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)

The coronary arteries were examined in 60 specimens from patients with mitral stenosis. In three, localized obstruction was nonatherosclerotic in nature (in one, arterial dysplasia; in two, embolic). In 18 of the remaining 57 cases (31.5%), significantly obstructive atherosclerosis in one or more segments of the coronary arterial system was found. This represented 46% of the males and 27% of the females. The incidence of involvement of three or more arteries by significantly obstructive atherosclerosis was 39%, while in a cited series of subjects with angina pectoris three or more vessels were involved in 79% of the cases. It may be concluded that, on the average, the distribution of lesions in patients with mitral stenosis and significant coronary atherosclerosis is less wide than in subjects with clinical coronary disease.
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PMID:Coronary atherosclerosis in subjects with mitral stenosis. 94 83

Clinical and electrophysiologic studies (EPS) were carried out in 12 patients who were resuscitated from cardiopulmonary arrest (CPA). They were 8 males and 4 females, ranging from 33 to 73 years of age with a mean of 55 years. Underlying diseases included old myocardial infarction (OMI) with aneurysm (An) in 6 patients, variant angina, arrhythmogenic right ventricular dysplasia, Romano-Ward syndrome, complete atrioventricular block in one each, and diseases of unknown etiology in 2. Ergonovine-provocative coronary angiography (CAG) was performed in 3 patients, and EPS including ventricular tachycardia study was performed in 7. Coronary artery spasm was induced in one patient during CAG; sustained monomorphic ventricular tachycardia in 4 patients; and repetitive ventricular response in 2 of 7 patients examined by EPS. The causes of cardiopulmonary arrest were clearly demonstrated by the above-described examinations in 3 cases of clinically unidentified etiology. Drug therapy was performed in 6 patients during EPS (1.7 drugs/case), which was effective in one, ineffective in 3, and undetermined in 2. Of 2 patients whose surgical treatment was unsuccessful, atrial pacing with propranolol administration was used in a patient with Romano-Ward syndrome. The remaining patients were followed up medically. Cardiopulmonary arrest recurred in 3 patients and resuscitation was not successful in any of them; one with OMI and the other 2 with idiopathic ventricular fibrillation who refused EPS and died suddenly 10 months and 12 months after their initial resuscitation. Cardiac arrest did not recur in any of those who underwent complete examinations and were treated with medications, however, it recurred in 3 of 5 patients without complete medications. As a whole, cardiopulmonary arrest recurred in 3 of 12 patients (25%) within one year after the onset of symptoms. To reduce the possibility of the recurrence of arrest and improve prognosis in patients with previous successful cardiac resuscitation, intensive examinations for the causes, therapy including EPS and ergonovine CAG, full medications and surgical treatment may be helpful.
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PMID:[Patients resuscitated from cardiopulmonary arrest: clinical and electrophysiologic study]. 184 24

The case of a patient with abdominal angina due to fibromuscular dysplasia is described. Arteriography revealed dysplasia of both renal arteries and occlusion at their origins of both coeliac and mesenteric arteries. Digital subtraction angiography later showed fibromuscular dysplasia of both carotid artery systems. An unusually long right internal iliac artery allowed it to be anastomosed to the superior mesenteric artery. Follow-up studies have confirmed patency of this reconstruction.
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PMID:An unusual case of fibromuscular dysplasia. 320 21

