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Adverse cardiovascular events are the result of a slow process that probably begin is childhood or adolescence. Investigators have been studying the origins of left ventricular hypertrophy as an independent risk factor for cardiac morbidity and mortality. Although blood pressure has a major influence on the development of congestive heart failure, it may be only one of several related hemodynamic, structural, humoral, neural, and other unknown factors that lead to left ventricular hypertrophy and ultimately to heart failure.

Below are 3 sections on treating key heart issues naturally. I hope you and your patients find them helpful. Feel free to use these as patient instruction sheets as well. [...]

Forty-two infants with a ventricular septal defect (VSD) (21 asymptomatic and 21 symptomatic) were compared with 17 control infants to determine if symptoms of congestive heart failure (i.e., tachypnea/poor growth) were due to depressed contractility or defect size, or both. Echocardiographic indexes of defect size, left ventricular performance (shortening fraction), preload (left ventricular end-diastolic dimension), afterload (left ventricular end-systolic wall stress) and contractility (the relation between velocity of circumferential fiber shortening and wall stress) were measured. Clinical assessment included measurement of weight and respiratory rate. Pulmonary and systemic blood flow were assessed in 17 symptomatic and 3 asymptomatic patients by cardiac catheterization. Although there was no significant difference in age, the symptomatic group had significantly lower weight (5.5 [+ or -] 2.9 vs 7.3 [+ or -] 2.3 kg, p0.5 cm (or defect size indexed for body surface area>1.8 [cm/m.sup.2]) was predictive of the presence of symptoms. It is concluded that contractility is normal in infants with a VSD. Symptoms may be related to pulmonary congestion. Perhaps VSD size can be used to predict patient course. (Am J Cardiol 1991;67:1097-1102), Ventricular septal defect (VSD) refers to a defect in the septum, or wall, between the right and left ventricles of the heart, which allows blood to be shunted between the two ventricles. Infants born with a large ventricular septal defect have symptoms of congestive heart failure, including fast breathing (tachypnea), shortness of breath (dyspnea), tiring when feeding, and growth failure. Whether these symptoms are caused by decreased ability of the heart to contract or overcirculation of blood in the lungs has not been determined. In infants with VSD, symptoms of heart failure are routinely treated with digoxin, which increases the force of the contraction; it is assumed that the symptoms result from decreased contractility. This assumption is not supported by research. New, noninvasive techniques now make it possible to estimate the contractility of the heart. Forty-two children with VSD who were less than two years old were compared with 17 children without heart disease to determine if symptomatic infants with a large VSD had depressed contractility. Half of the group with VSD had symptoms of heart failure, and the other half did not. The symptoms of the infants in this study were associated with normal contractility. The size of the left ventricle was not useful in determining the significance of a VSD in regard to blood circulation. VSD size was the most important factor in predicting whether or not a patient had symptoms. A defect size of one-half centimeter was the point above which symptoms began to appear. (Consumer Summary produced by Reliance Medical Information, Inc.)

