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)

A case is reported of a patient who developed exfoliative dermatitis while being treated with practalol for angina pectoris. The patient also had trigeminal neuropathy, renal impairment and keratoconjunctivitis sicca. The antinuclear factor was diffusely positive but other antibodies were negative. At post mortem the patient was found to have acute pancreatitis, and peritonitis. It is postulated that the patient has antecedent Sjogren's syndrome and on introduction of practalol therapy developed a drug reaction with a generalised exfoliative dermatitis and exacerbation of keratoconjunctivitis sicca leading to bilateral corneal ulceration. The association of similar conditions in patients receiving practalol therapy is reviewed.
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PMID:Sjogren's syndrome and drug reaction to practalol. 12 54

Peripheral neuropathy has been noted as a complication of therapy with perhexiline maleate, a drug widely used in France (and in clinical trials in the United States) for the prophylactic treatment of angina pectoris. In 24 patients with this complication, the marked slowing of motor nerve conduction velocity and the electromyographic changes imply mainly a demyelinating disorder. Improvement was noted with cessation of therapy. In a few cases the presence of active denervation signified a poor prognosis, with only slight improvement. The underlying mechanism causing the neuropathy is not yet fully known, although some evidence indicates that it may be a lipid storage process.
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PMID:Perhexiline maleate and peripheral neuropathy. 22 May 63

Perhexiline maleate (Pexid) which has been in general use in France with good results for the treatment of angina pectoris since 1973, may be associated with severe side effects including peripheral neuropathy. The present study is a comparison of the pharmacokinetics of perhexiline maleate in anginal patients with and without signs of peripheral neuropathy. Compared to the latter, those with neuropathy had higher plasma levels of perhexiline, slower hepatic metabolism and a longer plasma half-life. Thus, peripheral neuropathy associated with perhexiline maleate treatment appears to be a direct toxic effect due to accumulation of the drug. The accumulation might result either from a decreased volume of distribution secondary to a loss of body weight, possibly drug-induced, or to slow hepatic metabolism of perhexiline of genetic origin or due to hepatic disease, possibly drug-induced. The neuropathy is rarely an isolated event, as it is often associated with one or more adverse effects of perhexiline.
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PMID:Pharmacokinetics of perhexiline maleate in anginal patients with and without peripheral neuropathy. 72 14

To elucidate the characteristics of acute myocardial infarction, preinfarct angina and postinfarct angina in diabetic patients, we compared 51 diabetics and 73 non-diabetics who had myocardial infarction and angiographically-proven coronary artery stenosis. There was no statistical difference between these 2 groups with respect to age, sex, histories of smoking, hypertension and hypercholesterolemia, and hemodynamic parameters. Mean of the number of diseased vessels and of the jeopardy scores were higher in diabetics than in non-diabetics (2.4 vs. 1.9, p < 0.01; 7.2 vs. 5.7, p < 0.02, respectively). The absence of preinfarct angina (59 vs 32%, p < 0.01) and typical chest pain of myocardial infarction was more frequent in the diabetic group than in the non-diabetic group (43 vs 15%, p < 0.005). Congestive heart failure was more common in diabetics than in non-diabetics (45 vs 14%, p < 0.005). Though there was no difference in the frequency of postinfarct angina between the 2 groups (54 vs 52%), painless myocardial ischemia during treadmill exercise tests was more frequent in diabetics than in non-diabetics (75 vs 30%, p < 0.025). Compared to diabetic patients with typical chest pain of myocardial infarction, diabetics without typical chest pain had preinfarct angina less frequently (82 vs 41%, p < 0.01), but had diabetic neuropathy (71 vs 43%, p < 0.05) and retinopathy (67 vs 32%, p < 0.025) more frequently. We concluded that diabetic patients with myocardial infarction frequently lack 1) preinfarct angina, and 2) typical chest pain of myocardial infarction. 3) They often suffer from congestive heart failure, 4) frequently accompanied by painless myocardial ischemia during exercise stress tests. Therefore, special attention should be paid for the management of diabetic patients with specific neuropathy and retinopathy.
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PMID:[Characteristics of acute myocardial infarction, preinfarct angina and postinfarct angina in patients with diabetes mellitus]. 130 56

To elucidate the prevalence and features of painless myocardial ischemia among diabetic patients, 44 consecutive patients with angiographically-documented coronary artery disease and positive treadmill tests were examined. They were 26 with diabetes and 18 without it. Painless myocardial ischemia was defined as the absence of chest pain with 1 mm or more ST segment depression during the exercise stress tests. The severity of ischemia was determined by the magnitude of the ST segment depression. Painless myocardial ischemia was observed in 18 of the 26 (69%) diabetics, and in three of the 18 (17%) non-diabetics (p less than 0.005). The frequency of painless ischemia in the diabetics was relatively high regardless of the severity of ischemia, while painless ischemia was less frequent in the non-diabetics with severe ischemia. With a level of 2.5 mm ST depression, 11 of 12 (92%) diabetics were free of pain compared to four of 11 (36%) non-diabetics (p less than 0.01). Absence of chest pain during the exercise tests was not concordant with prior angina in diabetics, as opposed to non-diabetics in whom both clinical and exercise-induced angina developed concordantly. The diabetic patients without chest pain had a higher prevalence of three major diabetic complications such as neuropathy, nephropathy and retinopathy compared to those developing chest pain (p less than 0.025). It was concluded that in diabetics, painless myocardial ischemia is frequently observed during exercise stress tests and its prevalence is relatively high regardless of the severity of ischemia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Painless myocardial ischemia in diabetic patients with coronary artery disease: evaluations by treadmill exercise tests]. 210 4

