Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0002962 (angina)
 21,142 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Chronic myelomonocytic leukemia is a disease of the elderly. It tends to have a variable clinical course, as the patient's state is immunologically dysunctional. There has been reluctance to perform open cardiac procedures because of concern about early postoperative sepsis leading to death. A 84-year-old man was admitted for the management of effort angina. PTCA was performed twice. He had left nephrectomy for Grawitz tumor nine years ago and additionally, he had been diagnosed as having chronic myelomonocytic leukemia since the next year. Preoperative laboratory assessment revealed that the total white blood cell counts were 2500 with 25 per-cent of granulocytes, a hematocrit of 31.1%, and platelet counts were 10.0 x 10(4). At the night of the treatment of his granulocytopenia with injection of granulocyte stimulating factor, he complained of continuous anterior chest pain with ST depression on ECG. Emergency single CABG was performed using a saphenous vein graft under the diagnosis of impending myocardial infarction. Postoperative course was uneventful. This is the first case report of CABG in octogenarian with chronic myelomonocytic leukemia in the world.
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PMID:[Coronary artery bypass grafting in an octogenarian with chronic myelomonocytic leukemia]. 917 Aug 68

Chronic myelomonocytic leukaemia (CMML) is a myelodysplastic/myeloproliferative neoplasm affecting the production and differentiation of the monocyte cell lineage. Cardiac surgery in the context of CMML poses challenges that are not routinely encountered. This is the first reported case in the literature of a patient with active CMML undergoing urgent on-pump coronary artery bypass grafting. A 68-year-old Caucasian man with a history of hypertension, hyperlipidaemia, hypothyroidism, and hypercholesterolaemia, who had been diagnosed by the haematologists with CMML a few months earlier but had remained untreated, underwent urgent surgical coronary revascularisation because of postinfarction angina following a non-ST elevation myocardial infarction associated with troponin I rise. The patient had fulminant postoperative myelomonocytic leukaemoid reaction, with a clinical picture of severe systemic inflammatory response syndrome and multiple organ dysfunction syndrome. This led to extensive vasodilation and heart failure that resulted in the death of the patient. Various authors have suggested different techniques and treatment options, each attempting to mitigate the effect of the postoperative inflammatory response. However, this is a high-risk endeavour with a myriad of inflammatory signals mobilised into action because of the surgical insult. Off-pump surgery or preoperative pharmacological attenuation of CMML activity might have dampened this response and resulted in a positive outcome for the patient.
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PMID:Urgent Coronary Artery Bypass Surgery in a Patient with Postinfarction Angina and Active Myelomonocytic Leukaemia. 2799 Jan 15