Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0002962 (angina)
 21,142 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Obstructive and non-obstructive asymmetrical septal hypertrophy (ASH) is a relatively common disease which has no characteristic clinical symptoms. In only 14 of 71 patients in whom the diagnosis had been confirmed echocardiographically had it been possible to make the diagnosis by clinical means alone. Most of the patients had no specific clinical symptoms (angina, dyspnoea, systolic murmur, non-specific ECG changes) indicating a cardiomyopathy. Every patient with such uncharacteristic signs should therefore be studied by echocardiography in order to exclude ASH. In 17 patients there were no clinical symptoms at all, the diagnosis being made entirely by echocardiography.
 ...
PMID:[Familial asymmetrical septal hypertrophy with and without obstruction: clinical findings in patients with echocardiographically confirmed diagnosis (author's transl)]. 86 24

Simultaneous determinations of systolic time intervals (preejection period index [PEPI], left ventricular ejection time index [LVETI] and ratio of preejection period to left ventricular ejection time [PEP/LVET]) and echographic measures of left ventricular performance (percent change in minor axis diameter [%delta D], circumferential shortening rate [Vcf] and end-diastolic diameter [Dd]) were obtained in 25 normal subjects and 37 patients with previously documented transmural myocardial infarction. The group with previous infarction demonstrated significant (P less than 0.001) differences from the normal group in each of the noninvasive measures. PEP/LVET and %deltaD were the most sensitive measures of left ventricular dysfunction. Deviation from the normal range in these measures occurred, respectively, in 70 and 65 percent of patients without dyspnea or fatigability (20 patients) and 85 percent of those without angina pectoris (13 patients). Abnormalities in systolic time interval and echocardiographic measures were related to the severity of dyspnea and fatigability but not to that of angina. Neither the presence of phonocardiographically documented third or fourth sound gallops nor an abnormal cardiothoracic ratio by chest roentgenogram reliably detected patients with abnormal left ventricular performance. The range of abnormality in left ventricular performance did not differ between patients with prior anterior or diaphragmatic myocardial infarction. The frequency of abnormal performance was greatest among patients with combined sites of prior infarction. Among 26 patients studied by coronary arteriography, abnormal left ventricular performance as determined by values for PEP/LVET and %deltaD occurred in fewer than 30 percent of those with 70 percent or greater obstruction of one coronary artery and in more than 80 percent of those with two or three vessel involvement. There was a high correlation between systolic time intervals, %delta D and Vcf, the closest correlation occurring between PEP/LVET and %deltaD (r = -0.93). These data document the sensitivity of the noninvasive systolic time intervals and echographic measures and their superiority over current clinical bedside methods in evaluating left ventricular performance in patients with prior myocardial infarction.
 ...
PMID:Left ventricular performance in coronary artery disease evaluated with systolic time intervals and echocardiography. 94 20

Determinations of systolic time intervals and echocardiographic measures of left ventricular performance were made in twenty-five normal subjects and 37 patients who had convalesced from a previous transmural myocardial infarction. On group analysis the patients with previous myocardial infarction demonstrated significant differences from the normals in each of the noninvasive measures. Among the noninvasive measures the PEP/LVET and deltaD% proved to be the most sensitive indicators of left ventricular dysfunction. Deviations from the normal range in PEP/LVET and deltaD% occurred in 65% to 70% of patients asymptomatic for dyspnea and fatigability (20 patients) and in 85% of patients asymptomatic for angina pectoris (13 patients). Neither the presence of phonocardiographically documented S3 or S4 or the finding of an abnormal C/T ratio on standard chest x-ray reliably detected patients with abnormal left ventricular performance. Among 26 patients studied by coronary arteriography, abnormal left ventricular performance by PEP/LVET and deltaD% occurred in less than 30% of those with obstruction (70% or greater) of one coronary artery and in over 80% of those with obstruction of two or three major arteries. A close correlation existed between the level of left ventricular performance measured by the PEP/LVET and the deltaD% (r = 0.93). These studies document the high degree of sensitivity of the noninvasive measures and demonstrate their superiority over clinical methods for detecting abnormal left ventricular performance in patients with previous myocardial infarction.
 ...
PMID:Left ventricular performance in coronary artery disease by systolic time intervals and echocardiography. 96 Apr 23

