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 early diagnosis of heart disease during or better before pregnancy is one of the most important problems, as cardiac diseases are the most common cause for maternal deaths throughout the world. The knowledge of hemodynamic alterations in circulatory and respiratory physiology during pregnancy complicated by heart disease is a prerequisite for their management. The following indications for therapeutic abortion of pregnancy complicated by heart disease can be concluded according to our own observations: 1. history of significant heart failure (more than grade IV according to the classification of the New York Heart Association), frequent attacks of angina pectoris and longstanding cyanosis: 2. in spite of the most careful heart treatment with digitalis, diuretics and salftree diet cardiac-thorax-rate of more than 55% in congenital heart disease, cardiac-thorax-rate of more than 60% in acquired heart disease, significant signs of heart failure, namely more severe than grade III, tachycardic atrial fibrillation, pulse deficit of more than 30/min, active inflammatory processes of the heart (rheumatic fever, subacute bacterial endocarditis, Takayasu's disease); 3. especially severe metabolic disorders, i.e. diabetes mellitus, malignant hypertension, kidney diseases; 4. primiparae of an age of more than 35 years with any heart disease. Commissurotomy can be accomplished during pregnancy if it is too late for therapeutic abortion. Pregnancy in case of artificial valves is not recommended in general because of impending hemorrhagic diathesis.
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PMID:[Indication for pregnancy interruption in patients with heart diseases]. 85 89

A 73-year-old man with effort angina after myocardial infarction is admitted for percutaneous transluminal coronary angioplasty (PTCA). During PTCA, the left anterior descending artery (LAD) was completely occluded. He was suffered from severe cardiogenic shock with systemic cyanosis and loss of consciousness. Under assist of intraaortic balloon pump (IABP) and cardiac massage, he was transferred to an operating room. Before the start of operation, cardioversion were required 13 times because of repeat attacks of ventricular tachycardia and fibrillation. Coronary artery bypass was completed in 177 minutes after total occlusion of the LAD. At the 5th postoperative day, IABP could be discontinued, and at the 8th postoperative day, the patient was weaned from mechanical ventilation. He was transferred to the prior hospital for rehabilitation on the 65 days after operation. We must try to perform CABG for salvage of myocardium, even if a patient falls in severe cardiogenic shock presenting intractable ventricular tachycardia and fibrillation.
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PMID:[An emergency coronary artery bypass for failed percutaneous transluminal coronary angioplasty with intractable ventricular tachycardia and fibrillation]. 140 55

The case is reported of a 62 year-old male having a clinical history of grade II dyspnoea from 9 year ago and recently showing grade II angina. He had presented mild cyanosis. Suspecting the existence of coronary arteriosclerosis, and with the clinical diagnosis of tetralogy of Fallot based particularly on two-dimensional and M-mode echocardiography, and angio-hemodynamic study was made which confirmed the presence of congenital heart disease and also revealed significant coronary lesions of the circumflex and right coronary arteries. The patient underwent surgery which involved complete correction of the tetralogy of Fallot and the placing of two aortocoronary grafts onto the circumflex and right coronary arteries. Favorable progress was noted both immediately after operation and 6 months later. Although cases have been described of Fallot disease associated with acute myocardial infarction, we believe that this is the first time a patient has undergone myocardial revascularization at the same time as undergoing complete correction of the congenital heart disease.
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PMID:[Myocardial revascularization and complete correction of tetralogy of Fallot in an adult. A case report]. 185 65

