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)

Pulmonary alveolar proteinosis is a rare disease of unknown etiology characterized by alveoli filled with PAS-positive material high in protein and lipid. A 30-year-old man was referred because of respiratory failure. 2 years previously exertional dyspnea and productive cough appeared and gradually worsened. A year later he sought medical advice but defaulted on follow-up. After further deterioration he returned for treatment. On examination he had tachypnea and cyanosis. Diffuse crackles were audible in both lungs. X-ray revealed diffuse bilateral airspace consolidation. Arterial blood gases on air showed PaO2 41 mm Hg, PaCO2 35 mm Hg, and pH 7.46. There was a restrictive pattern on pulmonary function testing. Fiberoptic bronchoscopy with broncho-alveolar lavage and transbronchial biopsy established the diagnosis of pulmonary alveolar proteinosis. Whole lung lavage lead to gradual improvement over the next few weeks. However, chest X-ray, arterial blood gases and pulmonary function tests failed to revert completely to normal. Such severe manifestations and such an aggressive course as in this case might have been prevented had the diagnosis been made and treatment instituted earlier in the course of the disease.
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PMID:[Pulmonary alveolar proteinosis]. 816 55

This multicenter study evaluated the efficacy and tolerability of coenzyme Q10 in 1715 outpatients with chronic heart failure (New York Heart Association classes II and III), stabilized with standard therapy for 3 months. The patients were treated with coenzyme Q10 at a daily dose of 50 mg for 4 weeks, in addition to receiving conventional therapy. The efficacy of coenzyme Q10 was assessed by an open study that evaluated the improvement in clinical signs and symptoms of heart failure. After the baseline evaluation the subjects were seen on days 15 and 30. The intensity of signs and symptoms was assessed by a semiquantitative 4-point scale. Our results demonstrate that the administration of coenzyme Q10 in association with standard therapy improves dyspnea at rest, exertional dyspnea, palpitations, cyanosis, hepatomegaly, pulmonary rales, ankle edema, heart rate, and systolic and diastolic blood pressure in patients with stabilized heart failure. The rate of improvement and the low number of side effects in this large group of patients demonstrate that despite some methodological limitations in the study design and the short period of treatment (4 weeks) coenzyme Q10 given at a daily dose of 50 mg led to an improvement in the signs and symptoms of heart failure and in the quality of life.
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PMID:Italian multicenter study on the efficacy and safety of coenzyme Q10 as adjuvant therapy in heart failure. 824 96

A 63-year-old man was referred to our hospital for evaluation and treatment of severe dyspnea on exertion which had persisted for a few years. He presented with cyanosis and markedly clubbed fingers, and laboratory data disclosed hypoxemia, polycythemia, and liver dysfunction. A chest X-ray film showed increased vascular markings in both lower lung fields. Arterial blood gas analysis showed severe hypoxemia, with a PaO2 of 46 Torr and a PaCO2 of 31 Torr while the patient was breathing room air. The PaO2 increased only slightly with inhalation of 100% oxygen, which suggested the presence of a large R-L shunt. The hepatopulmonary syndrome was diagnosed. Angiography of the pulmonary artery revealed a large pulmonary arterio-venous fistula with markedly dilated arteries in both lower lobes. Transarterial embolization was done three times with a total of 62 metal coils. There were no complications. Embolization reduced the shunt from 56% to 31%, increased the PaO2, and relieved the dyspnea. Pulmonary artery embolization can be useful in treating pulmonary arterio-venous fistulas associated with the hepatopulmonary syndrome.
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PMID:[Pulmonary arterio-venous fistula treated by embolization with steel coils]. 875 16

We report a successful surgical treatment for tetralogy of Fallot with pulmonary atresia. A 18-year-old girl was admitted because of increasing exertional dyspnea and cyanosis. She had undergone bilateral classical Blalock-Taussing shunt. Prior to the correction, two major aortopulmonary collateral arteries were embolized using steel coils. Under cardiopulmonary bypass, posterior wall of the pulmonary artery was anastomosed directly to the cranial margin of the ventriculotomy for a floor made of autologous tissue. The roof was reconstructed using a patch with a monocusp. The patient is in a good postoperative condition. A coil embolization is useful and this reconstruction utilizing autologous tissue could prevent a late stenosis of the reconstructed pulmonary artery tract.
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PMID:[Reconstruction of right ventricular outflow tract-pulmonary artery utilizing autologous tissue in extreme tetralogy of Fallot after coil embolization for major aortopulmonary collateral artery: report of a case]. 895 92

