hospitalization for men were pulmonary edema, coronary angiography, intraaortic balloon pump use, and coronary bypass; for women, they were peak levels of creatine kinase and coronary bypass. Thus, predictors of length of stay and hospitalization costs differ based on gender. Efforts at cost containment may need to be gender-specific.
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PMID:Do gender-based differences in presentation and management influence predictors of hospitalization costs and length of stay after an acute myocardial infarction? 748 95


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