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)

A 40 year old man with far advanced coronary heart disease consistently experienced pain and exhibited marked S-T segment depression after 44 crossings during a Master two-step test. When the number of times traversed was miscounted so that he exercised less, the pain occurred at the precise count of 44 and he showed the same marked degree of S-T depression. However, when the count was accurate, he had neither pain nor S-T segment deviation at the reduced exercise level. The possible basis for verbal conditioning provoking angina pectoris is explored.
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PMID:Verbal conditioning of angina pectoris during exercise testing. 91 Jul 28

Three patients with thyrotoxicosis are described, in whom the presenting symptom was severe cardiac pain at rest or on effort and who were admitted to hospital with suspected or proven myocardial infarction. All patients were studied by selective coronary arteriography and left ventriculography after thyroid function tests which confirmed thyrotoxicosis. There was no demonstrable disease of the major coronary arteries in any of the patients, yet myocardial infarction and left ventricular aneurysm were shown to be present in 1, and there was definite electrocardiographic evidence of ischaemia in all 3. In addition, under stress the myocardium of all 3 patients produced lactate. It is recommended that thyrotoxicosis be seriously considered in the differential diagnosis of cardiac pain, particularly in younger women. The cause of the pain seems related to the cellular effects of thyrotoxicosis on the myocardium and current views of these effects are summarised. Of the 3 patients, 1 died suddenly 6 months after becoming euthyroid, indicating that the disease may not be as benign as expected. A guarded prognosis and continued medical follow-up are recommended when thyrotoxicosis presents with angina pectoris even when normal coronary arteries have been demonstrated.
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PMID:Thyrotoxicosis and lactate-producing angina pectoris with normal coronary arteries. 91 54

Molsidomine was shown to have a strong pain-relieving action in 22 coronary patients investigated one hour after oral intake of 2 mg of the substance. During comparable maximal exercise load the ST interval lowering was reduced from an average of 0.22 mV to 0.09 mV (P less than 0.0005). At the termination of exercise it was still reduced from 0.23 mV to 0.12 mV (P less than 0.0005). At the same time the exercise tolerance increased from 570 to 717 Watt-minutes (P less than 0.0025). Pectanginal complaints were clearly reduced at the same exercise loads, 11 patients became symptom-free at the same load. Even when exercise loading was stopped at higher loads a decrease of the severity of angina pectoris could be shown. Seven patients became symptom-free at that stage. The heart rate was not influenced markedly at rest and during exercise. Systolic blood pressure was reduced from 135 mm Hg to 118 mm Hg (P less than 0.0005), and in comparable submaximal loads from 177 to 165 mm Hg (P less than 0.005).
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PMID:[Influence of molsidomine on exercise-ECG'S In coronary insufficiency (author's transl)]. 92 59

A 30-year-old man with variant angina pectoris and ventricular arrhythmias had an angiographically demonstrable 60% obstructive lesion of the proximal left anterior descending coronary artery that was observed to progress to 100% during spasm. Control of pain and arrhythmia by pharmacologic means was unsuccessful. Aortocoronary saphenous vein-internal mammary coronary bypass was associated with an anteroseptal wall myocardial infarction and relief from both angina pectoris and arrhythmias. It is suggested that infarction of the ischemic myocardium played a role in the successful management of this case.
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PMID:Variant angina pectoris. Pain and arrhythmias controlled after postoperative myocardial infarction. 94 12

Twelve patients suffering from abdominal angina have been operated upon with revascularization of the superior mesenteric artery. Preoperatively, all had the classical symptoms: postprandial pain, wieght loss and abnormalities of the stools. The surgical procedure of choice was endarterectomy with patch grafting; in two cases a vein by-pass have been used. In general, it will be sufficient to reconstruct one artery, even with two or three of the mesenteric arteries afflicted. Peroperative measurements of pressure gradients and flow may guide in choice of procedure. Two patients died postoperatively, both had additional extensive reconstruction of the aorta and the renal arteries. The remaining 10 patients were all relieved of their symptoms after the operation and gained considerably in weight. They were followed over 25 months in mean. During the period of observation 2 patients have died from other diseases. The good longterm results after arterial reconstruction in contrast to the poor prognosis without operation call for early diagnosis and surgical treatment. The difficulties involved with the diagnosis of abdominal angina are discussed and a functional diagnostic test is proposed.
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PMID:Abdominal angina. Results of arterial reconstruction in 12 patients. 96 19

Seventeen patients presenting with anginal-type pain were studied by bicycle exercise testing, rapid atrial pacing, and coronary angiography. Ten patients with angina and abnormal pacing tests at rates less than 180/minute were found to have significant coronary artery disease as demonstrated by coronary angiography. Seven patients with pacing-induced chest pain only at rates of 180 and above had normal coronary angiogram. This suggests that patients requiring rates of 180 or more to produce a positive atrial pacing test, following our protocol, do not usually have significant coronary artery disease though confirmation requires a larger study.
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PMID:Evaluation of rapid atrial pacing in diagnosis of coronary artery disease. Evaluation of atrial pacing test. 97 85