PURPOSE: Doppler ultrasound is a sensitive modality for detecting and quantitating valvular regurgitation in patients with infective endocarditis. Because valvular regurgitation leads to heart failure, we evaluated the prognostic significance of Doppler-detected valvular regurgitation in patients with endocarditis who had not yet developed clinical heart failure. PATIENTS AND METHODS: We reviewed the medical records of 65 patients with a clinical diagnosis of infective endocarditis from May 1985 to March 1990. A total of 49 patients were included in the study- 33 patients with native valve endocarditis and 16 patients with Prosthetic valve endocarditis. The initial Doppler echocardiogram was examined in these patients to determine the presence and degree of valvular regurgitation. RESULTS: Significant (moderate to severe) valvular regurgitation was detected in 23 (47%) Patients. The presence or absence of significant valvular regurgitation did not predict the development of congestive heart failure, the need for surgery, or death p = NS). The development of congestive heart failure was significantly associated with the need for surgery (P [is not greater than]0.0001) and death (p [is not greater than]0.05). CONCLUSION: We conclude that the detection of significant valvular regurgitation in patients with infective endocarditis who have not yet developed heart failure is not predictive of future complications nor does the absence of significant valvular regurgitation identify a group of Patients with a more favorable prognosis. In our series, patients who developed congestive heart failure had a significantly higher incidence of surgery and death. Therefore, decisions regarding clinical management in patients with infective endocarditis should not be made solely on the presence or absence of echocardiographically detected valvular regurgitation., Infective endocarditis is the inflammation of the lining of the heart due to infection with microorganisms. This disease is associated with a high rate of disability and death. Congestive heart failure, an inability of the heart to pump leading to congestion of the lungs, is associated with a poor prognosis, and is often treated by heart surgery. Surgery can improve survival if patients with endocarditis and a high risk of congestive heart failure can be identified early. Doppler ultrasonography is a diagnostic method in which sound waves are used to provide images of the heart and blood flow through the major blood vessels. This technique may be used to identify impaired function of the heart valves, indicated by backflow of blood through the valves. This valvular regurgitation causes an overload of blood volume, leading to congestive heart failure. Doppler ultrasonography may be used to detect valvular regurgitation, and thereby identify patients at risk of developing congestive heart failure. The effectiveness of Doppler-detected valvular regurgitation in identifying 49 patients with endocarditis at risk of developing congestive heart failure was assessed. Valvular regurgitation was detected in 23 patients, but was not correlated with congestive heart failure, death, or need for surgery. However, the development of congestive heart failure was correlated with the need for surgery and occurrence of death. These findings suggest that the presence of valvular regurgitation alone does not predict the development of congestive heart failure. (Consumer Summary produced by Reliance Medical Information, Inc.)

Preface Imagine ... a 4:00 a.m. phone call to a worried mother. The voice on the other end of the line is that of her son, who is attending college [...]

We report a case of vein of Galen malformation presented at birth with congestive heart failure with subsequent discussion about this rare anomaly. Keywords: Vein of Galen malformation | Median prosencephalic vein, All the investigations and clinical work up was done at University of Iowa hospitals and clinics, Iowa, USA Case History A newborn male was referred for evaluation of congestive heart [...]

Issue Depression is one of the most prevalent psychiatric disorders and when co-occurring with medical illnesses likely creates a vicious circle in which each separate ailment makes treatment outcomes worse [...]

Glitazones do not increase the risk of cardiovascular death, but they raise the likelihood of congestive heart failure, a US study shows. The findings go against reports earlier this year [...]

Avandia, Risk of Congestive Heart Failure Significant Safety Risk Pharmacology Watch GlaxoSmithKline's rosiglitazone (Avandia) will receive a black box warning by the FDA because of concerns over heart failure associated [...]

Avandia, Risk of Congestive Heart Failure Significant Safety Risk Pharmacology Watch GlaxoSmithKline's rosiglitazone (Avandia) will receive a black box warning by the FDA because of concerns over heart failure associated [...]

