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)

308 patients with the clinical diagnosis of intramural myocardial infarction made elsewhere were re-investigated more than eight weeks after the acute event. ECGs and pulmonary "wedge" pressures were recorded at rest and during exercise and coronary angiography performed (Sones' or Judkin's technique). In the first group (1973/74) of 77 patients, 35 (45.5%) had a normal coronary angiogram, compared with 0.7% in a control group with transmural myocardial infarction. A normal coronary angiogram was found in 85% of the 40 patients who had no angina during exercise. In a second group (1974/77) of 231 patients, there was a steady decrease in the number of patients without angina pectoris during exercise, in parallel with a decrease in the number of those with normal coronary angiograms. This change in pattern was apparently due to improved diagnosis in the referring hospitals. Of the 37 patients (first group) with angina during exercise, all but one were subsequently found to have significant coronary arteriosclerosis. It is suggested that most patients with a normal coronary angiogram had sustained a myocarditis and (or) pericarditis which produced the symptoms and the altered ECGs, leading to the misinterpretation of "intramural myocardial infarction".
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PMID:[Coronary angiographic findings in 308 patients with the clinical diagnosis of intramural myocardial infarction (author's transl)]. 63 72

An observation of malignant mesothelioma of the pericardium is described. The tumour grew as papillomatous formations and thick plaques lining the inner surface of the pericardium with transition to the epicardium and the development of massive hemorrhagic pericarditis. The mixed nodular-plate form is histological close to adenocarcinoma. There were metastases in the pleura, paratracheal and posterior mediastinal lymph nodes. Clinically the disease ran a course with angina pectoris and simulated idiopathic myocarditis not confirmed histologically.
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PMID:[Malignant mesothelioma of the pericardium]. 72 68

Interleukin-2 (IL-2) is increasingly used to treat patients with cancers refractory to conventional treatment. Flu-like syndromes are extremely frequent but usually mild. A variety of skin complications (mostly erythema and mucositis) have been reported. Life-threatening skin reactions have also been described. Acute reactivation of psoriasis can also occur. Immediate hypersensitivity reactions have so far not been described, but IL-2 treatment has been shown to predispose to acute hypersensitivity reactions to iodine-containing contrast media. Hypothyroidism is the major endocrine complication and antithyroid antibodies have been detected in approximately 50% of patients. Neurological and psychiatric disturbances with moderate or severe mental status changes are common and sometimes treatment-limiting. The occurrence of peritumoural oedema in patients with brain metastases can also be a major practical problem. Musculoskeletal disorders are transient and resolve spontaneously. The vascular leak syndrome is the most frequent and severe complication of IL-2 of which weight gain, generalised oedema, hypotension and impaired renal function are the main features. Even though a damaging effect on vascular endothelium cells by various cytokines released by activated lymphoid cells or mediated by non-lymphocyte-dependent factors has been proposed to be involved, the mechanism remains unclear. Other cardiovascular injuries, possibly life-threatening, including myocarditis, angina pectoris and myocardial infarction, can occur during the first days of treatment. Supraventricular arrhythmias are the most common rhythmic disorder. Decreases in myocardial contractility and haemodynamic pattern similar to those of septic shock have been encountered in most cases. Acute renal dysfunction is common but resolves with symptomatic management. Intrahepatic cholestasis with hyperbilirubinaemia is observed in most patients but permanent liver damage has not been described. Several cases of pancreatitis have been reported. Anaemia, thrombocytopenia, lymphocytopenia and eosinophilia are frequent and occur in most if not all patients. Some data suggest a high incidence of infectious complications, particularly in patients with surgically tunnelled catheters, but marked flu-like syndromes may be confounding. Finally, death directly related to IL-2 treatment has been noted in less than 1% of all patients. Investigations are under way to minimise IL-2 toxicity with varying dose regimens and combined treatments.
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PMID:Clinical toxicity of interleukin-2. 141 98

The expression of cardiac dysfunction in pediatric patients with myocarditis may not be conspicuous. While older children with myocarditis may abruptly present with pleuritic or angina-like pain, infants and toddlers with fulminant disease are unable to verbalize such complaints. Cardiac compromise in preverbal children may only be inferred from variable examination findings that include gallop rhythm, tachycardia, malignant dysrhythmias, murmur, rub, and signs of congestive heart failure. The emergency physician is likely to overlook a cardiac origin for wheezing in a child with a past medical history of asthma. Therapeutic modalities chosen for reactive airway disease may adversely influence the outcome of a patient with myocarditis.
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PMID:The wheezer that wasn't. 160

A 49-year-old man suddenly developed dyspnoea, sweating, fever (up to 38.5 degrees C), vertigo and angina. After emergency admittance to hospital the ECG showed 3 degrees A-V block, requiring temporary pacemaker insertion. The patient reported that a month before he had been bitten, probably by a tick. Serological tests demonstrated a recent Borrelia infection (rise of IgG antibody titre to 1:2048, IgM antibody titre to 1:128). Coronary angiography excluded any haemodynamically significant coronary heart disease as a cause of the conduction disorder. Myocardial biopsy showed changes pointing to a past myocarditis. This suggested Borrelia infection as the cause of the complete A-V block. Under treatment with broad-spectrum antibiotics for 15 days the fever subsided and the ECG became normal. Shortly before discharge, an elevated pulmonary wedge pressure on 150 W exercise indicated persistence of mild left-ventricular failure.
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PMID:[Transient complete AV block as a sequela of Borrelia myocarditis]. 173 75

