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)

Calcium antagonists (slow channel blocking agents) are a very heterogeneous group of agents with dissimilar structural, electrophysiologic and pharmacologic properties. Nifedipine is a potent, long-acting vasodilator that has proved highly efficacious in relieving anginal symptoms caused by coronary vasospasm. In vivo, it exerts no myocardial depressant effects and has no antiarrhythmic properties. Treatment with nifedipine can safely be combined with administration of a beta receptor blocking agent. VErapamil prolongs atrioventricular (A-V) conduction (A-H interval) in a dose-dependent manner. It is the drug of choice for the treatment of reentrant supraventricular arrhythmias, irrespective of whether reentry occurs within the A-V node or through an accessory pathway (the Wolff-Parkinson-White syndrome). Verapamil is only moderately effective as an antianginal agent. Diltiazem is efficacious for the treatment of angiospastic angina, but its value as an antiarrhythmic agent remains to be delineated.
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PMID:Comparative pharmacology of calcium antagonists: nifedipine, verapamil and diltiazem. 625 87

Verapamil, nifedipine, and diltiazem are effective in the treatment of stable effort angina and angiospastic (variant) angina. In addition, there is evidence that the agents are beneficial in patients diagnosed as having unstable angina. The efficacy of calcium antagonists for the treatment of effort angina appears to be augmented by combining them with beta-adrenergic blockers. Intravenous verapamil, but not nifedipine, is very effective in terminating paroxysmal supraventricular tachycardias caused by re-entrant mechanisms with or without involvement of accessory pathways (WPW syndrome). Verapamil is also effective in slowing the ventricular response to atrial fibrillation or flutter. The use of verapamil for the treatment of ectopic atrial or ventricular dysrhythmias is less well established and will require further evaluation.
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PMID:Clinical pharmacology of calcium antagonists. 632 41

We studied the T wave during normal conduction in 25 patients aged 42 to 81 years (average 62 +/- 5) during sinus rhythm and complete left bundle branch block which regressed transiently after carotid sinus massage (22 cases) or injection of adenosine triphosphate (5 cases). Six patients had angina pectoris; coronary arteriography in 3 of the other 19 patients was normal. The reversion to normal intraventricular conduction was obtained with a lengthening of the ventricular cycle in all patients. The T wave axis with narrow QRS complexes was between + 70 degrees and -140 degrees (normal T axis in 11/25 patients); in the horizontal plane, the T wave was negative in V2 in 4 patients, in V2-V4 in 12 patients, in V2-V6 in 7 patients and in V4 in 1 patient. The amplitude of inversion in V2 varied from 0.1 to 1.5 mV; there was no significant difference between the patients with angina (0.50 +/- 0.31) and the remainder (0.43 +/- 0.16). In normal conduction, the T wave changes were more common in the horizontal plane (24/25 patients: 96%) than in the frontal plane (14/25 patients, 56%). The high incidence of abnormalities of ventricular repolarisation after regression of complete left bundle branch block does not appear to be related to coronary artery disease. Another explanation is proposed because of the analogy with the changes observed after terminating right ventricular pacing and after regression of a Wolff-Parkinson-White syndrome. An abnormality of initial ventricular depolarisation--common to left bundle branch block, the Wolff syndrome and right ventricular pacing--could be responsible for these T wave changes during normal conduction.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Anomalies of the T wave following treatment of complete chronic left branch block by massage of the carotid sinus or injection of adenosine triphosphate]. 643 42

A 53-year-old man known to have Wolff-Parkinson-White syndrome suffered an acute posterior-wall myocardial infarction. Despite successful thrombolysis treatment with streptokinase he continued to have attacks of supraventricular tachycardia with angina. The ECG showed a short P-R interval and pre-excitation with positive delta waves in leads V1-6, as well as signs of re-infarction. The tachycardias could not be satisfactorily suppressed by drug treatment. Coronary angiography revealed triple vessel disease. During this investigation ventricular extrasystoles occurred which initiated orthodromic supraventricular tachycardia and angina, as well as monophasic S-T elevations in leads II, III and aVF. This provided the indication for immediate high-frequency catheter ablation left laterally at the mitral anulus after a left-lateral accessory conduction pathway had been identified. Three days later the stenoses of the circumflex and anterior interventricular branches were dilated. The patient has been free of symptoms for 3 months and can exercise up to 150 W. The tachycardias have not recurred.
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PMID:[Catheter ablation as an emergency treatment in Wolff-Parkinson-White syndrome with signs of acute infarct]. 783 43

