Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0231807 (exertional dyspnea)
 3,402 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ventricular pacing was performed in forty-one children ranging from one day to twenty years of age (median age = 10). Weight of the recipient at implant ranged from 2 kg. to 86 kg. Indications included presyncope, syncope, dyspnea on exertion, congestive heart failure, postoperative infra-Hisian heart block, and inadequate cardiac rate during pharmacotherapy. Four patients died during follow-up, but no deaths were attributable to pacemaker management. In contrast, 66% of the patients required more than one pacemaker related-operative procedure, and 43% of leads implanted failed by 48 hours. Indications for permanent cardiac pacing in this population at this time are symptomatic congenital AV block, symptomatic sinus node disease, and AV block in the postoperative period. Technological developments which might reduce complications seen in this population and electrophysiologic techniques which may better define indications for pacing in children are also reviewed.
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PMID:Ventricular pacing in children. 618 85

In rare instances, chronic alcoholism leads to the congestive heart failure which is characteristic of alcoholic beriberi with edema. The affected patients is usually a young man with longstanding alcoholic intoxication and often with neurologic features. Onset is often sudden, with dyspnea on exertion, orthopnea, and palpitations. The clinical sings of cardiac failure are unequivocal. Roentgenography shows cardiomegaly mainly due to enlargement of the right cavities and of the pulmonary artery. ECG shows sinus tachycardia and abnormal repolarisation in the precordium. The cardiac output and the cardiac index are increased, as well as the coronary output. Pyruvic acid levels exceed 15 mg/l, the provoked hyperpyruvicemia test is abnormal, thiamine levels are low, and the tryptophane test is normal. The course is variable. Cardiac beriberi progresses by exacerbation and remissions. Prognosis is poor, with a risk of sudden death. However, with adequate treatment combining rest, a low sodium diet, alcohol withdrawal, diuretics, and vitamin B1 (IV) recovery occurs. Our two observations clearly fit this description.
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PMID:[Congestive heart failure due to chronic alcoholism (author's transl)]. 628 71

A case of rhabdomyosarcoma of the left atrium and left ventricle demonstrated by echocardiography was reported. A 31-year-old man was admitted to our hospital for evaluation of recently developed exertional dyspnea. A holosystolic murmur and a protodiastolic sound were audible at the apex. A chest X-ray showed pulmonary congestion without cardiomegaly. The two-dimensional echocardiogram showed a dense stratified mass of echoes occupying the medial half of the left ventricular cavity, and a part of the abnormal mass of echoes was observed to move toward the left ventricular outflow tract during systole. Another small mass attached to the anterior mitral leaflet was also observed to prolapse partly into the left atrium during systole. The interatrial septum showed a thick and hard band of echo in the short-axis view. Right cardiac catheterization revealed pulmonary hypertension and the levogram of the pulmonary angiography showed left atrial and left ventricular filing defects. The repeated echocardiographic study showed the growth of the abnormal mass. The patient underwent operation, but he died of congestive heart failure thereafter. The necropsy diagnosis was rhabdomyosarcoma of the heart, involving the left atrium and left ventricle.
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PMID:[Rhabdomyosarcoma of the heart involving the left ventricle and left atrium]. 664 8

It is not the purpose of this paper to dismiss the possibility that tricyclics may somehow cause cardiac function to deteriorate, with resulting congestive heart failure. Any patient with heart disease should receive intense clinical scrutiny for the development of cardiac symptoms--dyspnea on exertion, ankle edema, orthopnea, paroxysmal nocturnal dyspnea, rales, and the presence of an S3 are never taken lightly. These parameters should be monitored because the patient has cardiac disease, not because he or she is on a tricyclic antidepressant.
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PMID:Cardiovascular effects of antidepressants. 681 88

This article discusses the effects of thyroid hormone on the heart, cardiovascular symptoms and signs in elderly patients with hyperthyroidism and hypothyroidism, and the diagnosis and therapy of hyperthyroidism and hypothyroidism in elderly patients. Cardiovascular symptoms of hyperthyroidism include palpitations, angina, pectoris, and dyspnea on exertion, orthopnea, or paroxysmal nocturnal dyspnea. Atrial fibrillation or congestive heart failure may be the only clinical manifestation of hyperthyroidism in elderly patients with apathetic hyperthyroidism. Atrial fibrillation with a rapid ventricular rate due to hyperthyroidism should be treated with propranolol to control the rapid ventricular rate. Elderly patients with coronary artery disease and hypothyroidism should be treated cautiously with thyroid hormone replacement to avoid precipitating or exacerbating angina pectoris, precipitating acute myocardial infarction, and precipitating or aggravating ventricular arrhythmias or congestive heart failure.
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PMID:The heart and thyroid disease. 760 91