In a 27-year-old man blunt chest-wall trauma after a car accident gave rise to several retrosternal pain. Coronary angiography demonstrated severe generalised coronary arteriosclerosis. The history revealed heavy smoking (60 cigarettes daily for ten years). Although it must be assumed that there was severe generalised coronary arteriosclerosis without angina pectoris before the accident, the infarction was considered to be a direct consequence of it: it prematurely precipitated the infarction. In a second case, of a 37-year-old woman, severe precordial pressure and contusion of the thorax occurred after a collision. Cardiac symptoms developed two months later and two weeks after this acute myocardial infarction occurred. Coronary angiography demonstrated isolated sub-total occlusion of the anterior interventricular branch in the upper third of the septum without other abnormalities. Because of the two month symptom-free interval, trauma and subsequent myocardial infarction are thought not to be causally related, especially as the patient was a heavy smoker and taking oral contraceptives.
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PMID:[Myocardial infarction after accidents (author's transl)]. 97 12

We compared patients with variant angina (ST-segment elevation during pain) who had normal or near normal coronary arteriograms (Group 1) with 20 in whom variant angina occurred in the presence of obstructive coronary lesions (Group 2). A long history of nonexertional angina without angina of effort or previous infarction was the rule in Group 1, whereas recent-onset unstable angina preceded by effort angina and infarction predominated in Group 2 (P less than 0.001). Normal electrocardiograms at rest, with ischemic ST-segment elevation in the inferior leads, and ischemia-induced heart block and bradycardia, characterized Group 1, whereas abnormal electrocardiograms, ischemic involvement or fibrillation were more common in Group 2 (P less than 0.001). Variant angina with normal coronary arteriogram generally has a benign course and is probably unrelated to atherosclerosis.
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PMID:Clinical syndrome of variant angina with normal coronary arteriogram. 98 80

Prior to undergoing diagnostic coronary angiography, 94 men responded to tests for the coronary-prone behavior pattern, anxiety, depression, and neuroticism. Independently, cardiologists rated cineangiograms by the percent of atheromatous luminal obstruction in four major coronary arteries. The patients with greater atheromatous obstruction scored significantly higher than those with lesser disease on all four scales of the test for the type A coronary-prone behavior pattern. Those with more seriously diseased vessels also scored significantly higher on anxiety and depression scales but significantly lower on a denial scale. Men rated as having more frequent and intense angina pain scored significantly higher on hypochondriasis, depression, and admission of symptoms than men less subject to ischemic pain. Multivariate statistical analyses revealed that the findings regarding extent of atherosclerosis are independent of anginal pain or congestive heart failure.
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PMID:Psychological correlates of coronary angiographic findings. 98 97

In a series of 63 patients, 60 with angina pectoris and 3 with cervical spondylosis and "thoracic spondylosis" showing angina like pain detailed assessments were made of the mode of onset of attack, including electrocardiography during attacks, X-ray examination of the thoracic and cervical vertebrae and neurological examinations, along with coronary arteriography in some cases, with the following results: 1. The cases of angina pectoris were classifiable grossly into two groups according to mode of onset of chest pain: Group A: Angina began with pain in the anterior chest (39 cases); Group B: Angina in the anterior chest was preceded by "pain" occurred elsewhere in the chest (21 cases). The cases in group B were further classified under two categories, types BI and BII, the former being characterized by a sudden onset of "pain" in a somatic area or areas other than the anterior chest where there is usually no dysesthesia, followed by development of retrosternal or precordial pain (6 cases), while the latter type of angina began with paroxysmal exacerbation of preexistent dysesthesia in the nape, shoulder and arms and eventuated in pain in the anterior chest (15 cases). There were two subtypes in the type BII angina viz. types BIIa and BIIb. There was no ECG evidence of ischemic changes at exacerbation of the nucha-omo-brachial dysesthesia in type BIIa while significant ischemic ECG changes were evident in association of aggravation of dysesthesia in the type BIIb patients. 2. Concomitant "cervical spondylosis" with radiographic evidence of abnormalities in cervical vertebrae and associated subjective symptoms accounted for 22.9% of group A and for 71.4% of group B. In no case of type BI was there evidence of such complication whilst all the cases of type BII had this complication. 3. The mode of appearance of pain in patients with cervical spondylosis showing angina like pain resembled to that of angina pectoris in type BII but ECG during attack did not reveal any significant ischemic changes. 4. As for interrelation between findings by selective coronary angiography (26 cases of angina pectoris) and complication of "cervical spondylosis", the complication of "cervical spondylosis" was higher in incidence in the group of cases with low-grade coronary arterial changes (degree of occlusion less than 50%) than in the group with greater arterial changes (degree of occlusion over 50%). The findings described suggest the possibility that the mode of manifestation of anginal attack may be modified by the concomitant presence of "cervical spondylosis".
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PMID:Clinical analysis of angina pectoris and angina-like pain --With special reference to ECG during attack, "cervical spondylosis" and selective coronary arteriography. 99 8


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