Avandia, Risk of Congestive Heart Failure Significant Safety Risk Pharmacology Watch GlaxoSmithKline's rosiglitazone (Avandia) will receive a black box warning by the FDA because of concerns over heart failure associated [...]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.amjmed.2006.05.015 Byline: Steven R. Goldsmith Keywords: Congestive heart failure; Vasopressin receptor antagonist; V.sub.1a/V.sub.2 receptor antagonist Abstract: Arginine vasopressin (AVP) signals predominantly through the V.sub.1a receptor, which subserves vasoconstriction in the peripheral circulation, and is linked directly to stimulation of myocardial hypertrophic growth factors, and the V.sub.2 receptor, the main function of which is to alter the expression of aquaporin channels in the renal collecting ducts, which leads to water retention. Agents that antagonize or block these receptors could be expected to reduce vascular tone (assuming sufficient V.sub.1a signaling is present to be causing an effect), reduce direct mitogenic signaling in the myocardium (again assuming sufficient V.sub.1a effect is present), and increase water excretion (assuming sufficient V.sub.2 signaling is present). The case for antagonizing both sets of receptors depends on the clinical situation. Pure V.sub.1a antagonists might be useful in treatment of hypertension or heart failure, but they are of little use in hyponatremia unless it is caused by heart failure. V.sub.2 antagonists would be useful in any euvolemic or hypervolemic condition associated with hyponatremia and may help produce an effective and safe diuresis independent of serum sodium when used in conjunction with loop diuretics in patients with heart failure. Selective blockade of either receptor could lead to increased signaling at the unblocked receptor sites, potentially a problematic result, especially in heart failure where disease progression is affected by increased afterload, preload, and the direct myocardial effects of neurohormonal imbalance. Therefore, a strong rationale exists for the use of combined vasopressin antagonists in patients with heart failure, particularly if the agents are used on a chronic basis. Author Affiliation: Division of Cardiology, Hennepin County Medical Center, Minneapolis, Minnesota, USA

Patients with sub-clinical hypothyroidism are at increased risk of congestive heart failure (CHF), according to US research. An association between overt hypothyroidism and cardiovascular disease has been widely recognised, but [...]

LIVE LONGER > Men who've had heart attacks have double the risk of developing congestive heart failure, or CHF--meaning the damaged heart gradually loses its ability to pump blood. Treatments [...]

The risk of congestive heart failure (CHF) in elderly individuals treated with any peripheral alpha-1 antagonist for hypertension with any thiazide are compared to test whether the risk persists in subjects without cardiovascular disease (CVD) at baseline. The CHF risk in normotensive men without prostatism treated with alpha antagonists are also examined.

Hyperkalemia Risk Alert in Managing Heart Failure Abstract & Commentary Synopsis: Patients treated with spironolactone and ACE inhibitors for congestive heart failure (CHF) have a markedly increased risk of hyperkalemia. [...]

* A high-sodium diet increases the risk of congestive heart failure in people who are overweight, according to government data. Researchers tracked over 10,000 people, half of whom were overweight, [...]

Risk Factors for CHF Exacerbations Abstract & Commentary Synopsis: Potentially preventable risk factors can be identified before a CHF exacerbation. Source: Tsuyuki RT, et al. Arch Intern Med. 2001;161: 2337-2342. [...]

Low doses of anthracyclines induce subclinical myocardial damage that may predispose breast cancer patients to congestive heart failure, according to Dr. M.T. Meinardi of University Hospital, Groningen, the Netherlands, and [...]

The FDA has issued two public health advisories concerning oral antifungal agents that are indicated for the treatment of onychomycosis. The agency warns of serious risks associated with the use [...]

Background: The incidence of congestive heart failure (CHF) has been increasing steadily in the United States during the past 2 decades. We studied risk factors for CHF and their corresponding attributable risk in the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study. Participants and Methods: A total of 13 643 men and women without a history of CHF at baseline examination were included in this prospective cohort study. Risk factors were measured using standard methods between 1971 and 1975. Incidence of CHF was assessed using medical records and death certificates obtained between 1982 and 1984 and in 1986, 1987, and 1992. Results: During average follow-up of 19 years, 1382 CHF cases were documented. Incidence of CHF was positively and significantly associated with male sex (relative risk [RR], 1.24; 95% confidence interval [CI], 1.10-1.39; P [is less than] .001; population attributable risk [PAR], 8.9%), less than a high school education (RR, 1.22; 95% CI, 1.04-1.42; P=.01; PAR, 8.9%), low physical activity (RR, 1.23; 95% CI, 1.09-1.38; P [is less than] .001; PAR, 9.2%), cigarette smoking (RR, 1.59; 95% CI, 1.39-1.83; P [is less than] .001; PAR, 17.1%), overweight (RR, 1.30; 95% CI, 1.12-1.52; P=.001; PAR, 8.0%), hypertension (RR, 1.40; 95% CI, 1.24-1.59; P [is less than] .001; PAR, 10.1%), diabetes (RR, 1.85; 95% CI, 1.51-2.28; P [is less than] .001; PAR, 3.1%), valvular heart disease (RR, 1.46; 95% CI, 1.17-1.82; P=.001; PAR, 2.2%), and coronary heart disease (RR, 8.11; 95% CI, 6.95-9.46; P [is less than] .001; PAR, 61.6%). Conclusions: Male sex, less education, physical inactivity, cigarette smoking, overweight, diabetes, hypertension, valvular heart disease, and coronary heart disease are all independent risk factors for CHF. More than 60% of the CHF that occurs in the US general population might be attributable to coronary heart disease. Arch Intern Med. 2001;161:996-1002

