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Query: UMLS:C0002962 (angina)
 21,142 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The cardiovascular and respiratory actions of the adrenergic beta adrenoceptive drug sotalol have been studied in an open, short term trial. Fifteen patients with angina performed standardized orthostatic and exercise tests before and after injection of 20 mg sotalol intravenously. Although there was a significant reduction of heart rate and blood pressure at the time of appearance of angina pectoris and ST-segment depression, there was only a slight and statistically insignificant increase in work before the appearance of angina pectoris, and ischaemic changes in the ECG disappeared more rapidly after work. In a different group of patients suffering from obstructive lung disease, sotalol 10 mg intravenously produced a significant increase in airway resistance. It has no such effect on normal subjects.
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PMID:Cardiovascular and respiratory effects of the beta-adrenoceptive antagonist sotalol: studies in health, angina pectoris and obstructive lung disease. 123 40

The clinical characteristics and long-term survival of 284 patients from the Coronary Artery Surgery Study (CASS) registry data base who had moderate to severe congestive heart failure symptoms and a left ventricular ejection fraction greater than or equal to 0.45 were studied. A control group consisting of registry patients with an ejection fraction greater than or equal to 0.45 who did not have heart failure was used for comparison. Patients who had heart failure were older and more likely to be female and to have a higher incidence of hypertension, diabetes and chronic lung disease than registry patients who did not have heart failure. As a group, patients with heart failure had more severe angina and were more likely to have had a prior myocardial infarction than were registry patients without heart failure. At 6 year follow-up, 82% of patients in the heart failure group survived compared with 91% of patients in the control group (p less than 0.0001). Multivariate analysis using the Cox proportional hazards model identified the following independent predictors of mortality: regional ventricular systolic dysfunction, number of diseased coronary arteries, advanced age, hypertension, lung disease, diabetes, increased left ventricular end-diastolic pressure and heart failure symptoms. Among patients with heart failure, the 6-year survival rate of those who had three-vessel coronary artery disease was 68% compared with 92% for the group without coronary artery disease. However, the 6-year survival rate for patients with heart failure who underwent surgical revascularization of diseased coronary arteries was not significantly improved compared with that of patients treated medically.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Congestive heart failure symptoms in patients with preserved left ventricular systolic function: analysis of the CASS registry. 185 5

beta-Blockers are effective in reducing the blood pressure of many patients with systemic hypertension. They differ in terms of the presence or absence of intrinsic sympathomimetic activity, membrane-stabilising activity, beta 1-selectivity, alpha-blocking properties, and relative potency and duration of action. All beta-blockers appear to have blood pressure lowering effects. The choice of which beta-blocker to use in an individual patient is determined by the pharmacodynamic and pharmacokinetic differences between the drugs in conjunction with the patient's other medical condition(s). This review discusses the practical use of beta-blockers and provides rational suggestions for which drug(s) to use in selected patient groups (Black, elderly, postinfarction, diabetes, renal disease, obstructive lung disease, elevated lipid levels, coexisting angina, and left ventricular hypertrophy).
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PMID:Clinical use of beta-adrenoceptor blockade in systemic hypertension. 197 82

A comprehensive clinical and instrumental examination of patients aged 45 years or more with coronary heart disease and bronchial asthma (BA) indicated that the incidence of documented large myocardial infarction was high and equal to 24.3%. In patients with a long history of BA, myocardial infarction was more frequently characterized by a typical anginal onset, clinical symptoms of the concomitant lung disease regressing. No substantial differences were found in the site and magnitude of focal changes, in the incidence of first and recurrent myocardial infarctions among the patients with a prior history of BA and among those who had myocardial infarction before BA manifestations. An older age and shorter history of angina pectoris were typical of patients sustaining myocardial infarction in the presence of a long-term prior course of BA. Late complications of myocardial infarction included aggravated concurrent BA more frequently (25%), which was largely of allergic origin and pathogenetically applied to the postinfarction syndrome.
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PMID:[Characteristics of the clinical course of myocardial infarct during acute and functionally restorative periods in patients with concomitant bronchial asthma]. 263 24