Over an 18 month interval at the University of Louisville Affiliated Hospitals, 40 patients were evaluated in a nonrandomized prospective study to determine the value of methylthionine chloride / tetramethylthionine chloride (methylene blue--MB) as an aid for the rapid intraoperative identification of parathyroid hyperplasia of end-stage renal disease (ESRD). Patients assigned to the MB infusion subgroup had infusion of 1 per cent MB (5.5 milligrams per kilogram) over a time interval of 25 to 60 minutes (mean of 43.9) prior to anesthetic induction. A total of 159 glands were identified in both the control and MB infusion groups (3.98 glands per patient) of which the predominant histopathologic diagnosis on frozen section was chief cell hyperplasia (78.3 per cent). Of 91 hyperplastic glands submitted for analysis after subtotal parathyroidectomy in those in the MB infusion group, 82 glands (90.1 per cent) were observed to have positive staining with identifiable differentiation from surrounding tissues. Analyses of the correlation of the serum calcium value and probability of MB staining or its relation to serum intact parathyroid hormone (intact-PTH) values were not statistically significant (p greater than 0.05, correlation coefficient equals 0.149). Furthermore, no relationship existed between the glandular size (millimeter to the third power) and probability of MB staining (chi-square equals 1.750, p greater than 0.05) or between hyperplastic size and serum intact-PTH value (correlation coefficient equals 0.068). Conversely, analysis of MB gland staining with regard to intact PTH concentration disclosed 59 of 59 glands stained intensely with MB when intact-PTH concentration was not less than 700 picograms per milliliter (p less than 0.01). Non-staining of hyperplastic parathyroid tissue was observed in 28.1 per cent of glands submitted for histopathologic analysis in which preoperative intact PTH values were more than 699 picograms per milliliter. Time of operation was reduced from 119.0 +/- 47.53 minutes (mean +/- S.E.M.) in control patients to 92.1 +/- 20.12 minutes (mean +/- S.E.M.) for the MB infusion group (V per cent equals 21.85, p less than 0.01). Furthermore, this technique appears to have value in the detection of ectopically located parathyroid tissue as demonstrated by the in vivo staining of seven ectopic glands in six patients of the infused group. Complications were restricted to the patients in the MB infusion group (21.7 per cent) and included: pseudo-cyanosis in three; pain in the infusion site in two, wound hematoma in one patient, pancreatitis in one and angina in one.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Intraoperative localization of parathyroid glands using methylthionine chloride / tetramethylthionine chloride in secondary hyperparathyroidism. 257 72

A case of acute myocardial infarction due to the lesion in the left main coronary artery was reported. A 50-year male was referred to our department for suspected acute myocardial infarction. Physical examination on admission revealed slight cyanosis with cold sweating due to severe chest pain. Pulse was irregular and heart rate was 78 beats/min. Blood pressure was 100/80 mmHg. A series of electrocardiograms (ECG) and laboratory data provided the diagnosis of wide-ranged anterolateral infarction in the left ventricle. Emergency coronary angiograms taken without delay showed a subtotal occlusion (99% stenosis) of the left main coronary trunk (LMT) before the initiation of intracoronary thrombolysis (PTCR). Following the intracoronary infusion of urokinase of 1,200,000 units, symptoms and ECG changes transiently improved but worsened later, and LMT stenotic lesion and delayed filling of myocardium were similar with before PTCR. Emergency coronary-aorto bypass graft (CABG) was undertaken without a significant delay to both the left anterior descending artery (LAD) and left circumflex coronary artery (LCX). With these treatments, the patient could survive despite the wide area of infarction due to LMT lesion. Coronary angiograms performed 37 days after the CABG showed that the graft to LAD was completely occluded and the LCX graft was patent with partial stenosis. Treadmill test at this time induced an anginal episode with ischemic ECG changes on moderate exercise, indicating the presence of significant area of ischemic myocardium. For salvage of the ischemic myocardium, percutaneous transluminal coronary angioplasty (PTCA) was successfully performed for the LMT stenosis, resulting in no episode of angina nor ischemic ECG changes during exercise loading.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of myocardial infarction due to the left main trunk lesion, in which percutaneous coronary recanalization and emergency coronary-aorto bypass graft, and subsequent percutaneous coronary angioplasty were effective not only from a viewpoint of survival but from comeback to social life]. 260 80

Type Ia tricuspid atresia, with extensive coronary artery abnormalities, is identified in the oldest living patient with this condition, a 22 year old woman. Clinical characteristics include severe cyanosis, effort dyspnea, myocardial infarction in the past and persistent angina pectoris. "Ideal" pulmonary flow and adequate left ventricular function, despite an akinetic apical segment, are substantive factors for this exceptional longevity. Coronary abnormalities consist of: 1) total proximal occlusion of the left anterior descending coronary artery; and 2) partial diversion of coronary artery flow to a segmental pulmonary artery branch. Nonvisualization of the coronary sinus is also noted. Factors other than atherosclerosis may account for total proximal occlusion of the left anterior descending coronary artery. Survival is threatened by adverse effects of ongoing ischemic coronary events.
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PMID:Type Ia tricuspid atresia with extensive coronary artery abnormalities in a living 22 year old woman. 366 6