Blood cysts of the heart valves are commonly reported at postmortem examination of infants but are rare seen in older children and adults. A 42-year-old woman was referred to our hospital for cardiac evaluation because of dyspnea on exertion and heart murmur. There was no history of cyanosis or cardiac failure. Cardiac catheterization revealed valvular pulmonary stenosis and atrial septal defect. Right ventricular angiography showed the circular filling defect 0.7 x 0.7 cm in size at the suprapulmonary valve. However, this preoperative abnormal finding was diagnosed as a blood cyst after surgery. At operation a blood cyst originating from the right cusp of the pulmonary valve was found and resected, and was followed by commissurotomy of the pulmonary valve and direct closure of the atrial septal defect. Her postoperative course was uneventful.
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PMID:[Blood cyst of the pulmonary valve in an adult--a case report]. 917 Aug 73

Pulmonary arteriovenous fistulas are a very infrequent illness. The majority of these cases are associated with hereditary haemorrhagic telangiectasia, therefore their isolated presentation is exceptional. We present a patient that was diagnosed of two arteriovenous fistulas non associated with hereditary haemorrhagic telangiectasia. His main symptom was progressive dyspnea on exertion, with cyanosis and clubbing. His evolution after surgery was satisfactory. Theirs clinical, diagnosis and therapeutic peculiarities ware discussed.
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PMID:[Congenital pulmonary arteriovenous fistulas]. 937 80

Cardiac fibromas are rare lesions which occur more often in infants and children than in adults. These tumors are benign proliferations of connective tissue most often found in the left ventricular myocardium or septum. In an 8-month-old infant with cyanosis and progressive exertional dyspnea, a huge cardiac tumor obstructing the right ventricular outflow tract (RVOT) was diagnosed by means of 2-dimensional echocardiography and cardiac catheterization. At surgery, a whitish gray solitary tumor measuring 5.0 x 4.5 cm could be well visualized. It was nearly totally resected, and the RVOT was reconstructed with an Equine pericardial patch. Histologic examination classified the tumor as a fibroma. Although surgical mortality in cardiac fibroma with RVOT obstruction is extremely high, early diagnosis and prompt excision of the tumor is mandatory in relieving its dangerous symptoms.
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PMID:Cyanosis caused by a huge obstructive right ventricular fibroma. 1085 May 40

Pulmonary arteriovenous fistula (PAVF) is a rare condition which occasionally causes neurological complications. A 43-year-old female with multiple PAVFs presented with several episodes of amaurosis fugax and transient right hemiparesis. She had no other vascular abnormality, and her human leukocyte antigen haplotype did not coincide with previous patients with hereditary hemorrhagic telangiectasia. She underwent PAVF embolization to prevent further neurological complications, and had an uneventful subsequent clinical course. Amaurosis fugax is a slight neurological symptom and may be an early important sign of PAVF. We stress that PAVFs should be considered in the differential diagnosis of patients with amaurosis fugax who complain of exertional dyspnea or demonstrate cyanosis.
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PMID:Pulmonary arteriovenous fistula manifesting as amaurosis fugax--case report. 1198 92

Pulmonary artery dissections typically occur at the site of a pulmonary artery aneurysm associated with pulmonary hypertension or connective tissue disease. Dyspnea on exertion, retrosternal chest pain, central cyanosis, and sudden hemodynamic decompensation are the four main clinical signs and symptoms associated with a pulmonary artery dissection. Diagnosis of a pulmonary artery dissection frequently occurs postmortem, as many of these patients experience sudden death when the main pulmonary artery dissects into the pericardium, causing acute cardiac tamponade. Pulmonary artery dissection has been diagnosed in living patients using transthoracic echocardiogram, computed tomography (CT) scanning, magnetic resonance imaging (MRI), and angiography. Surgery is curative. Emergency physicians should consider the diagnosis of pulmonary artery dissection in patients presenting with either retrosternal chest pain, dyspnea on exertion, central cyanosis, or sudden hemodynamic decompensation and who have a past medical history of pulmonary hypertension, pulmonary artery surgery, or a disease causing chronic inflammation of myocardial or vascular tissue.
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PMID:A case of pulmonary artery dissection diagnosed in the Emergency Department. 1235 83

A 10-year-old girl with a patent ductus venosus associated with multiple autoimmune disorders presented with hypoxia, cyanosis of her lips, and exertional dyspnea. Ultrasonography and abdominal computed tomography of the liver showed a communication between the portal vein and the inferior vena cava through a patent ductus venosus. Portography showed flow from the portal vein directly into the inferior vena cava via the portosystemic shunt. The portosystemic venous shunt ratio was estimated to be 71.8% by scintigraphy using 123I-IMP. Intraoperatively, the authors diagnosed this portosystemic shunt as patent ductus venosus because of the absence of the ductus venosus on real anatomic position. The portal venous pressure was 8.2 cm H2O, which increased to 17.7 cm H2O when the ductus venosus was temporarily occluded. After surgical ligation of the ductus venosus, the color of liver improved, indicating restored liver circulation. The postoperative course was uneventful, and the patient has been asymptomatic for 6 months.
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PMID:Patent ductus venosus in children: a case report and review of the literature. 1469 96


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