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Query: UMLS:C0042571 (vertigo)
 7,148 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effect of lisinopril 5-20 mg once daily or enalapril 5-20 mg once daily on exercise capacity, ventricular ectopic activity, and signs and symptoms of heart failure have been studied in 278 patients with mild-to-moderate (New York Heart Association [NYHA] classes II and III) heart failure in a randomized, double-blind, parallel-group study of 12 weeks' duration. Exercise duration was significantly increased by both angiotensin-converting enzyme (ACE) inhibitors after 6 and 12 weeks of treatment compared with their respective baseline values. There was a trend toward a greater increase in exercise duration on lisinopril after 12 weeks, although this did not reach statistical significance (p = 0.0748). There were no significant treatment differences with respect to the effect of the 2 drugs on ventricular ectopic counts, couplets, or nonsustained ventricular tachycardia. Both drugs were equally effective in improving NYHA grading and symptoms. Neither treatment had any significant effect on mean heart rate or mean blood pressures. Both treatments were equally well tolerated. The most commonly reported adverse events on both drugs were cough, dizziness, fall in blood pressure, vertigo, and myocardial infarction. The results of this study indicate that lisinopril 5-20 mg once daily is at least as effective and well tolerated as enalapril 5-20 mg once daily.
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PMID:Comparison of treatment with lisinopril versus enalapril for congestive heart failure. 132 78

Myocardial infarction is very rare in women under the age of 40 amounting to only .3-.57% of cases according to Polish studies, and it is 10 times less in women than in men. Nevertheless, the use of contraceptives has been implicated in triggering it by diminishing the synthesis of antithrombin III. The use of alcohol can cause the reduction of the fibrinolytic activity of the blood. The case of a 33- year old female patient, a laborer in a brewery is presented, who sought medical help from the company medical staff after 2 weeks of generalized weakness, vertigo, chest pain, and loss of breath under strain. Physical labor had to be discontinued. EKG (electrocardiogram) showed extensive primary and secondary myocardial infarction in progress. She had been taking contraceptives for 3 weeks (1 pill of Femigen once a day). She was drinking 50 g of alcohol daily in the form of 1 liter of beer. She did not smoke, and no circulatory disorder was ascertained. Laboratory tests showed no disorder of aminotransferase or LDH activity, but fibrinogen level (23.5 mcmol/1), antithrombin III level (.124 g/l), and fibrinolysis time (320 minutes) values were abnormal. There was no disorder in the lipid and carbohydrate metabolism, and thyroid hormone level was normal. traditional therapy was prescribed for 2-3 weeks of the infraction: nitrates, rest and avoidance of physical exertion. After administration of castor oil, 2 weeks late an EKG test showed the normalization of all parameters of blood coagulation, and the HDL cholesterol level also dropped. The concomitant use of contraceptives and alcohol can increase the risk of myocardial infraction, therefore they should not be used together, but if such a situation occurs, the control of blood coagulation parameters must be undertaken.
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PMID:[A case of extensive myocardial infarction in a young woman as a complication of oral contraceptives and alcohol]. 245 8

The angiotensin converting enzyme (ACE) inhibitor captopril proved to be an effective antihypertensive drug during a 5-year follow-up study of patients with severe hypertension who had been resistant to a triple-drug regimen. Of the 42 patients, 41 had to be treated additionally with diuretics. Because of hypokalemia, potassium supplements were necessary in 26 patients, despite the use of "potassium-saving" diuretics in 12 patients. Blood pressure was controlled sufficiently in 3/4 of the patients during the 5 years. Patients with a large elevation in plasma renin activity showed the best response to the treatment. Six patients died during the 5 years. Therapy had to be stopped in 11 patients because of complications. The following complications and adverse effects were observed: cerebral ischemia (n = 10), vertigo and orthostasis (10), exanthema (9), hypogeusia (7), circulatory failure (7), myocardial infarction (6), and scintigraphically demonstrable decrease of renal perfusion (5). One patient with bilateral renal artery stenosis suffered from acute renal failure, which was reversible after withdrawal of captopril. Significant changes of red and white blood cell counts, transaminases, lipids, urine protein excretion, and heart rate were not observed.
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PMID:[Results of a 5-year study with captopril in patients with severe therapy-resistant hypertension]. 302 Mar 11