We measured cardiac functions by means of mechanocardiogram and echo-cardiogram in 93 patients with diabetes mellitus, excluding those who had apparent cardiac diseases, such as angina pectoris and cardiac failure. We used pre-ejection-period/ejection time (PEP/ET) as the index of the left ventricular systolic function and isovolumic relaxation time (IRT) as that of the left ventricular diastolic function. We compared the diabetic cases without complications to those with complications such as retinopathy, nephropathy, neuropathy and autonomic disorder. Conclusions obtained were as follows; An abnormal IRT was noted in the early stage of diabetic complications. The IRT was not normal among the subjects even when those with cardiac hypertrophy or ST-depression on the ECG were excluded. On the contrary, the PEP/ET did not show any abnormality in the early stage of diabetic complications until they advanced into, eg. renal failure or severe neuropathy. Our findings suggest that the disorder of the left ventricular diastolic function precedes that of the left ventricular systolic function, indicating the association of microangiopathy and autonomic disorder.
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PMID:[Left ventricular function in patient with diabetes mellitus--Evaluated by mechanocardiogram and echocardiogram]. 261 9

Aortic aneurysm thrombosis with extra-anatomic bypass has been proposed for persons with infrarenal aortic aneurysms who are "too debilitated" to undergo standard aortic reconstruction. Thirteen patients (mean age, 75 years) were selected between January 1980 and June 1984 for axillobifemoral bypass with bilateral iliac artery occlusion to manage their infrarenal aortic aneurysms (mean size, 6.3 cm; range, 4.9 to 7.5 cm). Preoperative risk factors were cardiac (angina, compensated congestive heart failure, and significant preoperative arrhythmias), 100% of patients; pulmonary (symptomatic chronic obstructive pulmonary disease with a 1-second forced expiratory volume less than 50% of the predicted value), 46% of patients; renal (creatinine value greater than or equal to 2.0 mg/dl or creatinine clearance less than 20 ml/min), 46% of patients; or nutritional (albumin less than or equal to 3.5 gm/dl or body weight less than 90% of ideal), 46%. Ninety-two percent of the patients had two risk factors whereas 46% had three or more risk factors. The operative mortality rate was 31%; three patients died of multisystem organ failure and another died of thrombin-induced consumptive coagulopathy and hemorrhage. (Our operative mortality rate for conventional graft replacement of abdominal aortic aneurysms is less than 3%.) Morbidity in persons surviving at least 1 month included thrombosis of the extra-anatomic bypass graft requiring thrombectomy (three patients), ischemic colitis (two patients), ischemic neuropathy (one patient), and patients), ischemic colitis (two patients), ischemic neuropathy (one patient), and bilateral above-knee amputations (one patient). Thrombosis of the aneurysm was not achieved in two patients despite use of fluoroscopically controlled embolization of runoff vessels.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Is thrombosis of the infrarenal abdominal aortic aneurysm an acceptable alternative? 395 Oct 29

In a 78-year-old woman receiving perhexiline maleate for intractable angina pectoris, a syndrome of parkinsonism and peripheral neuropathy developed. The neuropathy was confirmed by electromyographic and nerve conduction studies. The parkinsonism and peripheral neuropathy disappeared when perhexiline maleate was discontinued.
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PMID:Perhexiline maleate as a cause of reversible parkinsonism and peripheral neuropathy. 626 60

Angina pectoris and asymptomatic myocardial ischemia are part of the spectrum of coronary heart disease. Not the presence or absence of angina determines the future of the patient, but repeated ischemia and the progression of the coronaropathy. This progression is neither linear with time, nor is the moment of plaque rupture foreseeable. Silent myocardial infarctions increase with age and are very frequent in diabetics. In patients without neuropathy but with asymptomatic myocardial ischemia the central pain threshold is higher than in patients with angina pectoris. The best noninvasive test for the detection, localization and estimation of extension of myocardial ischemia, be it pain-free or symptomatic, is 201-thallium scintigraphy, combined with the exercise ECG. The fight against all amendable cardiovascular risk factors and pharmacotherapy are the first steps, if asymptomatic myocardial ischemia is suspected. Augmented dyspnea on effort and rhythm disturbances are indicators of advanced multivessel heart disease. Under these circumstances coronary angiography is indicated, and further treatment should follow the generally accepted rules such as for patients with angina pectoris.
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PMID:[Asymptomatic ischemia--an important part of the spectrum of coronary disease]. 748 31

Both the late complications of diabetes and the means used to prevent them have a significant impact on the lives of people with the condition. Measuring quality of life is therefore important in assessing clinical need and evaluating the success of management. Three approaches to measuring health status were therefore compared in 284 randomly selected out-patients attending a hospital diabetes service. The measures used were the Nottingham Health Profile (NHP), four categories of an anglicized version of the Sickness Impact Profile (the Functional Limitations Profile (FLP)), and a scale of Positive Well-being (PWB). The results were found to be independent of questionnaire order and place of completion. The distributions of scores on the NHP and FLP scales were highly skewed, with a majority of cases scoring zero. NHP and FLP scores were related (p < 0.001) to age, but not otherwise to type of diabetes. Patients with angina, circulatory problems, and neuropathy scored significantly higher (up to p < 0.001) on several dimensions/categories of the NHP and FLP, but not the PWB scale. Severe visual impairment (worse than 6/36) was only related (p < 0.005) to NHP 'Mobility' and FLP 'Ambulation' and 'Home management'. Validation of scores by interview gave satisfactory results on all dimensions of the NHP except 'Energy', and all FLP categories except 'Recreations and pastimes'. No statistically significant association was observed between the PWB and the interviewer's assessments, but it did correlate (up to tau = 0.45, p < 0.001) with some social and psychological dimensions/categories of the NHP/FLP. In conclusion the PWB scale is independent of physical disability.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The performance of three measures of health status in an outpatient diabetes population. 840 22


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