Isopotential map, constructed from ECGs of many body surface electrodes, is an expression of body surface distribution of cardiac potentials at a moment. This ECG mapping technique, providing far more information than the conventional 12-lead ECG recordings, has proved moving multiple dipoles of the heart as electric power generator, and has clarified break through minimum indicative of the right ventricular epicardial depolarization. It is also utilized for diagnosis of right ventricular or posterior myocardial infarction, left ventricular hypertrophy, localization of accessory pathway in WPW syndrome, indication for intervention in acute myocardial infarction, identification of responsible coronary artery in angina pectoris, risk of ventricular tachycardia etc. Further information on the heart will be expected through this mapping technique.
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PMID:[Isopotential map]. 789 52

A 58-year-old man underwent simultaneous surgery for WPW syndrome complicated by frequent attacks of atrial tachyarrhythmia combined with angina pectoris persisting after anterior myocardial infarction. Repeated PTCA of 3 times failed and restenosis occurred with recurrent angina particularly when atrial tachyarrhythmia took place. The preoperative ECG suggested the presence of a left free wall accessory pathway confirmed by an electro-physiolosical study. Coronary bypass grafting (LITA-LAD, SVG-4 PD) and division with cryoalation of the accessory pathway were performed using a transseptal left atrial approach. The patient is doing well now and free from both angina and tachycardia.
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PMID:[Surgery for WPW syndrome with concomitant CABG: a case report]. 872 70

40 patients with various type of arrhytmia with stable angina were treated with 3 x 20mg Prajmalin (Neo-Gilurytmal) over 6-day period. A positive antyarhytmic response was observed in 30 patients (75%). In the remaining 10 patients considering the lack of adequate response after 6 days on 60 mg the trial was continued at a dose of 100 mg/day (5 x 20mg). With this dose bringing on the desired results. In 32 patients with VE'e and SVE's Neo-Gilurytmal was used in mono therapy. While in other types of arthymia it was used as previously as a first treatment and also in cases where other antiarhytmic drugs (e.g. Propahenone, Mexitil or Beta-blockers) were unsuccessful. Antiarhytmic effects were verified using 24-hour Holter monitoring before introduction of Neo-Gilurytmal, during the first fourth and seventh day of administration and also the eleventh day of observation (in 30 patients three days after cessation of treatment and in 10 cases three days after commencing on 100 mg daily). The results, as mean of the 24-hour observation was statistically analysed using the Wilcoxon test. We analysed the mean from the first day (H1), fourth day (H2), seventh day (H3) i.e. 6 days after administration and in 10 patients three day after increasing the dose to 100 mg/day (H4). We compared this to a base value (Ho) obtained before drug administration. The results obtained showed the Neo-Gilurythmal is an effective drug significantly reducing meanly VE's and SVE's and also gigemini, trigemini, coupled, runs. It was concluded that Neo-Gilurythmal did not significantly effect the heart rate and QT intervals and also QT adjusted to the heart rate. It was also noticed that these was a lack of therapeutic effect 3 days after cessation of treatment, which was suggested that constant therapy is required. Neo-Gilurythmal was find to be effective even in the case where other previously used antiarhymics were ineffective. We also observe a positive result in treatment of paroxismal tachycardia, in treatment of WPW Syndrome and also in prophylactic againts its recurrence. In our study no adverse effects (e.g. cardiac muscle depression, hypotensive episodes or noted in other studies gepatotoxicity or cholestatic episodes) were observed.
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PMID:[Antiarrhythmic effects of prajmaline (Neo-Gilurythmal) in stable angina pectoris in light of Holter electrocardiographic monitoring]. 883 38

