Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0151744 (myocardial ischemia)
 31,282 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report a 50-year-old female case of mitral stenosis with congenital coronary artery fistula communicating the left anterior descending artery to pulmonary artery. In reviewing the literature, mitral stenosis associated with coronary artery fistula is rare. The case was initially treated medically for congestive heart failure. The electrocardiogram revealed severe myocardial ischemia and no obvious etiology was found clinically. The coronary angiogram demonstrated the diagnosis of coronary artery fistula. Myocardial ischemia improved markedly after surgical correction of the valvular disease and the fistula. The patient continued to do well during 2 years and 10 months follow up. The concomitant mitral stenosis masked the symptoms of coronary artery fistula, and made us fall to diagnose the condition initially. Valvular heart disease associated with severe myocardial ischemia without obvious atherosclerotic stenosis of coronary artery reminded us of the possibility of coronary artery fistula, though it has rarely been reported.
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PMID:Coexistent mitral stenosis and coronary artery fistula presenting as myocardial ischemia: case report. 909 50

Clinical records of 136 cardiac patients with atrial fibrillation (AF) followed in the cardiac clinic of the Black Lion Hospital were analysed. The mean age of the patients was 41 +/- 13 years, with a male to female ratio of 1.0:1.6. Rheumatic heart disease (RHD) was found in 66.3%, hypertension in 10.3%, cardiomyopathy in 8.8% and ischaemic heart disease in 6.6%. Embolic episodes occurred in 26 (19.1%) cases with five deaths. Twenty-one patients had cerebrovascular accident while five had femoral artery occlusion. The major cause of embolisation was rheumatic valvular heart diseases (65.5%), especially mitral stenosis. In order to reduce the high risk of systemic emboli, it is recommended that patients with AF and associated recent onset of congestive heart failure, previous history of thromboembolism and hypertension should be anticoagulated if there are no contraindications.
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PMID:Atrial fibrillation and embolic complications. 914 66

Calcinosis of the mitral fibrous ring (CMFR) was detected echocardiographically in 11.7% of the examinees with ischemic heart disease (IHD) at the age over 60 years. In CMFR the mitral opening significantly narrows, maximal transmitral diastolic gradient rises, mitral regurgitation becomes more pronounced. In one-third of the patients calcinosis involves the posterior wall disturbing its kinematics. Narrowing of the mitral opening in IHD patients accompanying CMFR is considered to be moderate nonvalvular mitral stenosis.
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PMID:[Mitral valve fibrous ring calcinosis in ischemic heart disease]. 943 47

To avoid damage of myocardial ischemia, myocardial hypoxia and reperfusion injury, we designed mitral valve replacement in beating heart under extracorporeal circulation with low dose temperature of 31 degrees C to 35 degrees C in 137 cases of rheumatic heart disease, congenital heart disease mitral stenosis and mitral insufficiency, or concurrent aortic insufficiency. The patients were rept in unblocking aorta, unfilling cardiac arrest perfusion, idle pulse and dradycardia of 40-50 times/min, nose temperature of 32 +/- 1 degrees C. Patients with concurrent aortic insufficiency should first undergo replacement of aorta under cold cardiac arrest and then replacement mitral valve under beating heart to reduce the time of cold heart ischemia. Plastic surgery for tricuspid valve was done under beating heart. Good postoperative prognosis was nated: an average arterial pressure of 9.5-10.5 kPa (70 to 80 mmHg), dose of dopamine was obviously reduced. No low cardiac output syndrome, acute renal failure and severe arrythmia were observed in 137 cases, except 4 deaths due to infection and blood coagulation (2.9%). A left cardiac chamber no-level air removal device and aorta perfusioner leading flow device were designed for exsufflation of left pneumatocardia.
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PMID:[Mitral valve replacement under beating heart in 137 cases]. 959 Jul 59

Hoarseness of voice due to paralysis of the left recurrent laryngeal nerve caused by a dilated left atrium in mitral stenosis as discussed by Ortner, is a subject of controversy. Different authors have cited different mechanisms as explanation. A variety of cardiac problems such as primary pulmonary hypertension, ischaemic heart disease, various congenital heart disorders can all lead to paralysis of the left recurrent laryngeal nerve. Most authors believe that pressure in the pulmonary artery causes the nerve compression. In Papua New Guinea cor pulmonale and rheumatic heart disease are the commonest cardiac disorders seen. Ortner's syndrome is a rarity and has never been reported from here before. Here three different case reports are presented with mitral stenosis, primary pulmonary hypertension and combined mitral stenosis and regurgitation and the pathogenesis of hoarseness is discussed.
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PMID:Ortner's syndrome revisited. 965 3

Dynamic mitral regurgitation (MR) is typically associated with either severe systolic left ventricular dysfunction or episodes of acute myocardial ischemia. We report three patients with mild combined mitral stenosis and regurgitation and normal global left ventricular systolic function who presented with severe exertional dyspnea. Upright bicycle exercise echocardiography revealed development of severe dynamic MR in all three cases with Doppler evidence of severe pulmonary hypertension. There was no echocardiographic or electrocardiographic evidence of ischemia. Exercise echocardiography is an established tool for assessing dynamic changes in transvalvar pressure gradients. These results suggest that exercise echocardiography may also be useful for evaluating changes in severity of MR and for the assessment of dynamic changes in pulmonary artery systolic pressures.
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PMID:Exercise echocardiography in combined mild mitral valve stenosis and regurgitation. 1014 21