Transtentorial upward herniation is a rare complication of cerebellar infarction and its development indicates an emergency and necessity of posterior cranial fossa decompression. A 63-year-old man with a history of myocardial infarction was admitted to the hospital complaining of sudden onset of vertigo and headache. Neurological examination revealed marked upward gaze palsy, right blepharoptosis, facial weakness, hearing loss on the left side and ataxia of the left upper and lower extremities. A few hours later, he rapidly lost consciousness and MRI revealed massive infarction in the left cerebellar hemisphere and transtentorial upward herniation. Immediate surgical decompression of the posterior cranial fossa was performed, thereafter patient gradually improved. This case suggests that upward gaze palsy is an important initial sign of transtentorial upward herniation with massive cerebellar infarction.
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PMID:[A case of transtentorial upward herniation due to cerebellar infarction manifesting upward gaze palsy as an initial sign]. 847 70

From 1980 to 1992 we followed 12 patients with cardiac myxomas for an average of 4.4 years (8 months-11 years). Presenting symptoms were neurological in four patients (hemiparesis, aphasia, visual field deficits, progressive dementia or vertigo), progressive dyspnoea in six, pulmonary embolism in one, and peripheral arterial or renal emboli in three. The diagnosis was suspected clinically in 11 patients. It was confirmed by echocardiography in ten and by thoracic CT in one. All these patients had cardiac surgery. One diagnosis was made at autopsy; the patient died unexpectedly during surgery for emboli to the leg arteries. At follow-up, two additional patients had died, one from myocardial infarction and one from rhabdomyosarcoma. Only one of the nine surviving patients had recurrent symptoms after cardiac surgery. His dementia continued to progress. The patients without new symptoms after cardiac surgery had normal MRI of the brain or residual ischaemic lesions. MRI of the patient with progressive dementia showed multiple cerebral lesions with a bright centre and a dark rim on T1- and T2-weighted spin-echo images. On CT there were many calcified lesions. CT, MR angiography and contrast angiography revealed multiple fusiform aneurysms. The rare occurrence of progressive neurological symptoms after myxoma resection with multiple cerebral lesions and aneurysms should suggest myxoma metastases to the brain.
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PMID:Cardiac myxomas: a long term study. 856 32

Effects of doxasozine and atenolol on hemodynamics and myocardial ischemia were studied in 20 males (mean age 52.5 +/- 5.3 years) who had survived macrofocal myocardial infarction associated with arterial hypertension stage I-II. The treatment efficacy was assessed clinically, by functional and radionuclide tests. A new long-acting alpha 1-adrenoblocker doxasozine was given in a mean dose 4-8 mg/day. A course of this treatment lowered systolic arterial pressure by 8.3% and diastolic one by 8.1%. As all the patients developed sinus tachycardia on day 5-10 of doxasozine treatment, the patients received additionally beta 1-adrenoblocker atenolol (12.5-25 mg/day) which adequately controlled heart rate. The combined therapy reduced frequency and severity of angina by 34.7%, 24-h need in nitroglycerine by 37.9%, exercise tolerance--by 18.4% as well as improved myocardial perfusion. Patients with concomitant benign prostatic hyperplasia showed attenuation of disuric disorders. Side effects (vertigo, anxiety) occurred in 3 cases (15%), but were not severe enough to demand the treatment discontinuation.
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PMID:[Effects of monotherapy with an alpha1-adrenoblocker doxazosin and its combination with beta1-adrenoblocker atenolol on hemodynamics, reversible myocardial ischemia in postmyocardial infarction patients with arterial hypertension]. 1468 3

Cardiovascular diseases are extremely widespread and often cause vestibular system dysfunctions. They are related mainly to organic lesions of the brain. To investigate neurootological functional changes, we compared two samples from among our patients, of whom those in group A (42 persons: 92.86% male, 7.14% female) had experienced myocardial infarction within 1 year before our neurootometric investigation and those in group B had undergone infarction 1 year or more before examination (104 patients: 81.73% male, 18.27% female). Considering only the six most important vertigo symptoms experienced by patients, we found 1.48 symptoms per patient in group A and 2.02 symptoms per patient in group B. As regards acoustic symptoms, 45.24% of patients in group A experienced tinnitus and 52.38% reported hearing loss. In patients in group B, 48.08% were affected with tinnitus and 58.65% with hearing loss. Abnormalities in the neurootometric measurements were revealed as follows: in group A, butterfly calorigrams, 80.95%; stepping-test craniocorpography (CCG), 64.29%; and bone conduction audiometry on the right side, 40.48%, and on the left side, 52.38%; in group B, butterfly calorigrams, 78.85%; stepping-test CCG, 61.54%; bone conduction audiometry on the right side, 28.85%, and on the left side, 41.35%.
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PMID:Neurosensory deficits after myocardial infarction. 1537 55

