A pathognomonic murmur of "atypical" patent ductus arteriosus.
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Biomedical subjects
Publications and source records attributed to T Rosenthal.
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Hypertension in women has received less attention than hypertension in men, and the major controlled trials of antihypertensive therapy have been carried out in populations made up predominantly of and have emphasised outcomes in men. Recently it has been recognised that women develop high blood pressure, particularly systolic hypertension, at an increased rate as they age, and that this age-related blood pressure increase is exaggerated by the menopause. The age-related rise in blood pressure, particularly systolic blood pressure and pulse pressure, contributes substantially to the age-related increase in risk of heart attack, heart failure, and stroke in middle-aged and elderly women. This article reviews aspects of hypertension epidemiology, pathophysiology, diagnosis and treatment that are important to women's health with particular emphasis on important concomitant cardiovascular disease risk factors such as type 2 diabetes and the menopause. The role of ovarian hormones and their withdrawal in the pathogenesis of hypertension and related target organ damage is considered, as are the results of drug treatment of high blood pressure in women. Blood pressure in pregnancy is discussed in a separate article by Broughton-Pipkin and Roberts.
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Echocardiography was used to determine the incidence and severity of cardiac lesions in 20 patients with progressive systemic sclerosis. Abnormal findings were recorded in 14 (70%) patients. These included pericardial effusion in five, increased right ventricular diameter in five, increased left ventricular posterior wall thickness in four with no systemic hypertension, decreased diastolic closure of anterior mitral leaflet in five, and abnormal septal features in four patients. Dilatation of aortic root was found in two patients and moderated thickening of the anterior mitral valve in one patient. Clinical evidence of scleroderma heart was found in one of the 20 patients. Abnormal ECG changes were found in 12 (60%) of the patients. These included LVH, simulating MI pattern, conduction disturbances and P wave changes. Echocardiography proved to be an important non-invasive diagnostic tool which decreases the discrepancy between the relatively few clinical findings and rich cardiac pathology. Furthermore, this study confirms the usefulness of the method in the evaluation of the "asymptomatic" cardiac patient.
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