Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0344329 (collapse)
 28,634 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 13 year old Thoroughbred gelding was presented with a history of a single episode of collapse during mild exercise. Clinical examination revealed a high packed cell volume (PCV) of 72%, a haemoglobin concentration of 24.9 g/l and 15.2 millions erythrocytes/microliters. Despite continuous intravenous infusion therapy with large volumes, the PCV never decreased to a physiological level. The animal showed a normal appetite and no signs of discomfort or syncope. Arterial blood gas values were in the normal range as well as the concentration of erythropoietin (measured by radioimmunoassay, RIA). A test for neoplasms (carcino-embryonic antigen, CEA) was negative. The liver enzymes of the animal were extremely elevated and a liver biopsy showed a severe fibrosis. Examination of sternal bone marrow aspirate revealed no abnormalities. Based on these findings, the presumptive diagnosis was "absolute polycythaemia". The animal was treated for 7 days with repeated phlebotomy. During this time, the PCV never decreased below 50%, despite no obvious signs of discomfort from the animal. Because of the poor prognosis based on the liver biopsy result, the animal was euthanized 11 days after hospitalization. Post mortem findings were: a granular cell myoblastoma with a diameter of approximately 5 cm in the lungs, severe fibrosis of the liver, mild acute tubular nephrosis in the kidneys, activation of the erythropoietic cells in the bone marrow and thrombosis of the abdominal aorta. The possibility of secondary polycythaemia due to the lung neoplasia was not entirely excluded, but considered to be unlikely. Therefore, the definite diagnosis was polycythemia vera.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Case report: polycythemia in a horse]. 756 45

Mescalbean (Sophora secundiflora) toxicity is reported in a dog. Mescalbean toxicity causes intolerance to exercise, muscle rigidity and collapse upon exercise, with a rapid recovery upon resting in dogs. Mescalbean toxicity is a rare cause of the periodic weakness/syncope class of diseases in dogs in areas of the habitat of Sophora secundiflora.
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PMID:Mescalbean (Sophora secundiflora) toxicity in a dog. 757 54

Successful surgery for pulmonary thromboembolism is reported, with emphasis on the indication and the necessity of cardiopulmonary bypass. Surgical treatment is indicated for patients with localized large thromboemboli not amenable to medical management. Surgery is also an option for patients in whom medical treatment is not effective. In the present case, the etiology was unknown and there was no history of deep vein thrombophlebitis of the legs, which suggested that the cause was an embolus from a lung tumor that had already been treated surgically. Histological examination revealed a fresh blood thrombus, 9 months after pulmonary resection. This patient had syncope at the onset of the pulmonary thromboembolism (major vessel type) without circulatory collapse.
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PMID:[Surgical treatment for acute pulmonary thromboembolism occurring 9 months after an operation for lung cancer]. 766 20

Our experience with 18 cases of isolated right ventricular infarction is reported and the literature is reviewed. Chronic lung disease with right ventricular hypertrophy is an important risk factor. Chest pain is the usual symptom at presentation but some cases can have breathlessness, palpitations or syncope. Some cases can have sinus bradycardia, atrial fibrillation or ventricular tachycardia. Atrioventricular block is rare. Cases with pulmonary artery hypertension, extensive right ventricular infarction due to proximal occlusion of the right coronary artery, right atrial infarction or atrial fibrillation can have hypotension and/or systemic venous congestion. A surface electrocardiogram mainly showing changes in leads conventionally considered to represent left ventricle and right-sided chest leads may not show an infarct pattern in some cases. Echocardiography is, therefore, more reliable in diagnosing this condition. The cautious use of small doses of nitrates and diuretics is not hazardous in the absence of hypotension. High doses of steroids and anti-coagulants can be helpful. The prognosis is usually good, although sudden collapse can occur due to ventricular fibrillation, rupture of the right ventricular free wall or a massive pulmonary embolism.
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PMID:Isolated right ventricular infarction. 796 Feb 76

The authors report three cases of syncope due to systemic mastocytosis. This is a rare cause of syncope but should be recalled in certain circumstances. In the light of these cases, the authors review the literature with respect to this unusual presentation. Syncope may occur at any age. Loss of consciousness may be more or less complete, brief or prolonged, isolated or recurrent and usually accompanied by prodromal symptoms. The least controversial physiopathogenic mechanism of these syncopes is intense vasoplegia induced by the release of vasoactive mediators, especially histamine. When there is a clinical suspicion of mastocytosis, even in the absence of skin changes, the diagnosis is confirmed by biopsy which shows abnormally high numbers of mastocytes irrespective of the organ biopsied. The treatment of acute forms with collapse is based on intravenous infusion of macromolecular fluids and injections of epinephrine. Prevention is by drugs which inhibit the synthesis of histamine, the degranulation of mastocytes and the production of prostaglandin D2.
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PMID:[A rare cause of loss of consciousness: mastocytosis. Apropos of 3 cases]. 802 76

