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Biomedical subjects

J W Hurst

Publications and source records attributed to J W Hurst.

At least 163 records · Page 9Linked to original sources
PubMedDate not supplied

What I tell medical house staff about old hearts.

House officers tend to view elderly patients with heart disease in the same way they view middle-aged patients. This essay discusses the difference between old hearts and middle-aged hearts. The teaching setting, as well as the common cardiovascular problems seen in the elderly, are described in this essay. In addition, an explanation is given as to why the clinical picture of the same disease is different in elderly patients than in middle-aged patients.

Adult↗
PubMedDate not supplied

Etiology: unknown or ignored?

It is important to determine whether a patient's medical problem is a physiological complication that has resulted from a disease process (such as heart failure that is a complication of calcific aortic valve stenosis) or a structural complication that has resulted from a disease process (such as a stroke due to an embolus from a left atrial thrombus caused by atrial fibrillation in a patient with mitral stenosis). Whereas treatment is available for heart failure and stroke regardless of the cause, the progress of medicine is nullified when treatment is not directed at the etiology of heart failure and stroke. Finally, and most importantly, the identification and treatment of cardiovascular diseases that may cause heart failure and stroke may provide the physician with an opportunity to prevent these serious complications. The New York Heart Association four-part diagnosis (a complete diagnosis) requires the physician to consider all the important aspects of a patient's disease.

Cerebrovascular Disorders↗
PubMedDate not supplied

Descriptive terminology used in modern cardiovascular medicine.

The terms used to designate the type of heart disease (or any other disease) must be chosen carefully. This is more important now than it was several decades ago. An effort must always be made to designate the exact etiology, as well as the exact subset, of the disease. As pointed out in the beginning of this editorial, I became concerned because a reader believed that the word "heart" in the term "coronary heart disease" was redundant. The article this reader was criticizing was about the most common type of coronary disease, atherosclerosis. In that article, "coronary heart disease" was used to indicate that the coronary artery disease was sufficiently severe to produce myocardial events such as angina, infarct, or death. No attempt has been made to describe all the types of heart disease in this editorial. Although the major types of heart disease are described, the objectives of this editorial are to highlight the need for the proper use of terminology and to answer a note from an anonymous reader.

Heart Diseases↗
PubMedDate not supplied

"New" causes of heart disease and stroke.

I have discussed 10 "new" diseases. Some produce heart disease, some produce strokes, and some may produce both heart disease and stroke. It is of great interest to me that some of them are due not to nature's ravages but to the ingestion of agents such as toxic oil, L-tryptophan, ergot, adriamycin, and psychotropic drugs. I classify these man-made diseases as "environmental" diseases. Use of some of the offending agents cannot be justified; for example, toxic oil and L-tryptophan are not needed. On the other hand, drugs such as ergot preparations are extremely useful when used properly.

Cerebrovascular Disorders↗
PubMedDate not supplied

Angina pectoris: words patients use and overlooked precipitating events.

Routine questioning may be inadequate to identify angina pectoris or prolonged discomfort due to myocardial ischemia. The clinician must ask patients if they have had any unpleasant sensations in the chest, neck, throat, jaw, arms, elbow, wrist, or back that they have not noticed previously. Once the patient uses a word to describe the discomfort, the physician should use the same word and inquire about the duration of the discomfort and precipitating causes, including the less common and unusual ones discussed in this editorial.

Angina Pectoris↗