Surgical risk factors of abdominal aortic disease. Between January 1, 1982 and October 1986, 327 surgical repairs were performed on abdominal aortic obstructive diseases and aneurysms at the St. Luc University Hospital. 150 pre-, per- and postoperative data were collected retrospectively for each patient. Ninety-one per cent of patients were smokers, 57.5 per cent had heart disease, 43 per cent arterial hypertension, 51 per cent peripheral vascular disease and 28 percent had obstructive lung disease. Concerning cardiac morbidity, the post-operative infarction rate was 4.4 per cent in patients who had previously suffered from an infarction, and 1.9 per cent in patients with no previous infarction. Post-operative angina-ischemia rate were respectively 23 and 4.7 per cent. Two hundred and thirty two elective operations resulted in 6 deaths (2.6 per cent) while 95 emergency operations resulted in 34 deaths (35.8 per cent). The causes of the death and the post-operative complications are detailed. The decrease of the morbidity and the mortality rates inherent to this pathology depends on an early diagnosis and surgical treatment by a team, knowledgeable of this pathology, who are able to prevent and correctly treat the complications, especially those affecting the cardiovascular system.
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PMID:[Risk factors in surgery of the abdominal aorta]. 338 30

Beta-adrenergic blocking agents are commonly used for the management of hypertension, cardiac arrhythmias, and angina pectoris; several of these agents are now available for clinical use (1-5). A significant side effect of these agents in patients experiencing reversible airway obstruction is that they block the effects of beta-adrenergic agonists and can precipitate or worsen bronchospasm (6-8). Labetalol, a new adrenergic antagonist with both alpha- and beta-adrenergic blocking effects, has been shown to have certain advantages for the management of hypertension and is widely used for this purpose in many countries (9). To evaluate its effects on airway resistance in patients with obstructive lung disease, the authors conducted two separate clinical studies. This article summarizes the results of these trials.
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PMID:The use of labetalol for the treatment of hypertension in patients with reversible airway obstruction. 383 98

Although epidemiologic evidence suggests that patients with heart and lung disease are more vulnerable to the acute toxic effects of photochemical air pollution, no laboratory studies have been reported in patients with coronary heart disease. In the present investigation, six male volunteers, ages 46 to 64 years, with clinically documented coronary heart disease and a well-defined symptomatic angina pectoris threshold, served as subjects. Each patient was exposed on three 40-minute occasions to either filtered air or ozone at concentrations of 0.20 or 0.30 parts per million (ppm), while walking on a treadmill at workloads simulating their regularly prescribed exercise training regimen. Results of standard pulmonary function tests and periodic observations of exercise ventilation, respiratory metabolism, electrocardiographic changes, hemodynamic response, and clinical signs and symptoms were recorded. Analysis of variance revealed that none of the patients' physiologic responses to ozone exposure were statistically significant. Furthermore, neither onset of angina pain or ischemic changes were related to ozone exposure in a dose-dependent fashion. Hence, the patients not only failed to exhibit any unexpected cardiovascular strain while exposed to ozone during exercise, but also evidenced no significant pulmonary function impairment or exercise ventilatory pattern alteration, as has been observed in clinically normal subjects exercising at similar ozone concentration levels. This apparent incongruity may be due to the fact that acute ozone toxicity is more closely related to the total amount of ozone inhaled, which is a function of pulmonary ventilation volume and exposure time, as well as ozone concentration. In the patients with angina, symptom-limited exercise tolerance resulted in a lower total amount of ozone inhaled than that observed to effect ozone toxicity in clinically normal subjects who exercised at greater intensities and for longer durations. Patients with angina appear to be no more susceptible to ozone toxicity than are clinically normal subjects at the effective doses imposed. However, had the patients exercised longer, they might well have evidenced pulmonary function impairment and/or cardiovascular strain. Hence, caution is advised in generalizing these observations to other conditions and patient groups.
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PMID:Effects of ozone inhalation during exercise in selected patients with heart disease. 647 86