Hypertrophic obstructive cardiomyopathy (HOCM) is an autosomal, dominant inherited disease of the myocardium which leads slowly to increasing subvalvular, septal and left ventricular hypertrophy and deterioration of systolic and diastolic left ventricular compliance. Difficult molecular-genetic investigations localized genetic defects on different chromosomes. The disease is pathological-anatomically characterized by asymmetric subvalvular (aortic) septal hypertrophy and left ventricular outflow tract obstruction resulting in additional left ventricular hypertrophy and dysfunction. Histologically the myocytes are hypertrophied, exhibit atypical branching (disarray), and there is a high amount of interstitial connective tissue. In our biopsy material (from myectomies) dysplasia could be detected in more than 30% of dysplastic intramural arteries with partly extential media. These changes may indicate microcirculatory disturbances resulting in arrhythmias, syncopes, sudden death, and anginal pain on the basis of microcirculatory disturbances and scar development. Today the discussion of DDD-pacemaker therapy has resumed, but one must wait for definite results, especially in patients in whom surgical treatment seems to be the best choice. The indication for surgical treatment, which usually is transaortic subvalvular myectomy (Morrow) and modifications, is very restrictive. Only patients in clinical degree III (NYHA) after long-term medical treatment are candidates for surgery. In some mainly younger patients the indication in lower clinical degrees was accepted because of a family history with sudden death and personal experience of syncope, life-threatening tachycardia, or after resuscitation. In the period 1963 to 1994 466 patients were operated upon. The mean age was 44.9 years (range 3 months to 82 years). Total early mortality was 4.9% (n = 12).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Hypertrophic obstructive cardiomyopathy: surgical treatment]. 748 52

Atherosclerotic lesions usually occur in the proximal and middle portion of the coronary arteries. Multiple obstructive lesions appearing only in the peripheral branches without lesions in the proximal or distal portion have not been reported. We encountered a patient with ischemic heart disease showing multiple obstruction in the peripheral branches of the right and left coronary arteries without significant stenotic lesions in the proximal or middle portion. This 49-year-old male was admitted to Yamada Red Cross Hospital due to angina pectoris. Coronary risk factors for him included hypertension, abnormal glucose tolerance, smoking habit, and obesity. Laboratory studies showed a complete blood count and normal blood chemistries, as well as thromboplastin and prothrombin times. Coronary angiography showed multiple obstruction or marked stenosis in the distal portion and peripheral branches; there was no stenosis in the proximal and middle portions. Left ventriculography showed severe hypokinesis in the diaphragmatic segment. Biopsy of the left ventricular endocardium showed interstitial fibrosis but showed no abnormalities in the myocardial fibers or cell infiltration to perivascular areas and vascular walls. Coronary angiography after two months showed multiple lesions, as previously observed. Although ischemic heart disease is caused by various types of vasculitis, embolism, coronary spasm, and fibromuscular dysplasia, in this patient, there were no findings suggestive of causes other than atherosclerosis. This case is interesting in terms of rare angiographic findings and its cause.
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PMID:Ischemic heart disease showing unusual angiographic findings. 834 Oct 3

Among 125,000 patients who underwent coronary arteriography at the Cleveland Clinic Foundation from 1960 to 1988, 128 (0.1%) were found to have 50-99% stenosis of one or both coronary ostia. All cases were associated with minimal or no obstruction in the distal coronary arteries. Thirty-six percent were males and 64% were females. Fifty percent had ostial narrowing of the left main trunk, 41% had ostial narrowing of the right coronary artery, and 9% had bilateral ostial stenosis. Based on angiographic appearance, the patients were categorized into three groups: 1) atherosclerotic (77%), 2) primary (unknown etiology) (13%), and 3) secondary to aortic valve disease (10%). Compared with the other groups, primary solitary coronary ostial stenosis was commonly found in middle-aged premenopausal or postsurgical menopausal females who had few coronary risk factors and were experiencing severe angina symptoms. At autopsy, most cases were atherosclerotic, however, fibromuscular dysplasia may be found in primary solitary ostial stenosis. This rate entity is difficult to diagnose, and is associated with increased risk during cardiac catheterization and bypass surgery. Solitary ostial stenosis should be included in the differential diagnosis of ischemic heart disease, especially in young or middle-aged female patients.
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PMID:Solitary ostial coronary artery stenosis. 851 Mar 11

