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Disease
Symptom
Drug
Enzyme
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Target Concepts:
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Query: UMLS:C0002962 (
angina
)
21,142
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
A 65 year old woman with gall stones presented with crushing chest pain after an attack of
biliary colic
. The electrocardiogram showed ST segment elevation in leads I, aVL, and V1-V3 while leads II, III, and aVF showed ST segment depression. Cardiac enzyme activity remained within the normal range. During the next three weeks attacks of epigastric and right hypochondrial pain preceded by crushing chest pain with identical electrocardiogram changes occurred with decreasing frequency. Coronary arteriography showed 60% obstruction of the left anterior descending coronary artery and good left ventricular function. During the next three years the patient complained both of mild abdominal pain, probably
biliary colic
, and mild effort related
angina pectoris
without a relation between the two symptoms. It is suggested that the attack of variant
angina
was triggered by
biliary colic
through sympathoadrenal discharge causing vasospasm.
...
PMID:Variant angina induced by biliary colic. 367 31
Acute cholecystitis or
biliary colic
may be associated with
angina pectoris
, arrhythmias, or nonspecific ST-T wave changes on the electrocardiogram. A vagally mediated cardio-biliary reflex is the presumed cause of these changes. Three cases of acute exacerbation of biliary tract disease in patients with known coronary artery disease associated with transient electrocardiographic changes and no concurrent cardiac complaints or abnormalities are reported. The signs and symptoms of gallbladder and heart disease may overlap, making diagnosis difficult. These patients underwent extensive workups of both their cardiac and biliary disease, which did not document any acute cardiac problem. In patients with known coronary artery disease and acute cholecystitis, the surgeon should not be discouraged from cholecystectomy merely because of a "questionable" electrocardiogram. Undue delay in treatment while awaiting the results of the cardiac screen may result in both cardiac and septic complications.
...
PMID:Electrocardiographic changes in cardiac patients with acute gallbladder disease. 376 39
Classic coronary pain--or
angina
--involves a substernal pressure that commonly begins with exertion and is relieved by rest. However, some patients experience
angina
in the absence of physical exertion or emotional stress, and not all chest pain that begins after exertion is
angina
. Atypical chest pain must be differentiated from other types of chest pain, including chest wall pain, pleurisy,
gallbladder pain
, hiatal hernia, and chest pain associated with anxiety disorders. Careful examination of the chest wall is essential, and abnormal heart sounds can tell you a great deal. Further testing is individualized. An exercise ECG is important in identifying the presence of ischemic heart disease and the amount of myocardium at risk. If the ECG is abnormal at rest, the patient should undergo a thallium stress test or exercise echocardiography. A coronary angiogram is indicated if the exercise test or an ECG during pain show that a lot of live heart muscle is at risk.
...
PMID:Chest pain: how to distinguish between cardiac and noncardiac causes. Interview by Eric R. Leibovitch. 767 16