Sinus tachycardia caused by circulating catecholamines in the setting of congestive heart failure may impair systemic perfusion because of decreased diastolic filling time. We report the case of a patient with Wolff-Parkinson-White syndrome with angina and cardiogenic shock who improved dramatically following administration of neostigmine. Cardiac output, blood pressure, and stroke volume increased as heart rate was reduced. A previous attempt at heart rate control, in the same patient, using a low dose beta-antagonist, precipitated hemodynamic collapse. The remarkable recovery of our patient suggests that acetylcholinesterase inhibitors may warrant further investigation in patients with severe sinus tachycardia.
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PMID:High dose neostigmine treatment of malignant sinus tachycardia. 917 Jan 42

Hypertrophic cardiomyopathy is a primary disease of myocardium resulting in myocardial hypertrophy without any inciting pressure or volume overload. The typical triad of symptoms includes exertional angina, syncope, and shortness of breath. Sudden cardiac death, the most dreadful complication of this disorder, can be the first manifestation of the disease and is more common in young patients. Elderly patients, on the other hand, may have a relatively benign course with normal or near-normal life span. The electrocardiogram (ECG) and echocardiography are the two most useful measures to diagnose hypertrophic cardiomyopathy. The electrocardiographic features of hypertrophic cardiomyopathy are numerous, including ST segment elevation that may simulate other ST segment elevation syndromes, including acute myocardial infarction, variant angina pectoria, acute pericarditis, bundle branch blocks, ventricular paced rhythm, dyskinetic ventricular segment, ventricular aneurysm, left ventricular hypertrophy, Wolff-Parkinson-White syndrome, and early repolarization syndrome. This report describes a case of an asymptomatic patient who presented with ST segment elevation of acute injury type and, therefore, was admitted to rule out silent myocardial infarction. Myocardial infarction was ruled out by cardiac enzyme levels, but ST segment elevation remained persistent in all of the subsequent ECGs. Echocardiography was performed, which clearly showed hypertrophic cardiomyopathy with left ventricular outflow tract obstruction and a high intracavity pressure gradient. Subsequently, retrieval of old ECGs showed a similar type of ST segment elevation in the patient's previous ECGs.
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PMID:Persistent ST segment elevation: a new ECG finding in hypertrophic cardiomyopathy. 1033 93

We investigated the prevalence and characteristics of ischemic heart disease especially silent myocardial ischemia (SMI) and arrhythmia in need of careful observation in the exercise stress tests in the Total Health Promotion Plan (THP), which was conducted between 1994-96 for the purpose of measuring cardiopulmonary function. All workers (n = 4,918, 4,426 males) aged 18-60 yr old in an occupational field were studied. Exercise tests with an ergometer were performed by the LOPS protocol, in which the maximal workload was set up as a presumed 70-80% maximal oxygen intake, or STEP (original multistage protocol). ECG changes were evaluated with a CC5 lead. Two hundred and fifteen people refused the study because of a common cold, lumbago and so on. Of 4,703 subjects, 17 with abnormal rest ECG and 19 with probable anginal pain were excluded from the exercise tests. Of 4,667 who underwent the exercise test, 37 (0.79%) had ischemic ECG change, and 155 (3.32%) had striking arrhythmia. These 228 subjects then did a treadmill exercise test with Bruce protocol. Twenty-two (0.47% of 4,703) showed positive ECG change, 9 (0.19%) of 22 had abnormal findings on a 201Tl scan. 8 (0.17%) were diagnosed as SMI (Cohn I), in which the prevalence of hypertension, hyperlipidemia, diabetes mellitus, smoker and positive familial history of ischemic heart disease was greater than that of all subjects. In a 15-30 month follow up, none has developed cardiac accidents. Exercise-induced arrhythmia was detected in 11 (0.23%) subjects. Four were non-sustained ventricular tachycardia without any organic disease, 4 were ventricular arrhythmia based on cardiomyopathy detected by echocardiography, 2 were atrial fibrillation and another was WPW syndrome. It is therefore likely that the ergometer exercise test in THP was effective in preventing sudden death caused by ischemic heart disease or striking arrhythmia.
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PMID:[Silent myocardial ischemia and exercise-induced arrhythmia detected by the exercise test in the total health promotion plan (THP)]. 1132 53


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