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)

Six cases of complete or partial rupture of the papillary muscle after acute myocardial infarction are presented. All cases were treated by mitral valve replacement and concomitant coronary bypass surgery. An average delay of 3 days between rupture and operation occurred in the four patients with rupture of the main muscle trunk. The operative mortality rate was 50 percent. Such patients present with acute, florid left ventricular failure secondary to the severe mechanical burden imposed on the newly infarcted heart. The resulting valvular incompetence must be corrected by urgent mitral valve replacement if survival is to be lengthened. Patients with partial or apical head ruptures have a lesser degree of regurgitation and symptoms are largely dependent on intrinsic ventricular function. Both of our patients with partial muscle rupture presented with severe heart failure 2 to 4 months later, and both did well postoperatively. We believe that prompt operation without prolonged attempts at medical stabilization is the key to decreasing operative mortality, especially in instances of complete muscle rupture. Since ischemic heart disease remains the leading cause of death in such patients, coronary artery bypass surgery should be performed in conjunction with valve replacement.
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PMID:Papillary muscle rupture complicating acute myocardial infarction. Treatment with mitral valve replacement and coronary bypass surgery. 660 18

Two patients had cardiac complications of childhood onset systemic lupus erythematosus (SLE). A 14-year-old boy had extramural and intramural coronary arteritis demonstrated by angiography. The signs and symptoms of myocardial ischemia improved dramatically when corticosteroid dose and immunosuppression were increased. A 20-year-old woman had had SLE for 18 years and had functionally significant mitral stenosis and regurgitation. Calcification of the mitral valve was observed on echocardiography. Corticosteroid treatment has controlled the renal manifestations of SLE. Cardiac complications of SLE are now a significant clinical problems.
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PMID:Cardiac complications in children with systemic lupus erythematosus. 663 79

Regurgitation of the gastric contents into the esophagus is common and often unnoticed. When symptoms such as heartburn, a sour or bitter taste in the mouth, or even chest pain mimicking angina pectoris or myocardial ischemia prompt a patient to seek help, the factor or factors responsible for reflux must be sought. The possible underlying causes are numerous, as Dr Bachman points out in this discussion of the pathophysiology, diagnosis, and treatment of gastroesophageal reflux. The desired end point of management was well stated by Seneca over 2,000 years ago as "a good-humored stomach."
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PMID:Gastroesophageal reflux. Simple measures often suffice. 663 18

Clinical experience with calcium antagonists in congestive heart failure has, to date, been mainly restricted to the use of nifedipine but there is either no or only a limited extent of information available on diltiazem and verapamil. In patients with acute and chronic congestive heart failure, single-dose administration of nifedipine was seen to lead to a decrease in systemic vascular resistance, left ventricular filling pressure and ventricular volumes as well as to an increase in stroke volume, ejection fraction and mean velocity of circumferential fiber shortening. These favorable effects could not be detected in eight patients during a three-week treatment phase with 80 mg nifedipine daily: resting blood pressure, cardiac volumes, echocardiographically-dimensions and exercise tolerance were unchanged as compared with placebo. In patients with ischemic heart disease and impaired ventricular function, in addition to an improvement in systolic function, single-dose nifedipine administration led to favorable effects on diastolic function with a shift of the diastolic pressure-volume relationship downward and to the diastolic pressure-volume relationship downward and to the left. In patients with severe aortic regurgitation, the observed increase in effective cardiac output affected by nifedipine was primarily attributable to an increase in heart rate. In the presence of an initially-elevated systemic vascular resistance, the regurgitation fraction decreased. In pulmonary hypertension, favorable hemodynamic effects have been reported after acute administration of verapamil as well as diltiazem and nifedipine. In individual cases, promising results in patients with primary pulmonary hypertension have been reported during long-term therapy with nifedipine provided that a favorable initial response could be documented.
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PMID:Calcium antagonists in heart failure. 685 66

The determinations of stroke volume (SV) were used with the aid of different formulae in patients with the ischaemic heart disease with areas of akinesia of the left ventricle, and those with the acquired mitral and aortal valve disease, congestive cardiopathy and in healthy individuals. Tetrapolar rheography was used as control. The calculation of SV with echocardiogram of the left ventricle in patients with areas of akinesia of the left ventricle and valvular regurgitation gives unduly high figures. The same data have been obtained in determining the SV with echocardiogram of the mitral valve with relative insufficiency. The figures of SV calculated with the echocardiogram of the aortal valve in patients with the disease of the aortal valve are lower as compared to the rheographic data.
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PMID:[Various methods of determining left ventricular stroke volume by using echocardiography]. 731 Dec 98