The body surface signal-averaged electrocardiogram (SAECG) was recorded on 316 cardiac patients, 84% (266 patients) of whom were also taken 24-hour Holter ECG. VLPs were detected positively in 6.1%, 25%, 25.7%, 14.3% and 5.5% of patients with angina pectoris, myocardial infarction, myocarditis, cardiomyopathy and arrhythmia of unknown origin respectively, and the patients with complex ventricular arrhythmia had more VLPs positive determination definitely (P less than 0.05). The specificity of VLPs in the prediction of complex ventricular arrhythmia was greater than 80%, and the positive predictive accuracy was 70-80%. 5, 5 and 10 patients with VLPs were treated with Mexiletini Hydrochloridum, Lidocaini Hydrochloridum and Injection of Astragalus membranaceus respectively. As a result of treatment, the transfer of VLPs positive to negative was unsuccessful, but only the intervention of Astragalus membranaceus Injection made the duration of VLPs shortened significantly (39.8 +/- 3.3 ms versus 44.5 +/- 5.9 ms, P less than 0.01).
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PMID:[Primary research on the clinical significance of ventricular late potentials (VLPs), and the impact of mexiletine, lidocaine and Astragalus membranaceus on VLPs]. 187 28

Pediatric chest pain usually occurs in benign conditions. However, this case portrays the dramatic electrocardiographic appearance of acute myocardial ischemia in a boy with biopsy-proven myocarditis who had only mild chest pain. This underscores the need for eliciting a detailed history when evaluating a patient with chest pain. If the pain cannot be clearly attributed to chest wall phenomena, or if there are historical or physical findings suggestive of an arrhythmia or angina, then further investigation with a chest radiograph and a 12-lead electrocardiogram is recommended. Myocarditis must be considered in the differential diagnosis of any child whose electrocardiogram is indistinguishable from an acute myocardial infarction. Finally, endomyocardial biopsy allows early diagnosis and institution of therapy, which may have beneficial effect on decreasing morbidity and mortality. Further follow-up and research is still needed to evaluate the effect of early treatment of myocarditis on long-term myocardial function and the development of chronic cardiomyopathy.
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PMID:Acute myocarditis simulating myocardial infarction in a child. 198 39

In 1984-88 the authors examined in 813 subjects with the chest pain syndrome of varying aetiology (acute myocardial infarction, myocarditis, pericarditis, vertebrogenic algic syndrome, embolism of the pulmonary artery, patients lacking detectable organic causes of pain) the trend of myoglobin serum levels. They found significantly elevated values only in patients with myocardial infarction and myocarditis whereby the two diseases differ in particular as regards the shape of the curve of myoglobin values. In chest pain with another aetiology the myoglobin levels rose only rarely or not at all. From the differential diagnostic aspect it is particularly valuable that myoglobin was not elevated in any patient with embolism of the pulmonary artery and only very rarely in angina pectoris. Where in exceptional instances the myoglobin levels were elevated in patients with other investigated causes of chest pain, this increase was always due to another basic disease (right-sided cardiac failure, renal insufficiency, neuromuscular disease), whereby for these conditions prolonged persistence of the elevated serum myoglobin values was typical and the levels were never above 8 nmol/l.
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PMID:[The significance of myoglobin determination in the differential diagnosis of chest pain syndrome]. 205 2

A new scintigraphic method to detect myocardial necrosis has been developed using antimyosin monoclonal antibody Fab labeled with indium-111. Using this method, we studied 35 patients with myocardial infarction, 5 patients with myocarditis and 3 patients with angina pectoris. 111In antimyosin Fab was administered intravenously and antimyosin images were recorded by planar and single photon emission computed tomography (SPECT) 48 hours after injection. Planar images showed discrete localization of 111In antimyosin in 25 of 26 patients within 14 days after the onset of acute myocardial infarction. In 14 of these patients creatine kinase, glutamic oxaloacetic transaminase and lactic dehydrogenase had already normalized. Positive scans were also obtained in 6 of 12 patients between the third week to the ninth year after the onset of the disease. Three patients with acute myocarditis had positive scans 2 and 4 weeks after the onset of the disease. Thus, 111In antimyosin imaging may be a useful noninvasive method for the diagnosis of coronary diseases and myocarditis. Although the mechanism of persistent positive antimyosin images in the chronic stage remains to be clarified, 111In antimyosin scintigraphy holds potential promise as a non-invasive method for the detection of myocardial injury in the subacute to chronic stage as well as in the acute stage.
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PMID:111In monoclonal antimyosin antibody imaging: imaging of myocardial infarction and myocarditis. 236 20

A new scintigraphic method to detect myocardial necrosis has been developed using antimyosin monoclonal antibody F ab labeled with indium-111 (111In-antimyosin). We investigated 111In-antimyosin scintigraphy in 35 patients with myocardial infarction, 5 patients with myocarditis and 3 patients with angina pectoris. 111In-antimyosin F ab was administered iv and antimyosin images were recorded by planar and single photon emission computed tomography (SPECT) 48-72 hrs after injection. Planar images showed discrete localization of 111In-antimyosin in 26 of 27 patients within 16 days after the onset of acute myocardial infarction in 14 of whom creatine kinase, glutamic oxaloacetic transaminase and lactic dehydrogenase had already normalized. In addition, positive scans were also obtained in 4 of 8 patients 1 to 9 months after the onset of the disease. Three patients with acute myocarditis (two of whom were biopsy-proven) had positive scans 2 and 4 weeks after the onset of the disease. Although mechanism of persistent positive anti-myosin images in the chronic stage remains to be clarified, 111In-antimyosin scintigraphy holds potential promise as a noninvasive method for the detection of myocardial injury.
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PMID:[Clinical trial of 111In-antimyosin antibody imaging: (2). Imaging of myocardial infarction and myocarditis]. 279 99


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