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

The method of radionuclide cardangiography (RNCA) has become a well-established method amongst non-invasive assessments in coronary heart disease (CHD). By means of RNCA the most important parameters of left ventricular function, viz. ejection fraction (EF) and wall motion (WM), can be determined very exactly. The first bolus pass method (FBP), which allows satisfactory separation between right and left heart, enables the additional determination of EF distribution, stroke volume (SV) and SV distribution. This method requires the technical necessity of a multicrystal gamma camera. Special nuclear medicine characteristics have been worked out for different groups of CHD. EF and WM show typical signs of angina pectoris, caused by exercise correlating with reduced perfusion in the referring section of WM. While these changes may be reversible after nitrate administration, pathological myocardial function caused by acute myocardial infarction (AMI) or manifest heart failure is not reversed by nitroglycerine. Typical findings were seen in the course of AMI: initial decrease in global EF and diffuse (multilocated) asynergies in the left ventricular wall; in the second week possible start of recovery, including regression of dyskinesia to akinesia at the end of hospitalization. Especially in the early phase of AMI it was demonstrated that FBP--as a non-invasive technique--gives high information quality which is unequalled by other comparable methods. Therefore, the described method of FBP should be classified as very useful and effective in clinical cardiology.
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PMID:[Radionuclide cardangiography as non-invasive assessment in coronary heart disease (author's transl)]. 39 49

A spontaneous coronary spasm with a complete but reversible occlusion of the left coronary artery could be demonstrated by coronary arteriography in a patient with angina pectoris at rest and during exercise. This will prove that spasms of coronary arteries can cause angina pectoris or even acute myocardial infarction if the spasm is persisting for long enough and if there is no sufficient supply by collateral vessels. This can be a possible reason for akinesia or dyskinesia of the left ventricle associated with normal or near normal coronary arteries.
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PMID:[Spontaneous coronary spasm with reversible occlusion of the left coronary artery: a case report (author's transl)]. 43 68

Regional systolic left ventricular performance after myocardial infarct was assessed from 216 radionuclide angiograms performed in 170 patients. Recording of first transit of an intravenously injected bolus of technetium-99m pertechnetate was made by a multicrystal scintillation camera at a framing rate of 20 per second. The RAO view was used and a simultaneous ECG was employed. Statistics adequate for resolving regional events were obtained by a compact bolus input and phasic summation into one representative cycle of data obtained during left ventricular passage. Emphasis was given to imaging of regional systolic left ventricular function: perimeter images of end-systole and end-diastole, regional stroke volume images and ejection fraction images were processed. New trend images were presented that reflect total systolic contraction and improve image quality: regional rate of decrease and increase images, wall motion trend images and regional mean transit time images. In 96% of the cases, correspondence was found between the electrocardiographic location of the infarct and the region of major wall motion and ejection disorder. Akinesia and/or dyskinesia were seen in 77% of the cases; a ventricular aneurysm was found in 11%. Additional areas of wall motion anomalies were shown by 70%. Image analysis, nuclear image signs and their diagnostic meaning, as well as the indications for this nontraumatic examination in coronary heart disease are discussed. Relevant information for medical or surgical therapy can be obtained from early and follow-up studies in patients with unstable, progressive angina, ischemic electrocardiographic signs and those who have had myocardial infarctions.
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PMID:Radionuclide angiography of the heart in coronary heart disease: where do we stand? 74 2

A 57 year old women with substernal nonexertional chest pain and angiographically patent coronary arteries was evaluated with two dimensional echocardiography and myocardial perfusion scintigraphy after provocation of pain with methacholine. Simultaneous with the development of angina pectoris, the electrocardiogram demonstrated S-T segment elevation in leads II, III and aVF, followed by atrioventricular block. The echocardiogram revealed akinesia of the previously normally contracting left ventricular posterior wall during pain followed by hyperkinesia after the administration of nitroglycerin. Perfusion imaging suggested reversible inferior wall hypoperfusion. Thus, these studies provided noninvasive documentation of segmental left ventricular dysfunction and hypoperfusion during variant angina.
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PMID:Noninvasive documentation of Prinzmetal's angina. 76 Apr 85

Myocardial infarction occurs rarely with thyrotoxicosis. A 34-year-old woman with thyrotoxicosis sustained a transmural myocardial infarction and subsequently on cardiac catheterization studies had no significant coronary arterial disease but only residual apical wall akinesia. Thyroid hormone may directly influence myocardial oxygen supply and demand and, by some unknown mechanism exclusive of major coronary arterial blood supply, cause a critical imbalance resulting in angina pectoris and myocardial infarction.
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PMID:Myocardial infarction associated with thyrotoxicosis. 87 41

Fifteen subjects recovering from a myocardial infarction or suffering from angina were given a maximum effort test on a bicycle ergometer and hemodynamic and angiographic investigations before and after a period of physical training. The training program consisted of three sessions of 60 to 75 min each week for two months. Maximum effort tests showed that physical capacity had increased by 17% (P less than 0.02) and that for the same amount of effort the heart rate had decreased by 13% and the blood pressure by 7% (P less than 0.01). Hemodynamic and angiographic investigations showed no significant changes after training in the left ventricular end-diastolic pressure, ventricular volume, ejection fraction, VCF, percentage of shortening and segmental contractility, in the total group, in those patients whose contractility was considerably impaired, or in those who had large dyskinetic areas or widespread akinesia. It is concluded that training had no direct influence on the myocardium, either beneficial or detrimental.
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PMID:A study of left ventricular function in coronary patients before and after physical training. 88 93