There was evidence that abnormal left ventricular diastolic function was common in patients with coronary heart disease which led to symptoms such as dyspnea on exertion, distress in chest etc, even overt congestive heart failure. The changes of left ventricular diastolic function were examined with pulsed doppler echocardiography as well as of clinical symptoms, signs, electrocardiographic findings and plasma lipoprotein after Shuxinyin (SXY) therapy in 31 patients with coronary heart disease and abnormal left ventricular diastolic function. The SXY mainly consists of medicinal herbs capable of tonifying Qi and Yin. After treatment for one month the symptoms, signs and ECG were improved, the symptomatic effective rate was 87.1%. Plasma lipoprotein was reduced (P < 0.05). The main changes in doppler echocardiography were as follows. The peak of E wave, the area of E wave and Dec rate increased significantly (P < 0.01). The ratio of A wave peak to E wave peak was decreased. The changes in peak of A wave, the area of A wave and time index were insignificant (P > 0.05). It was concluded that SXY mainly improved the early left ventricular diastolic functions, increased the peak velocity and volume of rapid left ventricular filling blood flow during the early diastole, and thus alleviated symptoms as well as ECG findings.
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PMID:[Clinical study of improving effect of shuxinyin on abnormal left ventricular diastolic function in coronary heart disease]. 764 Apr 98

A 76-year-old man was admitted to our hospital in December of 1990, for investigation of progressive dyspnea on exertion over the previous 3 months. Physical examination revealed cyanosis, but no edema. Cardiomegaly was seen on chest X-ray, and findings compatible with right-sided congestive heart failure were revealed by ECG and echocardiography. Lung perfusion scintigrams showed multiple defects in both lungs, but no abnormal findings were detected on a ventilation study. Venograms of the lower extremities disclosed thrombosis of the right femoral vein. Therefore, a diagnosis of recurrent pulmonary thromboembolism was made. Furthermore, lupus anticoagulant and IgG-class anticardiolipin antibody were noted in the serum. The patient was treated with intravenous heparin, long-term warfarin, and transvenous placement of a Greenfield filter in the inferior vena cava. The clinical symptoms and signs improved, and no recurrence has been seen during the 13 months since the onset. On discharge, both antiphospholipid antibodies were negative. This case of primary antiphospholipid syndrome without autoimmune disease, with transiently positive antibodies only in the exacerbation phase, is discussed herein.
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PMID:[A case of recurrent pulmonary thromboembolism presenting with positive antiphospholipid antibodies]. 796 48

An autopsied case of systemic lupus erythematosus with pulmonary hypertension is reported. A 29-year-old woman with a seven-year history of polyarthralgia, butterfly rash, nephrotic syndrome and Raynaud's phenomenon was admitted because of progressive dyspnea on exertion. Tests for antinuclear antibody, anti-cardiolipin antibody and lupus anticoagulant were positive. Echocardiographic examination revealed right ventricular hypertrophy and a moderate pericardial effusion. Estimated systolic pulmonary arterial pressure was 53 mmHg. Despite treatment with corticosteroids including pulse methylprednisolone therapy, lipo-PGE1 and warfarin, she died of progressive congestive heart failure. Postmortem examination of the pulmonary vasculature revealed findings consistent with plexogenic pulmonary arteriopathy, without evidence of vasculitis, fibrinoid necrosis, or thromboemboli.
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PMID:Pulmonary hypertension in systemic lupus erythematosus: a report of an autopsied case. 800 Jan 4

A 53-year-old female presented with symptoms of severe chest and back pain associated with oliguria. The patient had a history of exertional dyspnea since the age of 20, and easy fatigability since the age of 27. At the age of 41, she noted marked exacerbation of these symptoms after suffering from a cold and was ultimately diagnosed as having Bland-White-Garland (BWG) syndrome with mitral valve regurgitation. The patient then underwent re-implantation of an anomalous left coronary artery from the pulmonary artery to the posterolateral wall of the aorta. Eleven years later, she re-presented with symptoms of angina and congestive heart failure. Coronary angiography was subsequently performed and a total occlusion of the right coronary artery with probable thrombus was revealed. The right coronary artery was filled via collaterals from the implanted left coronary artery. Mitral regurgitation was noted during angiography. The patient underwent aorto-coronary artery bypass grafting of the right coronary artery and concomitant mitral valve replacement. Her postoperative condition remained excellent.
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PMID:Thrombotic obstruction of the right coronary artery in a postoperative patient with Bland-White-Garland syndrome. 820 85

Indicators such as lowering of blood pressure in hypertension, alleviation of chest pain in angina pectoris, improvement in rest or exertional dyspnea from congestive heart failure (CHF) and suppression of ventricular arrhythmia are widely used in the management of cardiovascular diseases. There are often strong associations between the physiological indicators and the long-term clinical outcomes of cardiovascular disease such as stroke, myocardial infarction, sudden death and all-cause mortality. Physicians have assumed reasonably that early improvements in physiological markers will lead invariably to better long-term clinical outcomes. In recent years, a number of large clinical trials have demonstrated that short-term physiological improvements are not necessarily linked to better long-term clinical outcomes, but may be associated with less benefit than expected or even with detrimental outcomes. Management of cardiovascular diseases is complicated by the possibility that beneficial effects of a particular drug may be offset by its negative actions on the cardiovascular system. Effective antihypertensives may depress cardiac contractility; inotropes enhance left ventricular contractility in CHF, but may increase the risk of serious ventricular dysrhythmia; drugs which suppress ventricular arrhythmia may precipitate CHF or even excite pro-arrhythmic effects. Physicians must be conscious of this interplay of potentially beneficial and deleterious effects when cardiovascular drugs are prescribed. It is important in the analysis of large clinical trials of cardiovascular drugs to identify those situations in which the drug exhibits more benefit than harm and to determine, if possible, those aspects of drug action, drug dosage and population characteristics which contribute to the beneficial and detrimental actions.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Early effects of cardiovascular drugs--do they predict clinical outcomes? 820 69


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