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)

1. A quantitative in vitro study has been made of the actions of glyceryl trinitrate and sodium nitrite on vascular smooth muscle (dog femoral artery and saphenous vein; rat portal vein); these have been compared with the actions of papaverine, isoprenaline, salbutamol, pentaerythritol tetranitrate and trimetazidine. 2. Glyceryl trinitrate was more active on the saphenous vein than on the femoral artery in inhibiting noradrenaline and potassium-induced tone. 3. Unlike glyceryl trinitrate, sodium nitrite and isoprenaline, papaverine and diazoxide inhibited noradrenaline-induced contractions of venous and arterial smooth muscle to the same extent. 4. The selective dilator effects of glyceryl trinitrate on venous smooth muscle may explain its action in alleviating the pain of angina pectoris. It is suggested that the use of these three vascular smooth muscle preparations (arterial, and veins with and without spontaneous myogenic activity) is a useful initial screening procedure for prospective antianginal drugs acting by venodilatation.
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PMID:Comparative effects of glyceryl trinitrate on venous and arterial smooth muscle in vitro; relevance to antianginal activity. 40 60

Although greater than in patients with stabilised coronary insufficiency, the risks of carrying out coronary arteriography during the period of a threatened infarction are still modest in the hands of an experienced team. In a series of 66 such investigations under these conditions over an 18 month period, there were no deaths as immediate sequelae. Three myocardial infarctions occurred, one of which was probably encouraged by ceasing the propranolol prior to arteriography. Analysis of the results confirms the frequency of lesions affecting all three trunks (47% of cases), the anterior descending branch being the most commonly affected. A collateral circulation was established in 23% of cases. Ventriculography was normal in one third of cases. The mean value for the ventricular ejection fraction was 0.57 over the entire series. In 58% of cases, all the arteriographic and ventriculographic criteria of operability were satisfied. It therefore appears that coronary arteriography is justifiable during the period of threatened infarction; it may be undertaken at an early stage if the angina does not respond to medical treatment. It is always best to carry it out several days after cessation of the pain where possible. The investigation may lead to urgent surgical intervention.
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PMID:[Coronary arteriography in the threatened infarction syndrome]. 41 45

This study related to 163 cases of chest pain with the typical clinical features of angina of effort (AE) selected from a continuous series of patients who had carotid arteriography (CA) for anginal pain. These 163 cases were divided into two groups: a study group (SG) consisting of 44 patients with a normal CA, and a control group (CG) which, when patients with ECG evidence of transmural necrosis had been excluded, consisted of 119 cases of coronary artery stenosis, almost all amounting to more than 75 percent. Among those with typical AE (without ECG evidence of transmural necrosis), the proportion of normal CA was 27 percent. It was reduced to 17 percent when those patients with ECG evidence of transmural necrosis were added to the CG. The clinical features of the pain were noted for the SG and the CG, as well as the incidence of "risk factors". By contrast, the SG contained significantly more young subjects and females than the CG (P less than 0.001). The proportion with normal ECGs at reat was the same in the two groups (32 percent). The proportion of non-ischaemic abnormalities of repolarisation was 32 percent in the SG and 18 percent in the CG. Ischaemic abnormalities of repolarisation were present in 23 percent of cases in the SG, and in 49 percent in the CG (p less than 0.01). The exercise test on a bicycle ergometer was carried out for 16 cases in the SG was positive in 7 (44 percent: one male, six females). Of the 33 tests in the CG, a positive response was obtained in 20 (60 percent: 18 males, 2 females) (NS). 37 percent of patients in the SG showed an abnormality of volume or of left ventricular kinetics on arteriography (5 cases) and/or elevation of the end-diastolic pressure before and after arteriography (9 cases). These findings are not significantly different from those in the CG. 9 patients in the SG were studied for myocardial metabolism under pacing: 2 were found to have abnormalities in lactate production.
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PMID:[Electrocardiogram in the "typical angina of effort with normal arteriography" syndrome]. 41 14

A group of patients with athero-arteriosclerotic vascular disease (coronary heart disease and atherosclerosis of the extremities) have been subjected to platelet antiaggregating-antidyslipidaemic treatment with a chlofibrate-dipyridamol association; a control series was treated with chlofibrate alone. Frequency of angina pectoris, pain intensity and trinitrine consumption ware evaluated in patients with coronary heart disease, claudicometry, oscillometry and thermometry in patients with atherosclerosis of the extremities. The following laboratory parameters were also analysed: cholesterolaemia, triglyceridaemia, prothrombin activity, fibrinogenaemia, uricaemia and tolerance of oral glucose loading. Analysis of the results has shown that the association improved the parameters considered in statistically significant fashion; chlofibrate alone led to significant modifications of coronaropathic group parameters (with the exception of pain intensity) whereas it did not lead to significant changes in parameters evaluated for atherosclerosis of the extremities. All laboratory parameters were modified favourably by the association to a statistically greater extent than by chlofibrate alone. Both the association and chlofibrate were well tolerated.
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PMID:[The clofibrate-dipyridamole combination in the treatment of athero-arteriosclerotic vasculopathy]. 43 77

