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)

Serial study of 72-lead precordial ST-maps, SGOT, and SLDH was done in 30 cases of acute myocardial infarction. Infarct size was estimated by sum of ST elevation in all leads (sigma ST), number of sites showing ST elevation (NST), peak SGOT, and peak SLDH levels, and correlated with each other and with clinical features and hospital course. sigma ST correlated well with NST (r=0.92), but the correlations of sigma ST with SGOT (r=0.99) and SLDH (r=3.84) were better than those of NST with SGOT (r=0.22) and SLDH (r=0.53). There were close agreements between sigma ST and peak SGOT and peak SLDH except in the cases of non-transmural infarction, in whom smaller sigma ST suggesting small infract occurred with higher enzyme peaks indicating moderate or large infarct. Longer duration of chest pain, larger number of associated conditions (e.g. angina, hypertension, diabetes), complications (e.g. congestive heart failure, shock, arrhythmias) and mortality were associated with larger infarcts.
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PMID:Precordial ST-segment changes and serum enzyme levels in acute myocardial infarction. 73 32

A bicycle ergospirometric test was performed on 57 women and 26 men of age 40 or less in combination with coronary arteriography for angina pectoris or chest pain atypical for ischaemia severe enough to affect their working capacity. Nine men and 14 women had angina pectoris with coronary artery narrowings of 50% or more (Group I) and 5 men and 22 women had angina pectoris without obvious coronary artery narrowings (Group II). This means an incidence for coronary changes of 64% for men and 38% for women for angina pectoris. Group III consisted of 12 men and 21 women with a chest pain atypical for ischaemia and without coronary artery narrowings. Minor changes were found on angiographic examination in some patients. Four men and 11 women could not do the ergospirometry adequately. The patients with coronary artery narrowings had a lower maximal oxygen consumption than the others, even though only the mean values for the women showed a statistically significant difference. They also had lower maximal heart rates and their total work and maximum load were lower. The highest proportion of ST segment depressions of 0.5 mm or more was also found in the same patients. The pressure rate product did not show any clear difference with regard to the patient groups or the ST segment changes. As a purely diagnostic tool ergospirometry does not give more information about possible ischaemia in cases of chest pain than a routine upright bicycle test, but for following up patients with angina pectoris and evaluating treatment it gives valuable data about working capacity.
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PMID:Ergospirometry and coronary arteriography in young patients with angina pectoris or atypical chest pain. 73 6

The etiology of chest pain in patients with the anginal syndrome and normal coronary arteriograms has not been established. There has been no explanation for the association of electrocardiographic, hemodynamic, and myocardial metabolic abnormalities consistent with myocardial ischemia observed in some patients with this disorder. Historical, clinical, laboratory, and hemodynamic data of 45 patients (24 females, 21 males), mean age 47.5 years, with chest pain and normal coronary arteriograms are reviewed. Left ventriculograms were analyzed utilizing the single-plane cineangiographic measurement of left ventricular volume. Systolic ejection fractions for the 45 patients ranged from 0.66 to 0.91 (mean 0.80 +/- 0.01 SEM). Ventricular volumes determined angiographically revealed mean end-diastolic and end-systolic volumes of 83 +/- 5 ml and 18 +/- 2 ml, respectively. The mean changes in longitudinal and transverse segmental axis shortening that occurred during ventricular systole were 28.8% and 50.7%, respectively. These elevated values for ejection fraction, and reduced measurements of ventricular volumes, indicate that some patients with chest pain and normal coronary arteriograms may have small hearts with hyperdynamic ventricular contraction. These findings suggest that hyperdynamic ventricular contraction may play a causative role in the development of transient, angina-like chest pain in these patients. The etiology of the proposed hyperdynamic ventricle is unknown, but it may be attributable to increased beta-sympathetic stimulation of the myocardium.
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PMID:Elevated ejection fractions in patients with the anginal syndrome and normal coronary arteriograms. 73 29

A study was undertaken to evaluate the role of positive infarct scintigraphy in the diagnosis of acute myocardial infarction (AMI), using Technetium99m stannous pyrophosphate (Tc-PYP) and a portable gamma camera. Sixty-one patients admitted to the Coronary Care Unit (CCU) with a presumptive diagnosis of AMI or ischaemic cardiac pain were studied. Positive scans were present in 24/25 (96%) patients with AMI and new Q waves, and in 10/12 (83%) patients with AMI and no Q waves. Nine of eleven (82%) patients with chest pain and no infarction had negative scans. Of thirteen patients with unstable angina, ten (77%) had positive scans. A further eight patients undergoing coronary artery bypass surgery for angina pectoris were studied pre- and postoperatively. Two patients had strongly positive postoperative scans. The Tc-PYP scan is valuable in the detection of peri-operative infarction following coronary artery surgery, and in patients with unstable angina the technique may detect small amounts of myocardial necrosis undetectable by more conventional means. When the diagnosis of infarction is obvious from the ECG, enzymes, or a combination of the two, the Tc-PYP scan provides no extra information helpful in patient management.
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PMID:Positive myocardial scintigraphy at the bedside--evaluation using a portable gamma camera. 74 May 89