NEW ORLEANS -- Atrial fibrillation, widely recognized to be a major risk factor for stroke, is an equally powerful predictor of future congestive heart failure. And as is true for [...]

Does treatment of hypertension reduce the incidence of congestive heart failure? Yes There is an unequivocal association between hypertension and congestive heart failure (CHF) that is very consistent across the [...]

Source: Archives of Internal Medicine, March 27, 2000 Recent use of nonsteroidal anti-inflammatory drugs (NSAIDs) by older persons increases their risk of hospitalization for congestive heart failure (CHF). This increased [...]

LA JOLLA, CALIF. -- Depression is an independent risk factor for the development of congestive heart failure in elderly women, Dr. Setareh A. Williams said at the annual conference on [...]

Background: Experimental studies have shown that administration of nonsteroidal anti-inflammatory drugs (NSAIDs) to susceptible individuals can lead to the development of congestive heart failure (CHF). There have been few epidemiological investigations of the importance of this adverse effect. Objective: To estimate the relative risk of first admission to a hospital with CHF in recent users of NSAIDs, compared with nonusers, and to determine whether the estimated relative risk was increased in those with a history of heart disease and the extent to which the level of risk varied with the dose and half-life of the drugs consumed. Methods: We conducted a matched case-control study of the relationship between recent use of NSAIDs and hospitalization with CHF. Cases (n = 365) were patients admitted to hospitals with a primary diagnosis of CHF. Controls (n = 658) were patients without CHF who were admitted to the same hospitals as case patients. Structured interviews were used to obtain information on several study factors, including recent use of aspirin and other NSAIDs. Results: Use of NSAIDs (other than low-dose aspirin) in the previous week was associated with a doubling of the odds of a hospital admission with CHF (adjusted odds ratio, 2.1; 95% confidence interval, 1.2-3.3). Use of NSAIDs by patients with a history of heart disease was associated with an odds ratio of 10.5 (95% confidence interval, 2.5-44.9) for first admission with heart failure, compared with 1.6 (95% confidence interval, 0.7-3.7) in those without such a history. The odds of a first admission to a hospital with CHF was positively related to the dose of NSAID consumed in the previous week, and was increased to a greater extent with long half-life than with short half-life drugs. Assuming these relationships are causal, NSAIDs were responsible for approximately 19% of hospital admissions with CHF. Conclusions: The burden of illness resulting from NSAID-related CHF may exceed that resulting from gastrointestinal tract damage. NSAIDs should be used with caution in patients with a history of cardiovascular disease. Arch Intern Med. 2000; 160: 777- 784

OBJECTIVE -- Clinical proteinuria is a risk factor for both end-stage renal disease and cardiovascular disease. The prevalence of clinical proteinuria, its correlates and predictive value, and the effect of [...]

Synopsis: Patients with painless acute aortic dissection ate more likely to present with syncope, congestive heart failure or stoke, and have a higher mortality, especially with type B dissection. Source: [...]