Although no epidemiological studies are available to evaluate the exact risk of infective endocarditis complicating native cardiac disease, analysis of data in the literature shows that cardiac disease can be classified into three groups of decreasing risk: (1) high risk disease includes cyanotic congenital heart lesions, previous bacterial endocarditis, aortic valve disease, mitral regurgitation and uncorrected left-to-right shunt, but not atrial septal defect; (2) cardiac conditions of moderate risk include mitral valve prolapse with valvar regurgitation or leaflet thickening, isolated mitral stenosis, tricuspid valve disease, pulmonary stenosis and hypertrophic cardiomyopathy; (3) conditions of low or no risk include isolated atrial septal defect, ischaemic heart disease and/or previous coronary artery bypass graft surgery, surgically corrected left-to-right shunt with no residual shunt, mitral valve prolapse with thin leaflets in the absence of regurgitation, and calcification of the mitral annulus.
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PMID:Native cardiac disease predisposing to infective endocarditis. 767 19

Although there are no epidemiological studies allowing precise evaluation of the risk of infective endocarditis in given cardiac pathologies, a review of the literature allows classification of different conditions in three groups of decreasing risk: 1: high risk group: cyanotic, congenital heart disease, patients with previous infective endocarditis, aortic valve disease, mitral regurgitation and unoperated left-to-right shunts apart from atrial septal defects; 2: moderate risk group: mitral valve prolapse with myxoid valves or a systolic murmur, mitral stenosis, tricuspid valve disease, pulmonary stenosis, hypertrophic obstructive cardiomyopathy; 3: low or negligible risk: isolated atrial septal defect, operated or unoperated (bypass graft) ischaemic heart disease, operated left-to-right shunts without residual shunt, mitral valve prolapse with normal valve thickness and without a murmur, mitral ring calcification without regurgitation.
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PMID:[Risk of bacterial endocarditis and native heart diseases]. 802 94

The authors review the importance of echocardiography and duplex examination of the blood vessels of the lower extremities for early diagnosis of thromboembolic attacks. Echocardiographic examination rules out other causes of the patient's complaints such as myocardial infarction, heart defects, ischaemic heart disease and others. The main role of echocardiography is, however, detection of symptoms of an acute rise of the blood pressure in the right heart or symptoms of its failure. The most valuable symptom is dilatation of the right branch of the pulmonary artery and dilatation of the right ventricle found in as many as 75% patients. It is also useful to assess by the Doppler method the dextrolateral systolic pressure from tricuspidal regurgitation. For pulmonary embolism a regurgitation rate of 2.8-3.8 m/s is typical. The correlation coefficient is, however, lower than when the dimensions of the right and left ventricle are used. Evidence of deep venous thrombosis does not reveal pulmonary embolism but has the same therapeutic consequences. Duplex sonography has a 95-100% sensitivity and specificity in acute thrombosis. In recurrent thrombosis it is necessary to use a combination of the two methods. Concurrent echocardiography and duplex sonography of the blood vessels of the lower extremities makes it possible to start prompt treatment in 70-80% of the patients. In the remainder for diagnosis of thromboembolic attacks other methods must be used.
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PMID:[Ultrasound in the diagnosis of thromboembolism]. 814 Jul 53

Repair of acute aortic dissection with destruction of the right coronary ostia and aortic valve regurgitation is described. The patient was a 54 year-old female with Marfan syndrome, who was admitted to our hospital for acute dissection with annulo aortic ectasia, accompanied by myocardial ischemia of the inferior wall. Retrograde dissection to the aortic annulus and destruction of the right coronary ostia due to extended dissection were noted. Retrograde coronary infusion through the coronary sinus was conducted during replacement of aortic annulus by the Cabrol method in conjunction with supplementary vein grafting to the right coronary artery. Distal repair was carried out, supported by hypothermic circulatory arrest and retrograde cerebral perfusion through the superior vena caval cannula. Retrograde cerebral and coronary sinus perfusion have been shown to be quite effective for treating patients requiring complex reconstruction of the ascending aorta.
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PMID:Retrograde cerebral and coronary perfusion for acute dissection of Stanford type A with destruction of the right coronary ostia. 825 6

A 56-year-old female had pure regurgitation in all cardiac valves. Color Doppler echocardiography showed a regurgitant jet in all cardiac valves. The severity of regurgitation due to the prolapse in all valves was moderate. The patient had no history of rheumatic fever, ischemic heart disease, endocarditis or hypertension. Physical characteristics of the patient were neither of Marfan's nor Ehlers-Danlos' syndrome. The etiology of regurgitation in all cardiac valves of this patient may be due to multiple valve prolapse.
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PMID:An adult case with multiple cardiac valve prolapse and regurgitation. 832 22


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