Vitamin D has been proposed as a risk factor of ischaemic heart disease. In 12 patients with acute myocardial infarction the major circulating vitamin D metabolite, 25-hydroxy-cholecalciferol (25-HCC), did not show any fluctuations during the first 4 days after onset of symptoms. The serum 25-HCC level was then measured in 128 patients consecutively admitted because of chest pain, 53 of whom had myocardial infarction and 75 had angina pectoris. The values found did not differ from those measured in 409 normal persons. The seasonal variations of serum 25-HCC were less pronounced in heart patients than in normals, probably due to less sun exposure in the summer months. The levels of serum 25-HCC did not correlate with the concentrations of serum cholesterol, glycerides, calcium or magnesium. Low serum calcium and magnesium were observed in all patients. Serum calcium was further reduced in the course of acute myocardial infarctions while serum parathyroid hormone rose significantly. We conclude that patients with ischaemic heart disease are not ingesting or producing in their skin elevated amount of vitamin D.
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PMID:Vitamin D and ischaemic heart disease. 74 75

Ten patients 28-54 years old with recurrent attacks of variant angina (chest pain associated with transient ST-segment elevation) culminating in acute myocardial infarction were studied. Systemic blood pressure and heart rate remained unchanged or decreased during chest pain. Diagnosis of myocardial infarction was made on the basis of pathognomonic enzyme changes and T-wave inversions persisting for several weeks (seven patients) or development of Q waves (three patients). Complications were similar to the ones previously observed in conventional myocardial infarction. None of these patients died. Past history was characterized by absence of effort angina. Exercise stress testing after infarction was normal, and coronary arteriography revealed a spectrum of pathology, ranging from normal arteriograms to three-vessel disease. Intraaortic balloon pumping was ineffective in two patients, but subsequent coronary bypass surgery shortly after myocardial infarction was not followed by further attacks of chest pain. Follow-up of these patients revealed a benign course. Alcohol drinking and cigarette smoking appeared to be very prevalent in this group.
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PMID:The syndrome of variant angina culminating in acute myocardial infarction. 75 98

In order to determine the incidence and pattern of angina as a premonitory symptom of acute myocardial infarction, 577 consecutive patients with acute myocardial infarction were questioned shortly after hospital admission about the presence and pattern of chest pain prior to onset of infarction, with particular emphasis on the month prior to infarction. Two hundred and seventy-six patients (48 per cent) had no angina before infarction (Group I), whereas 301 (52 per cent) did. One hundred and seventy-nine patients (31 per cent) had a history of chronic angina, and of these, 75 had no change in the pattern of angina prior to infarction (Group II) while 104 noticed worsening of their symptoms in the month prior to infarction (Group III). One hundred and twenty-two patients (21 per cent) had new onset angina in the month prior to infarction (Group IV). The number of patients with unstable angina prior to infarction (Groups III and IV) was therefore 226 or 39 per cent of the total series. In patients with unstable angina, the increase in severity of symptoms or the development of new onset angina occurred within a period of 1 week or less in 69 per cent. Patients with a history of previous infarction or chronic angina had a higher incidence of unstable angina prior to infarction than patients without such a history (p less than 0.05). Patients with prior angina (Groups II, III, and IV) had a higher incidence of subendocardial infarction than patients without angina (p less than 0.05). The hospital mortality rate in the four groups did not differ significantly.
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PMID:The incidence and pattern of angina prior to acute myocardial infarction: a study of 577 cases. 76 Apr 49

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

It is apparent that a variety of factors may be responsible for myocardial ischemia, and even infarction, in the absence of occlusive major vessel coronary disease. In particular, it must be emphasized than angina-like chest pain may well have its origin in myocardial ischemia, even in younger patients with unusual patterns of chest pain but without predisposition to premature CAD. Increasing awareness of disorders such as coronary arterial spasm, functional impairment of subendocardial blood flow and the possible role of variant patterns of anatomic distribution of the coronary arterial tree, will provide a better understanding of their significance as determining or contributing factors in patients with the anginal syndrome.
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PMID:The anginal syndrome without evidence of coronary artery disease. 76 88

The sensory function of the upper limbs was examined in 18 subjects who had a myocardial infarction without a well-defined episode of chest pain. The cutaneous pain threshold was significantly higher than in normals. The ischaemia of the upper limbs induced patterns of sensations different from the normals, with onset of pain and of autonomic and coenaesthesic disturbances. These modifications of the sensory function are the same as observed in subjects with a previous painful infarction, but are quite different from those observed in patients with angina pectoris.
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PMID:Myocardial infarction without pain. A study of the sensory function of the upper limbs. 80 Feb 52


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