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

Experience in surgical correction of aortic valvular disease with extreme calcification of valves in 145 patients is generalized. The method for valve prosthetics preventing the development of specific complications is described. On the basis of analysis of the immediate and late postoperative results, it is recommended to use cold cardioplagia for protection of the myocardium. Hospital postoperative mortality was 13.9% in the last 4 years and 10.5% in the last 18 months. Preliminaly coronarography is suggested for the examination of patients with marked angina pectoris and with local changes on the ECG in the group of elderly patients for ruling out a concomitant organic lesion of the coronary artery.
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PMID:[Valve prosthesis in calcified aortic heart defects]. 31 37

Angina pectoris is a common symptom in aortic valvular disease. In our study of 100 consecutive patients it was found more commonly in patients with aortic stenosis than in those with aortic insufficiency. Only 21 of 80 patients with angina pectoris had significant narrowing (more that 75%) of one or several coronary arteries. Angina pectoris in aortic valvular disease thus seems to be most often functional due to disproportion between myocardial oxygen supply and demand. On the other hand, 5 of 20 patients without angina pectoris had significant coronary artery stenosis. As coronary artery involvement may jeopardize the results of aortic valve replacement in these patients, coronary angiography should always be carried out in patients evaluated for surgery of aortic vavlular disease. Coronary bypass surgery should be carried out during the same operation if the stenosis is severe and bypass is technically feasible.
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PMID:Angina pectoris in aortic valvular disease and its relation to coronary pathology. 43 64

In order to relate the frequency of angina pectoris to associated coronary artery disease, 66 consecutive patients with severe aortic valvular disease were studied by cardiac catheterization, including coronary angiography. Angina pectoris was found in 63 per cent of patients with predominant aortic stenosis, 62 per cent with aortic regurgitation, and 67 per cent with mixed disease. Associated coronary artery disease (larger than or equal to 75 per cent luminal stenosis) ranged from 14 to 28 per cent and averaged 20 per cent for the entire group of 66 patients. Only one patient without angina had significant coronary artery stenosis. Our studies indicate that angina pectoris is equally common in all forms of severe aortic valve disease and is usually not associated with significant coronary artery disease.
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PMID:The prevalence of angina pectoris and abnormal coronary arteriograms in severe aortic valvular disease. 87 Oct 97

Among 6,200 patients undergoing coronary arteriography using the Sones technique at the Juntendo University Hospital and the Juntendo Urayasu Hospital from 1975 to 1988, 121 patients (1.95%, 111 males and 10 females) were found to have significant (> or = 50%) stenosis in their left main trunks (LMT). Patients with systemic inflammatory disease such as syphilis or Takayasu's arteriitis, aortic valvular disease, or a history of mediastinal irradiation were excluded from this study. Stenotic lesions of the LMT were categorized into 7 types according to their locations and appearances. 1. The most common type was stenosis localized just before the branching from the left circumflex artery (42 patients or 34.7%). 2. Although the incidence of left coronary ostial stenosis was not very high (13 patients, 10.7%) as a whole, that for the female patients was the highest (30.8%) of the 7 types. Nine patients showed atherosclerotic irregularities with or without significant stenosis in the distal coronary arterial trees. Four patients, including 3 women, were diagnosed as "primary solitary ostial stenosis" of which the cause is unknown. All of the 3 women were premenopausal, and their clinical profiles were as follows: Case 1 (45-year-old): She was hospitalized because of anterior chest pain during exertion or at rest. Her electrocardiogram (ECG) showed severe ischemic ST-T changes. Coronary cineangiography disclosed a 95% stenosis in the left coronary ostium, and the distal portion of the coronary artery was normal. She had not experienced angina after her coronary artery bypass operation. Case 2 (45-year-old): She was hospitalized because of exertional chest pain.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Solitary ostial coronary artery stenosis in women]. 184 5

Mapping of blood velocities across the lumen of the ascending aorta was performed in eight patients during open-heart surgery. A Doppler ultrasound probe was constructed to measure velocities in 2 mm steps from the maximum convexity to the maximum concavity of aorta, 6 to 7 cm above the aortic valve. In five patients with angina and normal aortic valves, velocity profiles were very similar and showed the following main features: a skewed peak systolic velocity profile with the highest velocity along the left posterior wall, a bidirectional velocity profile in late systole and early diastole with retrograde velocities along the left posterior wall, and a sustained antegrade flow along the convexity well into diastole. The resultant mean velocity profile had the highest velocity at the convex side and a central minimum velocity. In patients with Medtronic-Hall tilting disc prostheses, where the larger opening was oriented backwards and to the right, mean flow velocity profile was skewed in the opposite direction of normal. Moreover, instant systolic velocity profiles were much more irregular and dependent on the exact orientation of the prosthesis. In one patient with aortic valvular disease, very irregular and different velocity profiles were found. Based on a symmetry assumption, overall mean velocity for the total cross section was computed, and the magnitude of error in estimation of total flow from measurement of velocities at different depths was calculated. To measure total flow in the aorta, i.e., cardiac output, by single-gated Doppler technique, the most representative sampling site was about one-third of the diameter from the convex wall.
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PMID:Blood velocity distribution in the human ascending aorta. 329 90