As many as 283 drivers with a history of acute myocardial infarction were examined. In the long-term postinfarction period, the number of the able-bodied accounted for 22.8%, the number of persons with restricted work fitness was 43.3%, that of the disabled amounted to 33.9%. It should be noted that about 60% of the able-bodied and those with restricted work fitness returned to the driving-related work. However, in some cases, the type of the trucking was either changed of the work scope was to be minimized. Criteria forming the basis for predicting the recovery of work fitness of the drivers were as follows: non-transmural character of myocardial infarction for the most part, the effective staged rehabilitation program, positive dynamics and smoothing of the ECG signs of myocardial infarction, the lack of areas of regional hypo- and akinesia of the myocardium, normalization of the ejection fraction, high and mean indicators of physical work fitness, exercise tolerance, coronary reserves, functional class I and II angina pectoris of effort, either the lack or initial clinical signs of circulatory failure, psychological readaptation, high occupational class, and labour orientation.
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PMID:[Myocardial infarct in motor transport drivers and the results of long-term observations]. 138 90

Thirty-one patients, mean age 54 years, had been on chronic ambulatory peritoneal dialysis (CAPD) for an average of 38 months. Mean values (mg/dl) for triglycerides (567), total-C (267), LDL-C (133), and Apo-B (154) were elevated, and HDL-C (30) were low. The low values for total-C/Apo-B and LDL-C/Apo-B suggest an increase in the number of low density lipoprotein (LDL) particles, rather than in the amount of cholesterol per LDL particle. Without knowledge of lipids, ischemic heart disease for the 31 patients was categorized into five grades in the following manner. All patients were graded based on history (angina, myocardial infarction, and bypass surgery), electrocardiogram (EKG), and echocardiography. In addition, five patients underwent coronary angiography, the results of which were considered in their grading. The five grades were assigned as follows: Grade I, no evidence (n = 15); Grade II, angina with EKG ischemia (n = 4); Grade III, myocardial infarction (MI) (n = 1); Grade IV, MI with dyskinesia-akinesia on echo (n = 4); Grade V, severe three vessel disease on angiography, or multiple infarcts, or Grade IV with heart failure (n = 7). Only Apo-B (r = 0.56) and total-C/HDL-C (r = 0.57) correlated with severity of grade, with p less than 0.001. When patients with and without detectable ischemic heart disease were compared by stepwise logistic regression, Apo-B was the only variable that independently predicted heart disease (p = 0.001). However, contribution of the lipid changes induced by CAPD has not been established.
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PMID:Ischemic heart disease, serum cholesterol, and apolipoproteins in CAPD. 175 Dec 58

The evaluation of coronary reserve within a few hours of aortocoronary bypass surgery could be of extreme utility for the follow-up or therapeutical management of these patients. In 11 men patients who underwent aortocoronary bypass surgery, a dipyridamole echocardiography stress test was carried out before (1 to 3 days), early after (68 to 130 minutes), and 1 week after surgery. The first and third tests were performed using a standard transthoracic approach, while the second was performed by a transesophageal approach. Dipyridamole was administered intravenously at a dose of 0.56 mg/kg body weight (low dose) and eventually adding 0.28 mg/kg body weight (high dose), always in the absence of antiischemic therapy. An arbitrary wall motion score (0 = eukinesia; 1 = hypokinesia; 2 = akinesia; 3 = dyskinesia) was assigned to the seven different myocardial regions in which the left ventricle was divided in order to have a semiquantitative score. Under basal conditions wall motion score per patient in the three series of tests did not change significantly (1.6, 1.4, and 1.5, respectively), while the mean score during dipyridamole administration showed significant differences (3.6, 1.9, and 1.9, respectively), indicative of the results obtained by surgical repair. The test, positive in all patients before surgery, showed wall motion abnormalities and ischemic ECG changes in two patients immediately after surgery by the transesophageal approach. One patient who had a normal basal contraction pattern and an abnormal response after the test developed in the following days a perioperative myocardial infarction, while a second patient in the follow-up period developed low-level effort angina.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Early assessment of coronary reserve after bypass surgery by dipyridamole transesophageal echocardiographic stress test. 223 61

We studied seven patients with Prinzmetal's angina and three patients with unstable angina pectoris type III (according to the criteria of Conti) during and after a spontaneous attack of angina pectoris by two-dimensional echocardiography. All patients underwent coronary angiography. The echocardiographic studies were performed during the attack (phase I), immediately after the attack (phase II), and 24 h after the attack (control). Left ventricular ejection fraction was significantly decreased during the attack (38.1 +/- 11% vs 59.8 +/- 7%), while left ventricular end-diastolic volume was increased (71.9 +/- 28 ml/m2 vs 50.3 +/- 13 ml/m2). The double product of heart rate and systolic blood pressure was equal at the 3 different examination times. In all patients transient regional disturbances of left ventricular contraction could be observed. In six patients the wall motion disturbances had already disappeared at phase II, while in four patients hypokinetic regions could still be found. At control, nine patients showed a normal left ventricular contraction pattern, while one patient with previous anterior myocardial infarction showed a small region of anterior akinesia. In all patients coronary artery obstructions were found in the same region of the left ventricle, where transient wall motion abnormalities occurred. Thus, two-dimensional echocardiography performed during an attack of angina pectoris in patients with Prinzmetal's angina and unstable angina pectoris type III can evaluate the localization, as well as the extent of transient myocardial wall motion abnormalities.
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PMID:[Echocardiography detection of reversible regional disorders of contraction in patients with unstable angina pectoris and Prinzmetal angina during an attack]. 250 59


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