Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0264733 (ventricular dilatation)
 2,163 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 76-year-old female patient complained of intermittent palpitation, shortness of breath, and orthopnea for 10 days. The patient was found to have cardiomegaly, left ventricular dilatation secondary to moderate regurgitation, with impaired ventricular dysfunction and persistent sinus tachycardia. The patient also had a nodular goiter with increased uptake on radionuclide scan on the right side of the thyroid gland, low serum thyroid-stimulating hormone, with normal triiodothyronine, and free thyroxine. Plummer's disease with ventricular dysfunction was diagnosed. We present this rare case and a review of the literature.
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PMID:Ventricular dysfunction in a patient with Plummer's disease: a case report. 1202 34

A 33-year-old primigravida presented at 32 weeks gestation with increasing shortness of breath related to left ventricular failure. She had severe bilateral ventricular dilatation of unknown aetiology. An urgent caesarean section was required when she failed to improve on medical therapy, and for this she requested general anaesthesia. The patient had a permanent pacemaker for congenital complete heart block and Harrington rods for kyphoscoliosis. In view of the cardiac problems we transferred the patient to our cardiac unit and performed the procedure with full invasive haemodynamic monitoring. An alfentanil based modified rapid sequence induction resulted in stable maternal haemodynamics. The 2.2 kg male neonate initially required ventilation for 12 h, but then made a good recovery along with his mother.
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PMID:Anaesthetic management of caesarean section in a patient with a permanent pacemaker and severe bilateral ventricular dilatation. 1532 Nov 8

Pulmonary arterial hypertension (PAH) is a rare and incurable disease, related to right ventricle overload and failure, which are late consequences of asymptomatic progressive pulmonary vascular occlusion. The clinical approach requires: a high clinical suspicion; the detection and confirmation of PAH by echo-Doppler and right heart catheterisation; identification of an etiology; assessment of functionality and life expectancy; and reversibility testing. We present the case of a 68-year-old male patient presenting with progressive fatigability and shortness of breath, abnormal heart beats in the last 4 years, aggravated in the last year. Clinical findings showed signs of cardiac failure. Multiple echocardiographies demonstrated right atrial and right ventricular dilatation, with severe PAH, subsequent severe pulmonary and tricuspid regurgitation, mild mitral and aortic regurgitation and efficient left ventricular function. Subsequent cardiac catheterization confirms severe PAH, excludes VSD, and sees a left-to-right shunt but an ASD could not be anatomically localized. Left ventricular function and the coronary arteries were normal. Transesophageal echocardiography demonstrated an ASD sinus venosus with bidirectional shunt associated with partial abnormal in pulmonary venous drainage, with right supranumery pulmonary vein with drainage in the sinus venosus, the upper and inferior right pulmonary veins flowing into the right atrium, the upper and inferior left pulmonary veins Bowing into the left atrium, associated to important superior and inferior vena cava dilatation. The patient receives treatment for right heart failure, oral anticoagulation, antiarrhythmic drugs, cardio-pulmonary rehabilitation is initiated and he is referred to a center specialised in PAH, for bosentan treatment. In this patient, it is surprising that even born with a potentially cyanogenic congenital heart disease, his condition is discovered at an advanced age on the edge for evolution towards an Eisenmenger Syndrome, being fairly asymptomatic until the last year when he receives treatment for left heart failure.
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PMID:[A rare cause of pulmonary arterial hypertension diagnosed in an elderly patient]. 2105 70

Heart failure is a syndrome in which the heart fails to pump blood at a rate commensurate with cellular oxygen requirements at rest or during stress. It is characterized by fluid retention, shortness of breath, and fatigue, in particular on exertion. Heart failure is a growing public health problem, the leading cause of hospitalization, and a major cause of mortality. Ischemic heart disease is the main cause of heart failure. Ventricular remodelling refers to changes in structure, size, and shape of the left ventricle. This architectural remodelling of the left ventricle is induced by injury (e.g., myocardial infarction), by pressure overload (e.g., systemic arterial hypertension or aortic stenosis), or by volume overload. Since ventricular remodelling affects wall stress, it has a profound impact on cardiac function and on the development of heart failure. A model of permanent ligation of the left anterior descending coronary artery in mice is used to investigate ventricular remodelling and cardiac function post-myocardial infarction. This model is fundamentally different in terms of objectives and pathophysiological relevance compared to the model of transient ligation of the left anterior descending coronary artery. In this latter model of ischemia/reperfusion injury, the initial extent of the infarct may be modulated by factors that affect myocardial salvage following reperfusion. In contrast, the infarct area at 24 hr after permanent ligation of the left anterior descending coronary artery is fixed. Cardiac function in this model will be affected by 1) the process of infarct expansion, infarct healing, and scar formation; and 2) the concomitant development of left ventricular dilatation, cardiac hypertrophy, and ventricular remodelling. Besides the model of permanent ligation of the left anterior descending coronary artery, the technique of invasive hemodynamic measurements in mice is presented in detail.
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PMID:Permanent ligation of the left anterior descending coronary artery in mice: a model of post-myocardial infarction remodelling and heart failure. 2548 95