Nitroglycerin (Ng) is a potent and short-acting coronary and systemic vasodilator, widely used in anginal pain treatment. When given to patients with pneumonia or chronic lung disease, Ng was found to cause a further decrease in arterial oxygen tension (PaO2) by increased perfusion of poorly ventilated territories in the lungs. In order to investigate the potential hazard in Ng decreasing the PaO2 in ischemic heart disease patients, who develop acute pneumonia, we administered 0.4 mg Ng sublingually to 11 patients who suffered concomitantly from ischemic heart disease and acute pneumonia. Arterial blood gases were monitored before, 2, 5 and 10 min following Ng administration, as well as a standard 12-lead electrocardiogram that was monitored as the same time. 8 out of the 11 patients showed a decrease in PaO2 which was mild to moderate, during the study period of time, none of them showed an increase, and there was tendency for the lower (less than 60 mm Hg) initial PaO2 to show a lesser decrease in the PaO2 in comparison to the higher (greater than 60 mm Hg) initial PaO2. There was no statistical significant correlation between the decrease in PaO2 and patients' age, sex, coexisting chronic obstructive lung disease and severity of systemic heart failure. Our conclusion is that the hazard in lowering PaO2 by Ng in ischemic heart disease patients who develop acute pneumonia is minimal, but the drug should be used with caution.
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PMID:Arterial hypoxemia following the administration of sublingual nitroglycerin in patients with ischemic heart disease and pneumonia. 679 69

The long-term cardiac prognosis of 24 clinically healthy men with complete right bundle branch block, identified from the 1,142 men constituting the population of the Baltimore Longitudinal Study on Aging, was assessed over a follow-up period averaging 8.4 years. When compared with a control group matched for age at which right bundle branch block appeared (mean +/- standard deviation 64.0 +/- 13.5 years), men with right bundle branch block showed no difference in the prevalence of antecedent coronary risk factors or obstructive lung disease. The incidence of angina pectoris, myocardial infarction, valvular heart disease, cardiomegaly, congestive heart failure, advanced heart block or cardiac death in these men did not differ from that of the control group over the observation period. Furthermore, at the latest follow-up study, maximal aerobic exercise tolerance and chronotropic response to maximal exercise were not impaired in men with right bundle branch block relative to control men (9.1 +/- 2.2 versus 7.3 +/- 3.0 minutes and 150.3 +/- 23.5 versus 147.7 +/- 20.7 beats/minute, respectively). However, axis deviation leftward of -30 degrees was present in 46% of men with right bundle branch block but in only 15% of control subjects at latest follow-up (probability [p] less than 0.01). Although the PR interval lengthened by 40 ms or more developed in only 6% of control subjects over the observation period, such prolongation occurred in 29% of men with right bundle branch block (p less than 0.05). These results support the concept that right bundle branch block in these asymptomatic men is a manifestation of a primary abnormality of the cardiac conduction system but has no demonstrable adverse effect on long-term cardiac morbidity or mortality.
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PMID:Right bundle branch block: long-term prognosis in apparently healthy men. 682 77

The prevalence of selected cardiorespiratory symptoms was ascertained by a common mail questionnaire for 73,884 men and women in the United States, Great Britain and Norway. The study groups were identified in the early 1960's and included 30,033 British and Norwegian migrants to the United States and 43,851 non-migrants who resided in Great Britain and Norway. The main study objectives were to contrast the morbidity and mortality experience of the migrant and non-migrant groups in the light of known national differences in mortality from cardiorespiratory diseases in the early 1960's. At that time, the U.S. had the highest death rates from coronary heart disease while Great Britain had the highest rates for lung cancer and for chronic non-specific lung disease. Norway had the lowest rates for all three rubrics. The prevalence of "angina" and other symptoms was ascertained for each of the study groups. Contrary to expectation, angina was reported much more frequently by persons remaining in Britain and Norway than by migrants to the United States. Mortality rates during the five years and responding to the symptoms questionnaire were determined and mortality patterns were evaluated according to the presence or absence of angina. Angina was found to be a strong predictor of cardiovascular mortality. In the absence of angina, it was observed that migrants had similar mortality rates to non-migrants regardless of country of origin. However, the British had higher mortality rates from cardiovascular and from non-cardiovascular causes than the Norwegians. The primary determinant of angina prevalence was found to be migration status. It is believed that this differential was determined primarily by selection of those who migrate, with the migrants to the U.S. being a healthier group than their counterparts remaining in the native country.
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PMID:The British-Norwegian migrant study--analysis of parameters of mortality differentials associated with angina. 709 15


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