A woman presented with a rapid onset of hypertension, angina pectoris, peripheral vascular disease, renal involvement, and a large liver cyst. Surgical removal of the liver cyst precipitated renal and liver failure and a terminal arrhythmia. At autopsy, there was intimal fibromuscular dysplasia involving the arteries to the heart, liver, kidneys, and intestines and evidence of recent infarction of the intestines, kidney, and liver. This case illustrates that intimal fibromuscular dysplasia (FMD) can be a diffuse and rapidly progressive disease. Some treatments currently being evaluated for preventing restenosis following angioplasty may find use in treating this uncommon disease.
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PMID:Diffuse intimal fibromuscular dysplasia with multiorgan failure. 895 5

We present a patient with left chest and neck pain due to fibrous dysplasia of the first rib. This condition was not considered as part of the differential diagnosis of chest discomfort, since it is typically painless. We believe this is the first patient described with fibrous dysplasia of the rib with left chest pain that mimicked angina pectoris.
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PMID:Fibrous dysplasia of the rib: an unusual cause of chest pain. 932 6

A huge coronary aneurysm resulting from a coronary artery-to-left ventricle fistula is a rare condition. A 57-year-old male had severe recurrent angina attacks. The cause of angina pectoris was a right coronary artery-to-left ventricle fistula with a huge coronary aneurysm. The histological examination of surgically excised specimens revealed that two vertical smooth muscle layers of media of the aneurysm might be associated with dysplasia. Mucoid degeneration was also shown in the intima and around the vasa-vasorum. Abnormal hemodynamics related to the fistula might have induced these vessel wall changes resulting in the huge coronary aneurysm.
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PMID:A huge coronary aneurysm resulting from a coronary artery-to-left ventricle fistula. 963 Jan 95

Type 1 neurofibromatosis (NF1) is the most frequently observed phacomatosis, but involvement of arterial trunks is uncommon. Expression depends on the localization and is not easily related to the causal condition. Seven patients with type 1 neurofibromatosis developed vascular manifestations (table I) disclosed by hypertension (n = 2) digestive angina (n = 1), arterial rupture (n = 1) and aneurysm of the subrenal aorta (n = 1). The diagnosis of NF1 was clear in 5 cases; in 2 cases, the diagnosis could only be established on the basis of pathology findings demonstrating dysplasia of the media with voluminous periadventitial hypertrophic nerves (table II). All the large arteries can be involved in NF1. A complete vascular work-up is needed to identify multiple arterial localizations as found in two of our cases. Thoraco-abdominal stenosis was observed in 5 cases leading, in 2 cases, to coarctation with a hemodynamic and functional impact requiring aortic revascularization. The most frequently observed localization involves the renal arteries: 3 of our patient had occlusive lesions of the renal arteries and in 2, aneurysms were observed. Three of our patients (including 2 of the preceding), had major occlusion of digestive arteries. Three other cases revealed an aneurysm of inflammatory subrenal aorta, a rupture of the iliac into the inferior vena cava and a rupture covered by a subclavian aneurysm. The indication for surgery depends on the arterial signs of associated complications (5 of our cases). In one case surgery was indicated to prevent rupture of a splenic artery aneurysm and an aneurysm of the subrenal abdominal aorta. Two cases were treated by exclusion (ilio-cava fistula) or excision (splenic aneurysm); renal or digestive revascularization was performed with arterial or venous autografts in young patients (3 cases). One extensive abdominal coarctation was repaired with a PTFE graft as were the subclavian and subrenal aorta aneurysms. One patient with an ilio-cava fistula died from collapsus. Long-term results of the revascularizations are satisfactory with good control of the hypertension and total regression of the digestive angina. Fibrodysplasia of the renal or digestive media occurring alone or thoraco-abdominal coarctation should suggest NF1 and lead to a complete work-up to identify other arterial localizations. Patients should be followed regularly to prevent complications which in case of rupture can be life-threatening.
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PMID:[Arterial complications of neurofibromatosis]. 1058 77


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