One hundred consecutive patients 80 years of age or older consented to and subsequently underwent open-heart operations at our institution between July 1976 and May 1987. Fifty of the patients had aortic valvular disease (28 with coexisting coronary artery disease), and 41 had isolated coronary artery disease. Eight patients had mitral valvular disease, and one had a dissecting aortic aneurysm. Ninety had Class IV disease that was functional, ischemic, or both. The most compelling indications for operation in 85 patients were unstable or postinfarction angina, syncope, acute pulmonary edema, or cardiogenic shock. Twenty-nine patients died soon after operation (within 90 days). New York Heart Association Class IV disease, previous myocardial infarction, cachexia, and emergency operation were preoperative variables associated with early death. Forty-three patients had no complications except for atrial arrhythmias and were discharged from the hospital a mean (+/- SD) of 11.5 +/- 3.7 days after operation. Low cardiac output, acute myocardial infarction, reoperation for bleeding, renal insufficiency, pneumonia, and prolonged endotracheal intubation were the most common serious postoperative complications. Twenty-eight patients who survived postoperative complications were discharged 24.9 +/- 19.6 days after operation. Seventeen patients died 2 to 104 months after discharge from the hospital. Actuarial calculation predicts the survival of 59 percent of patients at three years and 54 percent at five years. Of the 54 patients still alive at this writing, 53 have disease within New York Heart Association and Canadian Cardiovascular Society Classes I or II. For selected octogenarians with unmanageable cardiac symptoms, operation may be an effective therapeutic option.
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PMID:Open-heart surgery in octogenarians. 338 92

We report a subaortic aneurysm of the left ventricle causing compression of a coronary artery in a 52-year-old white man presenting with angina on effort. Endocarditis seemed to be implicated as the cause of this rare condition. To what extent coronary obstruction influenced the development of myocardial ischaemia was not defined since the patient also had aortic valvular disease. The clinical features, diagnostic studies and successful surgical treatment are described.
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PMID:Subaortic aneurysm of the left ventricle obstructing a coronary artery. 360 50

Coronary heart disease (CHD) was followed up in 239 patients with rheumatic heart disease. According to the clinical data 40 (16.73%) patients had myocardial infarction (MI), 100 (41.84%) cardiosclerosis (CS), 185 (77.4%) angina pectoris (AP). AP (44.35%) prevailed among the isolated (66.1%) forms of valvular disease, associated AP and CS (23%) among the combined (33.9%) forms. In the majority of patients, AP originated and ran its course as stable throughout many years; in one-fifth of patients, the disease occurred as unstable. The incidence of AP was significantly higher in the senior age group, in women with aortic valvular disease, in men with stage III circulatory failure, and in cardiomegaly, AP aggravated the disease and life prognosis. MI was manifested by a moderately pronounced painful attack; it was frequently complicated by acute or incremental chronic circulatory failure. Small-focal MI was seen more frequently while the electrocardiographic changes associated with the disease resembled those seen in rheumatic carditis. Postinfarction CS stimulated the onset and progress of chronic congestive heart failure in 93.02% of patients.
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PMID:[The course of ischemic heart disease in rheumatic defects in persons over 45]. 401 13

In view of the fact that stable echocardiograms are easily obtained during atrial pacing, pacing echocardiography was performed to evaluate the usefulness for detecting regional wall motion abnormalities during pacing-induced ischemia and to investigate the relationship between changes in the R wave and left ventricular dimension. The patients were 12 cases of angina pectoris (10 of coronary artery disease; CAD, and 2 of coronary patent aortic valvular disease; AVD) and 6 control cases. Simultaneous recording of two-dimensional and M-mode echocardiograms and electrocardiograms was done before, during and after the atrial pacing at increasing heart rate until angina appeared or the heart rate of at least 140/min was reached. In 12 angina cases, angina and ST depression were induced in 10 and 11, respectively. Excursion of the interventricular septum (IVS) decreased during pacing-induced ischemia in 6 of 7 CAD cases, in which the left anterior descending coronary artery was significantly stenosed (more than 75%). Excursion of the left ventricular posterior wall (LVPW) decreased during pacing-induced ischemia in 4 of 7 CAD cases, in which the vessels giving rise to posterior descending coronary artery were significantly stenosed (more than 75%). In 2 AVD cases, excursion of both IVS and LVPW decreased during ischemia. Left ventricular end-diastolic dimension (LVEDD) increased in only 2 angina cases, although R wave amplitude increased in 6 angina cases.
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PMID:Pacing echocardiography: regional wall motion, left ventricular dimension and R wave amplitude in patients with angina pectoris. 708 87

The paper analyzes the data on the examination and surgical treatment of 426 (313 males and 113 females) patients aged from 16 to 60 years with various aortic valvular diseases. Isolated aortic stenosis was detected in 122 (28.6%) patients, isolated aortic failure in 128 (30.0%), and aortic valvular disease concurrent with other valvular diseases in 176 (41.4%) patients. Some problems in the diagnosis of latent myocardial insufficiency and in the compensation of intracardiac hemodynamics, as well as the association of aortic valvular disease, angina pectoris, and coronary heart disease are dealt with. A contribution of risk factors, such as valvular calcification, age, etiology, and their influence on the outcome of surgical treatment are discussed in the paper.
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PMID:[Current aspects of hemodynamic compensation and surgical treatment in aortic valve diseases]. 860 Oct 81


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