Intraosseous access is an alternative route of pharmacotherapy during cardiopulmonary resuscitation. Extracorporeal membrane oxygenation (ECMO) provides cardiac and respiratory support when conventional therapies fail. This case reports the use of intraosseous thrombolysis and ECMO in a patient with acute massive pulmonary embolism (PE). A 34-year-old female presented to the emergency department with sudden onset severe shortness of breath. Due to difficulty establishing intravenous access, an intraosseous needle was inserted into the left tibia. Echocardiography identified severe right ventricular dilatation with global systolic impairment and failure, indicative of PE. Due to the patient's hemodynamic compromise a recombinant tissue plasminogen activator (Alteplase) bolus was administered through the intraosseous route. After transfer to the intensive care unit, venous-arterial ECMO was initiated as further therapy. The patient recovered and was discharged 36 days after admission. This is the first report of combination intraosseous thrombolysis and ECMO as salvage therapy for massive PE.
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PMID:Salvage intraosseous thrombolysis and extracorporeal membrane oxygenation for massive pulmonary embolism. 2570 56

The clinical manifestation included snoring and mouth breathing for 2 years, repeated coughing and shortness of breath in action for more than 1 year. Physical examination of oral cavity showed tonsils were in grade III. The endoscopy showed 2/3 of postnaris were blocked by the adenoids. The preoperative ultrasonic cardiogram revealed the right atrial and right ventricular dilatation, pulmonary artery widened. The preoperative polysomnography (PSG) showed apnea-hypopnea index (AHI) was 28.5 events an hour, and the lowest oxygen saturation (LSaO2) was 39%. The patient was diagnosed as severe obstructive sleep apnea hypopnea syndrome with pulmonary hypertension. The postoperative PSG showed the AHI was 11.7 events an hour, and the LSaO2 was 86%. The ultrasonic cardiogram at 5 months after surgery didn't show any abnormalities.
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PMID:[One case of pediatric obstructive sleep apnea hypopnea syndrome with pulmonary hypertension]. 2620 Dec 1

Known commonly as "broken heart syndrome," takotsubo cardiomyopathy is a poorly understood heart condition that results in acute decompensation of cardiac function. We report a case of a 68-year-old female who developed acute shortness of breath status after chemotherapy and radiation treatment for Stage IV squamous-cell carcinoma. Computed tomography pulmonary angiogram (CTPA) revealed a single subsegmental pulmonary embolism, pulmonary edema, and left ventricular dilatation. Further evaluation revealed evidence of reversible cardiomyopathy with left ventricular apical ballooning, consistent with takotsubo cardiomyopathy. In reviewing the case, we cover the Mayo clinic criteria for diagnosis of takotsubo cardiomyopathy, and we consider pulmonary embolism as a precipitating factor.
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PMID:Subsegmental pulmonary embolus as a precipitating factor for takotsubo cardiomyopathy. 2730 16

Point-of-care echocardiography is revolutionizing the management of patients presenting with undifferentiated shock and cardiac arrest in the emergency department (ED). Its primary purpose is to aid the clinician in rapidly ruling in and ruling out life-threatening diagnoses at the bedside. In addition, it has become an important component of the clinical examination for stable patients seen in the ED with nonspecific signs and symptoms such as shortness of breath or syncope. Although first described to facilitate the diagnosis of pericardial effusions and cardiac standstill, ED echocardiography has since evolved and is now widely used by emergency physicians to help diagnose other important cardiovascular pathologic conditions that may be contributing to undifferentiated shock, such as left ventricular failure and right ventricular dilatation resulting from pulmonary embolism. The use of echocardiography in the ED continues to expand, with advanced applications that include valvular assessment, diastolic dysfunction, and regional wall motion abnormalities, as well as the use of point-of-care transesophageal echocardiography. As the diffusion of these new skills continues and becomes routine, it will alter the practice of emergency medicine and the interaction with consulting cardiologists.
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PMID:Contemporary Application of Point-of-Care Echocardiography in the Emergency Department. 2927 59