The evaluation of cochleovestibular dysfunction in psychiatric patients often causes a difficult problem in neurootological experience. The authors discuss here the neurobiological basis of panic disorders and cochleovestibular dysfunction. In this multicenter study, we examined 63 patients with vertigo and panic disease. Twenty patients with primary panic disease and consecutive vertigo composed group 1, whereas group 2 comprised 43 vertiginous patients with secondary panic disease. The most interesting question is whether the patients have an organic vestibular lesion, which would explain why vertigo alone is the problematic symptom in these panic patients, whereas in other patients, panic disease can cause other severe symptoms that resemble heart attack, dyspnea, or abdominal crisis. Vertigo has a bidirectional connection with psychiatric disorders. The panic disorder can be superimposed on chronic vertigo, and psychiatric patients with a cochleovestibular lesion have diminished chances for complete recovery. The examination of psychiatric patients with vertigo is very time consuming and requires much more empathy than does examination of vertiginous patients with a normal mental state. Anxiety provokes somatic and behavioral symptoms in most such patients. The treatment of vertigo in panic patients and of the panic disorder in vertiginous patients requires cooperation between neurootologist and psychiatrist.
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PMID:Panic disorder in otoneurological experience. 1641 96

In this report, we present a 63-year-old woman who had limited cutaneous systemic sclerosis and subsequently developed typical primary biliary cirrhosis after an acute myocardial infarction. The patient initially developed Raynaud's phenomenon, and 4 years later visited the clinic in 1994 complaining of abdominal distress, xerostomia, and xerophthalmia. A diagnosis of limited cutaneous systemic sclerosis was based on Raynaud's phenomenon, sclerodactyly and anti-centromere antibodies. She was also found to have anti-inositol 1,4,5-trisphosphate receptor 3 (IP(3)R3) antibodies, but anti-mitochondrial antibodies were only weakly positive. Seven years later, she developed vertigo and nausea, and was hospitalized due to complaints of an oppressive sensation of the anterior chest. Electrocardiogram results showed a reduction of R waves and ST segment elevation in II, III, and aVf leads. Coronary angiography showed 99% obstruction of the left anterior descending artery and 50% of stenosis of the right coronary artery. Three years later, the patient was noted to have anti-mitochondrial antibodies. Retrospective analysis of the patient's sera showed that IP(3)R3 antibodies were decreasing. Since myocardium is particularly rich in mitochondria, it is thought that myocardial infarction may have been the triggering event that initiated antigen-presenting cells to selectively induce an anti-mitochondrial antibody response.
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PMID:A case of limited cutaneous systemic sclerosis developing anti-mitochondria antibody positive primary biliary cirrhosis after acute myocardial infarction. 1713 Oct 37

A 64-year-old female receiving clopidogrel and aspirin antiaggregation therapy after percutaneous coronary intervention for non-STEMI myocardial infarction developed nontraumatic bilateral subdural hematoma with dizziness, vertigo and headache. Craniotomy had to be postponed because of reduced ADP platelet aggregability. Four days after clopidogrel withdrawal and transfusion of 12 platelet concentrate units, ADP aggregation transiently normalized and bilateral trepanation with hematoma evacuation was performed. The procedure was followed by excellent neurologic and clinical recovery; however, decreased platelet aggregability was recorded by postoperative day 12 despite strict clopidogrel and other platelet inhibitor withdrawal. Suspicion of Glanzmann thrombastenia was excluded by flow cytometry. Two weeks after neurosurgery, the right femoral vein thrombosis was detected by color doppler ultrasonography and therapy with fractionated heparin was initiated, followed by warfarin. The risk and incidence of hemorrhagic complications of antiaggregation and anticoagulation therapy are discussed. Caution is warranted on prescribing this potentially harmful therapy to older patients, generally burdened with other chronic comorbidities.
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PMID:Nontraumatic bilateral subdural hematoma caused by antiaggregation therapy: case report and review of the literature. 2108 34


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