For the judgement of the function of heart and circulation in the expert's opinion concerning invalidity are significant; anamnestic data (dyspnoea, angina pectoris, giddiness, disturbances of consciousness); clinical findings (cyanosis, dyspnoea, stasis of the jugular vein, pulse, heart sounds and extrasounds, enlargement of the liver, oedemata); paraclinical findings (thorax-x-ray, ECG, ergometry). Already by a critically made anamnesis a classification according to clinical degrees of severity (NYHA) can be done. By synopsis of anamnesis, clinical and paraclinical findings apart from the establishment of a diagnosis an objective estimation of the disease-related restriction of the working capacity is possible. All data necessary for the judgement must be in the expert's opinion.
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PMID:[Which anamnestic data and which findings are meaningful in assessing coronary circulatory function in disability evaluation?]. 409 59

NEW DENOMINATIONS: With the arrival of new therapeutic strategies requiring rapid intervention, acute coronary syndromes required classification on earlier data than the Q-wave or MB creatinine kinase. In a patient with anginal pain and depending on the electrocardiogram, we now distinguish syndromes with or without ST segment elevation. REGARDING ANTIPLATELET DRUGS: Aspirin is used in all cases, as well as clopidogrel. Anti PG IIb-IIIa agents are set aside only for the forms at risk, when an angioplasty is envisaged in the short term. ANTICOAGULANTS: Enoxaparin has demonstrated its superiority over unfractionated heparin. In general, the biological controls are not indispensables; they can however be used in certain cases (notably elderly patients). OTHER TREATMENTS: These are beta-blockers (first dose via the intravenous route in the case of persisting pain, then relay to the oral route), calcium-channel blockers (diltiazem, verapamil) when beta-blockers are contraindicated, nitrate derivatives with demonstrated antalgic effect but not to be used if an extension to the right ventricle or low blood pressure is suspected, nasal oxygen in the case of cyanosis or respiratory distress, enzyme conversion inhibitors if hypertension persists, and repeated intravenous injections of morphine in the case of persisting intense pain. CORONARY REVASCULARISATION: In all the patients considered at high risk, coronary revascularisation is recommended within the first 24 hours, when technically possible.
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PMID:[Acute coronary syndromes without ST segment elevation]. 1522 96

The authors report the case of a 64 year old woman with typical valvular pulmonary stenosis in whom spontaneous and sudden reopening of the foramen ovale resulted in cyanosis. Transthoracic echocardiography with injection of contrast provides a complete diagnosis: valvular pulmonary stenosis with a mean pressure gradient of 83 mmHg and massive right-to-left interatrial shunt. The malformation was treated by interventional catheterisation in a two-stage procedure: pulmonary valvuloplasty followed by closure of the foramen ovale because of the persistence of a right-to-left interatrial shunt. The functional improvement was followed by the appearance of effort angina. Coronary angiography showed single vessel disease of the left anterior descending artery treated by stenting. The long-term outcome was satisfactory.
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PMID:[Sudden transformation of pulmonary stenosis to trilogy of Fallot in a 65 year old patient]. 1596 15

There is a long list of prescribed and over the counter oxidizing agents that can induce methemoglobinemia. We report a case of methemoglobinemia in a 46-year-old man with a mayor depression disorder who ingested 30 pills of diphenhydramine, 30 pills of haloperidol, 20 pills of dolagesic, 20 pills of cyclobenzaprine, 20 pills of naproxen, 14 pills of cephalexin, and 48 pills of chlorzoxazone. On admission, he was on mechanical ventilation, and responded only to painful stimuli. Five hours later his face, hands and feet became cyanotic. The pulse oximetry revealed a Sp02 of 85%. The dark chocolate color arterial blood showed a Pa02 of 290.8 mm Hg and oxygen saturation (Sa02) of 99%. The chocolate color arterial blood and unchanged Sp02 suggested the diagnosis of methemoglobinemia. One mg per Klg of intravenous methylene blue was administered in 5 minutes. Twenty minutes later, the cyanosis began to fade and one hour later, it had disappeared and the Sp02 was 99%. Early treatment of methemoglobinernia is crucial in preventing tissue hypoxia. Methylene blue is the treatment of choice in symptomatic patients. The initial dose of methylene blue is 1-2 mg/kg of a 1% solution administered over 5 minutes. Reduction of methemoglobin is usually complete within 1 hour. If methemoglobinernia persists, a second dose not to exceed a total dose of 5-7 mg/kg may be administered. Because headache, nausea, vomiting, diarrhea, and angina may occur with therapeutic doses, methylene blue should only be administered to those patients with symptoms or signs of hypoxia.
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PMID:Methemoglobinemia: life-threatening hazard of multiple drug ingestions. 1960


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