All eye drops raise problems of local tolerance, but with variable frequencies. They can induce pain on instillation, allergic reactions, delayed healing, punctate keratitis, disturbances of lacrimal secretion, disturbances of accommodation (especially the parasympathomimetics) and local pigmentation after prolonged use. Corticosteroids are associated with 2 major risks: chronic glaucoma and cataract, initially reversible if treatment is stopped. There is still a major risk of corneal herpes with corticosteroids. It is important to be aware of these local problems as they are responsible for poor patient compliance. The systemic effects essentially concern the agonists and antagonists of the autonomic nervous system. beta-Blocker eye drops can cause bronchospasm, heart failure, syncope and psychiatric disorders, especially at high doses and with nonselective beta-blockers. These consequences are usually related to failure to comply with the prescribing precautions. alpha-Adrenergic agonists, which exert dose-dependent effects, can induce hypertensive crises or angina attacks. Apart from patients at risk (children under the age of 30 months and the elderly), parasympathomimetics cause few systemic adverse effects; anticholinesterases, which have curare-like properties, are contraindicated for 6 weeks before general anesthesia. In the very young and the very old, atropinic eye drops carry a risk of cardiovascular collapse and neuropsychiatric disturbances. Problems may also occur with other classes of drugs such as anti-infectives, antispectics, anti-inflammatories and contact lens products. Nevertheless, it is clear that this form of treatment is generally very well tolerated in relation to the volume of eye drops prescribed by ophthalmologists each day.
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PMID:Systemic and local tolerability of ophthalmic drug formulations. An update. 809 91

I propose that fainting (vaso-vagal syncope) is caused by the sudden invagination of the walls of underfilled atria and great veins when their intraluminal pressure no longer exceeds intrathoracic pressure, leading to anomalous collapse-firing of veno-atrial stretch receptors. Impulses therefrom cause reflex systemic vasodilation and bradycardia, probably through a brainstem relay path involving opioids and possibly the A5 area of the medulla. The inappropriate increase of afferent atriovenous baroreceptor-nerve activity leads, by a vicious circle, to a sudden collapse of systemic arterial pressure. Activation of ventricular receptors is neither a probable nor a necessary cause of syncope, though it might be part of the response.
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PMID:Fainting precipitated by collapse-firing of venous baroreceptors. 810 20

Angiotensin converting enzyme inhibitors (ACEI) are established drugs for the treatment of congestive heart failure. Cases of symptomatic hypotension, especially on the first day of treatment, have been reported occasionally. The database we analysed consisted of 1,177 patients, mean age approximately 70 yrs, with congestive heart failure NYHA functional class II or III. These patients were treated and observed prospectively according to a uniform protocol, starting therapy with 2.5 mg enalapril and measuring blood pressure at hourly intervals for eight hours thereafter. 94.6% of the patients experienced no symptomatic hypotension, 4.75% moderate symptoms (e.g. dizziness, headache) and 0.59% severe symptoms (e.g. fainting, collapse, renal failure). For the analyses of risk factors a large number of baseline variables were analysed univariately to select those significant for inclusion in a multivariate stepwise logistic regression. Alternatively the CART-(classification and regression tree) technique was used. Both techniques showed diastolic blood pressure < or = 70 mmHg to be the single most significant risk factor. CART-analyses showed also pretreatment with nitrates and systolic blood pressure < or = 120 mmHg to be of prognostic relevance. Thus CART is a valuable complement when looking for prognostic factors.
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PMID:CART and logistic regression analyses of risk factors for first dose hypotension by an ACE-inhibitor. 814 29

Two swims (1993 and 1994) are described which led to post-swim orthostatic intolerance and one episode of syncope in a 50/51-yr-old well-trained and experienced marathon swimmer. The swims of 33 km and 38 km took 12 h 30 s and 17 h 35 min, respectively. Water temperature in each swim was above 23 degrees C and rectal core-temperature stayed above 37.0 degrees C. Air temperatures differed, ranging from 23 degrees to 37 degrees C and 15 degrees to 21 degrees C, respectively. Regular fluid consumption totalled approximately 5.0 and 6.0 1, respectively. Fifteen minutes after completing the 1993 swim, the swimmer experienced orthostatic intolerance and fainted at the lakeside; hospital tests revealed an elevated creatine phosphokinase (CK) of 521 U.l-1. The 1994 swim was abandoned due to severe muscle cramps and CK was found to be markedly elevated at 909 U.l-1. Orthostatic intolerance was recorded in both cases; however, no cardiac abnormalities were found. After overnight rest and intravenous saline infusions of 3.0 and 1.5 l, respectively, the orthostatic intolerance was relieved. Based on previous descriptions of exercise-associated collapse in marathon runners, the swimmer's orthostatic intolerance and syncope are attributed to blood pooling in his legs due to inactivation of the venous muscle pump on completion of the swim.
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PMID:Post-swim orthostatic intolerance in a marathon swimmer. 853 20

We describe three typical consequences of chronic or subacute proximal vein obstruction: venous claudication, narrowing of the spinal canal by dilated veins that function as collaterals, and hypovolemia caused by trapping of blood in the periphery and slow return. Venous claudication is a well recognized clinical entity. We emphasize that the syndrome is often diagnosed in patients who do not remember acute thrombosis and that the signs on the skin of chronic venous insufficiency are typically absent in these patients. Venous drainage after proximal thrombosis often involves the veins of the spinal canal. Under the condition of sustained physical activity these veins become dilated and occupy space causing the syndrome of a narrow spinal canal. The clinical features differ from those encountered in other forms of a narrow spinal canal; the symptoms appear only after prolonged and strenuous exercise, do barely depend on the posture of the spine and do not disappear readily with cessation of the effort. In patients with bilateral pelvic vein occlusions we regularly found evidence for a shock-like syndrome that follows vigorous exercise. The patients experience sudden weakness and dizziness, with sweats, pallor and tachycardia and have to interrupt the effort to prevent collapse and fainting. The clinical features depend on the anatomical localisation of the obstruction as well as on the pathways of the collaterals. In patients with typical symptoms a venographic workup may be indicated to assess the possibility of recanalisation by endoluminal stenting. The presence of peripheral valve incompetence may be regarded as a contraindication to stenting since it may increase the volume overload and make the chronic venous insufficiency worse.
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PMID:[Sequelae of proximal venous stenosis]. 865 51


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