Homograft aortic valve replacement was done in 103 patients and prosthetic aortic valve replacement in 106 between January 1962 and December 1973. Patients who received homograft and prosthetic valves were compared with respect to age, sex, preoperative functional impairment, infection, dyspnea, angina, hemodynamics, chest X-ray, electrocardiogram, associated operations, early and late mortality, and valve failure. Combined total mortality was 28% (12% operative, 8% first postoperative year, 8% late). Ten percent of valve required replacement. One year after operation, 70% of survivors were asymptomatic, 27% were improved, and 3% were unchanged or between homograft and prosthetic valve replacement. Valve-related failure and infections were more common after homograft aortic valve replacement. Emboli, hemorrhage, and hemolysis were commoner after prosthetic valve replacement. Fungal infections occurred in five homograft patients but in no patient with a prosthetic aortic valve. Severe properative symptoms or recent endocarditis was associated with greater mortality and valve failure in both the homograft and the prosthetic series. Increased mortality and failure was also seen in patients with either preoperative aortic regurgitation with high left ventricular end-diastolic pressure and low cardiac index, or aortic stenosis with cardiomegaly or roentgenographic evidence of congestive heart failure. Therefore, in two series of patients at equal risk, mortality and valve failure were similar for homograft and prosthetic aortic valve replacement.
 ...
PMID:Homograft and prosthetic aortic valve replacement: a comparative study. 99 28

During the 10 years from 1964 to 1973, fifteen patients with severe syphilitic aortic regurgitation were treated surgically at the National Heart Hospital. In thirteen the valve was replaced and in two it was repaired. In addition four had replacement of an aneurysmal ascending aorta with a Dacron graft and seven some form of plastic repair to the coronary ostia. Three patients died within 1 month of surgery and a further six during the follow-up period which varied from 1 to 55 months (mean 25-5). The six survivors have been followed-up for an average of 33 months. Factors contributing to this high mortality were analysed and it was found that the mean duration of effort dyspnoea was 22 months in the survivors compared with 48 months in those who had died. Similarly the average duration of nocturnal dyspnoea was 4 months in the survivors compared with a mean of 8 months in those who had died. Only six out of the fifteen patients had angina; this was present in two of the survivors and in four of the fatalities. The pulse pressure, heart size, and haemodynamic findings were similar in the two groups. The prognostic value of an elevated erythocyte sedimentation rate was also examined. It was concluded that preoperative investigations should include aortography, coronary arteriography, an assessment of left ventricular function, and whenever possible myocardial biopsy. These data were interpreted as suggesting that patients should be referred for surgery at an earlier stage in the disease--certainly before the onset of cardiac failure and--and that if this more aggresive attitude was adopted, as it has been in non-syphilitic cases of aortic valve disease, the present high mortality in this group would be reduced.
 ...
PMID:Syphilitic aortic regurgitation. An appraisal of surgical treatment. 100 17

The results of surgery in 21 patients with I.H.S.S. are reported. Dyspnea, angina pectoris and syncope were the most common symptoms in decreasing frequency. Before the operation, 5 patients were in New York Heart Association's functional class II, 10 in class III and 6 in class IV. The mean resting peak systolic pressure gradient was 66 mm Hg in 20 patients and mean left ventricular end-diastolic pressure was 14 mm Hg in 19 patients. The ventriculoseptomyectomy accomplished through a transaortic approach is the procedure of choice. The operative mortality rate was 14% (3 of 21 patients). There were 2 late deaths from congestive heart failure. Any sudden death did not occur. The remaining 16 patients have been followed up for a mean of 75 months (range 12 months to 11 years), 11 patients are in functional class I, 4 in class II and 1 in class III. Complete left-bundle-branch block occurred in 3 patients. Our study with a long post-operative follow-up period, documents that surgery results in good to excellent alleviation of symptoms in survivors. The elevated pre-operative left ventricular end-diastolic pressure has a significantly poor prognosis. We currently recommend surgery for the symptomatic patients who have not responded to medical therapy, not late in the symptomatic course of the disease.
 ...
PMID:Idiopathic hypertrophic subaortic stenosis: long-term surgical results. 103 83