75 out of 100 patients who had survived myocardial infarction, had had prodromal symptoms. 62 patients reported specific prodromi such as first manifestations of angina pectoris or increase in duration and intensity of angina pectoris which had existed for some time previously, and in some cases had been accompanied by general complaints. A further 13 patients had only general symptoms such as onset of dyspnoea, palpitations, or a drop in performance during the 3 months prior to the infarct. The primary manifestation of symptoms consisted of exercise-induced angina pectoris at the beginning of the defined prodromal period in most cases, whereas later in the course manifestations occurred in the form of exercise-independent and spontaneous angina pectoris. In 9 patients symptomatology changed and exercise-induced angina transformed either into spontaneous angina pectoris or permanent pectanginous pain. In 8 of these 9 patients infarction occurred within less than a week after the change of symptoms. Prodromi occurred with approximately the same frequency in anterior and posterior wall infarction. The same applied to the distribution between transmural and non-transmural infarction.
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PMID:[Prodromal symptoms of acute myocardial infarction (author's transl)]. 43 34

A 60-year-old patient with variant angina was shown to have myocardial ischemia in two different regions supplied by separate major coronary arteries. Neither artery had significant coronary atherosclerotic obstruction. Ventricular fibrillation was noted during ST-segment elevation in anteroseptal leads. The attacks of pain and arrhythmias disappeared during nifedipine therapy.
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PMID:Multivessel coronary artery spasm. 44 62

Eighteen women, all of whom had extensive but noninformative breast evaluations, including 10 mammograms and 4 biopies, were successfully treated by cervical traction for chronic breast pain. Each patient had distinct clinical or electromyographic evidence of cervical root compromise. Fifteen had roentgenographic evidence of cervical spondylosis, primarily at levels C6 and C7. Cervical angina, as a symptom constellation produced by cervical radiculopathy and mimicking coronary ischemic disease, is a well-defined entity. Less well recognized is persistent breast pain as a primary presenting symptom of cervical root compromise. In both instances, the early identification of the cervical radicular origin of the pain, with its quite different prognosis and associated therapeutic implications, can promptly help to allay the patient's physical and psychologic discomfort. The pathologic mechanism of pain production and the anatomic pattern of referral are described.
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PMID:Breast pain: a symptom of cervical radiculopathy. 45 30

Exercise electrocardiography and rest/exercise myocardial perfusion imaging with thallium-201 were performed in 43 patients with typical angina or atypical chest pain; the results were correlated with those of coronary arteriography. Exercise electrocardiography sensitivity was 65%, specificity was 78%, predictive value for a positive result was 73% and for a negative result was 93%. The low sensitivity of the exercise electrocardiogram was mainly due to the number (13 of 43, 30%) of inconclusive results (no ST-segment change on the electrocardiogram, but failure to attain the target rate), most of which were in the group with typical angina. The predictive value of exercise electrocardiography for both a positive and negative result was excellent in typical angina. In patients with atypical chest pain, the negative predictive value was high (90%) but the positive predictive value was very low (50%). The sensitivity of myocardial perfusion imaging was 71%, specificity was 59%, positive predictive value was 52% and negative predictive value 89%. The low specificity of this test is related to the number of false-positive results obtained, most of which occurred in the group with atypical pain. When the results of exercise electrocardiography and myocardial perfusion imaging are combined, the sensitivity is increased but specificity is unacceptably low. However, myocardial perfusion imaging in patients with an inconclusive result from exercise electrocardiography (most of them in the group with typical angina) showed a sensitivity of 80%, specificity of 88%, positive predictive value of 80% and negative predictive value of 100%.
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PMID:Exercise electrocardiography and myocardial perfusion imaging in the diagnosis of coronary artery disease: preliminary report. 45 62

Previous angiographic studies have shown that coronary spasm occurs in association with the variant angina described by Prinzmetal, confirming his original hypothesis. In this work we recorded the heart rate changes and the incidence of arrhythmias during variant angina. The patients were divided into two groups: anterior, with electrocardiographic signs of anterior ischaemia, and inferior, with changes in the inferior leads. There was a significant increase of heart rate during pain in anterior myocardial ischaemia and a significant decrease when the ischaemia was inferior. The incidence of ectopic arrhythmias during pain was significantly greater in patients with anterior ischaemia, but there was a high incidence of atrioventricular block in patients with inferior ischaemia. We suggest that these findings can be explained by different responses of the automatic nervous system to anterior and inferior acute myocardial ischaemia.
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PMID:Prinzmetal's angina:reflex cardiovascular response during episode of pain. 47 38

The natural history of variant angina is described in a patient with multiple exacerbations and remissions over a period of several years. Constant in-hospital electrocardiographic monitoring for 26 days documented 569 episodes of ST elevation, 89% of which were asymptomatic. Episodes ranged in duration from 15 seconds to 11 1/2 minutes, with 4% of episodes associated with premature ventricular contractions. Over the course of hospitalization, the episodes of ST elevation decreased in frequency and length, as did episodes of pain. During this period, a number of therapeutic agents, including propranolol, indomethacin, and chlorpheniramine were evaluated using double-blind crossover trials. No agent had a significant beneficial effect on the course of the disease, and there was an increase in the length of episodes with high doses of propranolol. Because of the great variability in the course of this disease, only double-blind crossover trials should be allowed to dictate the efficacy of therapeutic agents.
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PMID:Chronic recurrent angina. 48 89


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