AIDS has created considerable concern among the public regarding being transfused with potentially infectious blood. However, autologous blood donations are still not maximally provided nor utilized. Significant heart disease disqualifies all allogeneic and most autologous blood donors (American Association of Blood Banks (AABB) Standards 1994). Disqualification is based on the widespread belief that donating blood could possibly be detrimental to their health. However, this belief has not been sufficiently documented. Sixty-eight donors (ages 14-84 years), all with histories of significant cardiac diseases, donated 111 units of whole blood (1-3 units). Twenty-eight patients donated 1 unit, 37 donated 2 units, and three patients donated 3 units. Fifty-nine patients had ischemic heart disease, and nine had valvular heart disease (five with mitral stenosis and four with mitral valve prolapse). No patient received erythropoietin, and only one received equal volume replacement with normal saline during donation. All these patients eagerly wished to donate in spite of being informed of the possible complications. No patient wishing to donate has been refused, and none has experienced any adverse consequences from donating. Forty-four patients underwent total hip/knee replacements. Only 56 units (50%) were transfused to 37 patients (54%). Although our experience is limited, it appears that many patients with histories of well established cardiac diseases can easily tolerate donating blood without compromising their health.
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PMID:Should cardiac disease prevent autologous blood donation? 1017 96

The paper deals with different aspects of application of stress-echocardiography for assessment of mitral valve disease (acquired stenosis or insufficiency, mitral regurgitation due to ischemic heart disease and mitral valve prolapse). Continuity equation is preferable to pressure half-time and resistance for estimation of hemodynamic significance of mitral stenosis. In some patients studies at rest reveal only slight mitral regurgitation while during stress it becomes hemodynamically significant and associated with pronounced elevation of pulmonary artery pressure. Deterioration of left ventricular function in this pathology often occurs before appearance of symptoms and even before increase of left ventricular dimensions and lowering of ejection fraction can be registered by echocardiography at rest. In patients with mitral valve prolapse stress induced mitral regurgitation has high predictive power for unfavorable clinical course. It is necessary to remember that in this group of patients abnormalities of left ventricular function during stress can be found in the absence of ischemic heart disease or pronounced regurgitation.
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PMID:[Possibilities of stress-echocardiography in diagnostics of pathology of mitral valve. Part II]. 1289 Dec 92

A 57-year-old man with mitral stenosis underwent mitral valve plasty under general anesthesia. He had a history of cerebral infarction. Although he was with atrial fibrillation, his left ventricular function was good. Preoperative coronary angiography revealed no significant coronary stenosis. Induction of anesthesia and the surgical procedure had been uneventful, but the patient had difficulty to wean the patient from cardiopulmonary bypass because of unexpected low cardiac output syndrome. O1-prinone hydrochloride, a newly developed phosphodiesterase III inhibitor, was initiated in addition to high doses of dopamine and dobutamine. This increased the amplitude of the electrocardiogram and caused ST elevation of the lead II. A full dose of isosorbide dinitrate was administered intravenously to differentiate coronary artery spasm from coronary air embolism. This drastically improved the ventricular function and mixed venous oxygen saturation, and weaning from CPB was finally accomplished. The heart showed hypercontraction and inotropes were tapered gradually without further cardiac events. Although there are various etiologies for low cardiac output syndrome after CPB, the possibility of myocardial ischemia must be the first consideration. Full pharmacological support must be tried before initiating a mechanical assist modality. Coronary dilators, nitrates in particular, and phosphodiesterase III inhibitors are promising agents in such cases.
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PMID:[Successful management of a patient for cardiac surgery with difficulty in weaning from cardiopulmonary bypass by using both isosorbide dinitrate and olprinone hydrochloride]. 1529 45

The analysis of the clinical data permit some conclusions about the state of the art of valvular lesions. (i) Mitral stenosis is not the predominant lesion any more, particularly above 65 years of age, although is it still more frequent in females. The decreased appearance of new cases goes parallel with the reduced incidence of rheumatic fever, showing indirectly that the latter is the most common cause of the disease. (ii) Mitral insufficiency is the fourth most common lesion, without any age- and sex-dependent differences. Ischemic heart disease, floppy mitral valve and bacterial endocarditis are the usual causes above the age of 65 years. (iii) Aortic stenosis is becoming the predominant valvular lesion, especially in females over 65 years of age; two thirds of cases have good left ventricular function, emphasizing that surgical removal of the stenotic valve in persons above 75 years may be performed more frequently. (iv) The incidence of aortic regurgitation has not changed during the last 10 years; however, rheumatic fever and syphilis are not any more the main causes, but aortic annular ecstasy and bacterial endocarditis are the most common pathologies leading to the insufficiency of the aortic valve. Taking together these facts, and considering also the problems linked to the surgical treatment (or to the possibility of mitral angioplasty), the disease of the heart valves represent major problems even today.
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PMID:Non-rheumatic-acquired valvular disease in the elderly. 1537 43


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