A survey of 22 patients operated on with left ventricular (LV) infarctectomy during 1967-72 is given. Clinical, haemodynamic and angiographic results are discussed. In most patients, in whom pre- and postoperative examination was possible, there was improvement concerning anginal pain, dyspnoea and attacks of ventricular tachycardia. Exercise studies revealed a lower heart rate at follow-up. In general, heart size had decreased. Angiographically, there was a decrease in end-diastolic and end-systolic heart volume postoperatively, with an increased LV ejection fraction.
 ...
PMID:Resection of lef ventricular aneurysm-late results. 113 50

The clinical and laboratory findings in 29 patients with idiopathic hypertrophic subaortic stenosis are presented. Dyspnoea during exercise, angina pectoris, syncope combined with left ventricular hyperthrophy on ECG and chest X-ray and a systolic ejection murmur at the apex and the left sternal border are the most important findings. The findings were different in patients below and above 30 years of age. Most of the patients below 30 were in function group I, had a normal heart volume on chest X-+ray, and syncope was related to exercise. All patients above 30 had symptoms, nearly all were in function groups II-IV and often complained of palpitations, had increased heart volume on chest X-ray, sign of enlarged left atrium or atrial fibrillation of ECG. Syncope was not related to exercise, but always associated with palpitation in patients above 35 years of age. Pathologic Q waves were found more often in the younger age group. The differential diagnosis is discussed in relation to fixed aortic stenosis, mitral valve disease, ventricular septal defect, coronary artery disease, and hypertrophic cardiomyopathy without outflow tract obstruction.
 ...
PMID:Idiopathic hypertrophic subaortic stenosis. 116 70

In the third week after acute myocardial infarction, mean 18 days, exercise tests have been performed in 209 patients prior to discharge from the Coronary Care Unit. The exercise was done on a bicycle ergometer with electrically controlled braking, starting at the load 300 kpm/min (equal to 50 W), increasing with 300 kpm/min every 6th min, aiming at a maximal symptom-limited performance. ECG, in 3 extremity leads and 3 precordial leads, and heart rate (HR) were continuously recorded, and blood pressure (BP) was measured every minute. The most common cause for discontinuing exercise was fatigue (in 58%). Anginal pain or dyspnoea was the cause in 23.8%. Only in 9.1% was the exercise interrupted by the investigator because of rhythm disturbances or pronounced ST-T changes. Maximal work varied from 1 min exercise at 300 kpm/min to 6 min at 900 kpm/min (150 W); 18% of all patients were able to work for 6 min at 600 kpm/min (100 W). HR increased on an average from 80 beats/min at rest to 129 beats/min at maximal work load. Systolic blood pressure (SBP) increased on an average from 126 to 170 mmHg. The maximal values reached during exercise were HR 170/min, and SBP 270 mmHg. The product HR X SPB increased a little more than two-fold on an average. ST-T changes indicating myocardial ischaemia during exercise were observed in 70%. During exercise ventricular ectopic beats occurred in 42%. All rhythm disturbances provoked by exercise disappeared spontaneously shortly after work. Persistent ECG changes, reinfarction or other serious complications were not observed in connection with the exercise test. It is concluded that an exercise test under controlled circumstances is safe in patients of all ages in the third week after myocardial infarction. It is an objective measure of physical work capacity and described the reaction to physical activity. It gives a basis for advising return to normal life and is of great psychological importance to the patient.
 ...
PMID:Routine exercise ECG three weeks after acute myocardial infarction. 121 Dec 15

We report the clinical features and the results of investigation and surgery in 20 patients with significant left main coronary artery stenosis. All had moderate to severe angina; 8 had pain at rest. Three had dyspnoea as a major symptom. The electrocardiogram was abnormal in 17, with evidence of previous myocardial infarction in 10. Of the 11 patients exercised, 8 developed chest pain. Nine patients had a normal left ventriculogram. At coronary angiography all patients had major disease elsewhere in addition to the left main coronary artery stenosis. There were no deaths or major complications associated with this investigation. One patient was unsuitable for surgery because of diffuse left ventricular hypokinesia, one had a fatal myocardial infarction while awaiting operation, and there was one preoperative death. Sixteen of the 17 surgical survivors are free from angina. There has been a significant improvement in the maximum exercise capacity in the 10 patients who had pre- and postoperative exercise tests.
 ...
PMID:Clinical experience with left main coronary artery stenosis. 125 98


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>