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Query: UMLS:C0002962 (angina)
 21,142 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A patient experienced episodic pulmonary edema accompanying nocturnal angina pectoris. The symptoms were provoked at cardiac catheterization by atrial pacing. Simultaneous onset of chest pain, shortness of breath, and sudden appearance of a large V wave in the pulmonary artery wedge pressure contour confirmed acute mitral valve regurgitation. Rapid reversal of these changes after nitroglycerin administration supported "papillary muscle dysfunction" as the explanation for these hemodynamic changes.
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PMID:Severe papillary muscle dysfunction substantiated by atrial pacing during cardiac catheterization. 40 54

The haemodynamic effects of a new anti-anginal drug, dilitazem HCl, were studied in 20 patients with angina pectoris. The 131I-dilution method was used. In two patients, one with atrial septal defect and the other with pulmonic regurgitation, heart catheterization was carried out. The drug exerted significant decrease in stroke volume, cardiac output, cardiac work, stroke work and cardiac output/circulating blood volume ratio. The patients who underwent direct cardiac catheterization disclosed no changes in Vmax and ejection fraction, but there were decreases in stroke volume. The decrease in cardiac work and stroke work after after diltiazem Hcl therapy was apparently due to diminution of venous return and prolongation of systemic circulation time. It is postulated that such a decrease leads to inhibition of myocardial oxygen consumption, which in turn has beneficial effects on angina pectoris.
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PMID:Haemodynamic effects of a new anti-anginal drug, diltiazem hydrochloride. 57 68

Retrograde coronary artery flow was observed angiographically in 43 patients with aortic stenosis and/or regurgitation. In the 24 patients with pure or predominant aortic stenosis, retrograde flow was seen in all 24 during end-systole. In the eight patients with pure aortic regurgitation, retrograde flow was seen mainly during end-diastole (6/8). Among the 11 patients with stenosis and regurgitation, retrograde flow was both end-systolic and enddiastolic. Dominant left coronary arteries were seen in 13 patients; 13 showed retrograde flow in the dominant arteries. Dominant right coronary arteries were seen in 25 patients: all 25 showed retrograde flow equally in the right and left coronary. Five of the 43 patients could not be evaluated for dominance because of coronary artery occlusions. The severity of retrograde flow did not correlate with usual clinical, hemodynamic or tension-stress parameters: angina, electrocardiographic abnormality, end-diastolic pressure or volume, end-systolic pressure or volume, ejection fraction, severity of aortic regurgitation, peak or mean valve gradient, aortic valve area, myocardial tension and stress calculations, or DPTI:SPTI. In summary, retrograde coronary artery flow was seen in all 43 patients with severe aortic valve disease. The time in the cardiac cycle when retrograde flow occurred was related to the type of valve disease. Retrograde flow was seen mainly in the coronary arteries supplying the left ventricle and may result from increased regional myocardial stresses.
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PMID:Retrograde coronary artery flow in aortic valve disease. 94 80

Among 304 cases of aortic valvulopathies studied for surgical selection, the authors have found a high incidence of conduction disturbances (16% in aortic stenosis and 18,4% in aortic regurgitation). The conduction defects are mostly intraventricular among stenosis isolated or associated to regurgitation and mostly atrio-ventricular among pure aortic insufficiencies. The highest incidence (30%) being found in patients with bacterial endocarditis acute or healed. The incidence of conduction disturbances increases with age, with the presence of valvular calcifications, of left ventricular strain or failure, of coronary insufficiency and angina... practically with the duration and the severity of the valvular disease. Surgical risk is heavier and natural prognosis poorer in valvulopathies with conduction disturbances. But these disturbances never contraindicates surgery : it is sometimes necessary to insert a pacemaker with or without valvular replacement mostly in aortic stenosis with infrahisian conduction defects. During hemodynamic investigation of such cases one must be ready to stimulate the heart, particularly during right heart catheterization of patients with complete left bundle branch block.
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PMID:[Conduction disorders in aortic valve diseases]. 107 97

Intra-aortic balloon counterpulsation (IABC) is the form of mechanical circulatory assistance in widest clinical use today. The clinical results with IABC employed in 63 patients over a four-year period are presented. The clinical conditions necessitating mechanical circulatory assistance were: cardiogenic shock following acute myocardial infarction; myocardial infarction complicated by mitral valyular regurgitation or ventricular septal defect; preinfarction angina syndrome; postcardiotomy cardiogenic shock with pump oxygenator dependence; postcardiotomy cardiogenic shock during the postoperative recovery period; and septic shock. Survival and discharge from hospital occurred with 32 of 63 patients (51%). Evaluations of left ventricular function were studied in 20 patients on IABC by construction of Frank Starling curves, with cardiac output determined by thermodilution techniques. In general, IABC shifted the curves to the left and increased their slope.
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PMID:Applications of intra-aortic balloon counterpulsation. 111 8

The existence of specific, age-related changes in gastrointestinal motility with clinical significance is controversial. Beside the more infrequent primary motility disorders, secondary motility disturbances associated with collagen vascular diseases, endocrinopathies, and neuromuscular diseases are prominent in the older and often multimorbid patients. Especially in geriatric patients, motility associated symptoms are undesired side-effects of drug therapy. The pathophysiology, clinical syndromes, and therapeutic principles of motility disorders in the elderly are discussed. The major symptoms of esophageal dysfunction are dysphagia, chest pain, heartburn, and regurgitation. Oropharyngeal dysphagia, mostly caused by cerebrovascular accidents and other neurologic disorders, leads to disturbances in food intake, and is often complicated by broncho-pulmonary infections arising from recurrent aspiration of food or saliva. Gastrointestinal reflux disease and spastic motility disorders of the esophagus are regarded as possible causes of angina-like chest pain after exclusion of cardiac diseases. Motility disturbances of the stomach and small bowel are often related to systemic disease (i.e., diabetes mellitus, chronic intestinal pseudo-obstruction) of drug side-effects. Mental and physical decline, reduced fluid intake, and constipating drugs are the most relevant factors for idiopathic constipation in the elderly. Fecal incontinence means a great psychological strain for older patients and leads to social isolation.
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PMID:[Gastrointestinal motility in the elderly]. 144 9

35 patients with angina-like chest pain underwent esophageal manometry after a coronary artery disease had been ruled out by angiography. Furthermore, patients after gastric or esophageal surgery, with pathologic upper gastrointestinal endoscopy or with pathologic gastroesophageal reflux as seen on 24-hour-pH-metry were excluded from this study. 29 out of 35 patients (83%) had a normal manometric study, six patients (17%) had a motility disorder; five of these showed an unspecific dismotility pattern and were asymptomatic while the study was done; only one patient presented with esophageal spasm. Since only this latter patient was symptomatic while the study was done, a correlation between symptoms and this motility disorder seems likely. --If pathologic gastroesophageal reflux has been ruled out, esophageal manometry can establish a diagnosis in only 3% of patients with angina-like chest pain without esophageal symptoms (dysphagia, odynophagia, heartburn or regurgitation). We conclude that this complicated examination should not be done in these patients.
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PMID:[Esophageal motility disorders with thoracic pain of unknown origin]. 188 9

A 64-year-old man who had aortic valve regurgitation underwent aortic valve replacement. There had been no history of angina pectoris or taking of calcium channel blockers. When the operation was nearly completed, unexpected hemodynamic collapse happened without ST-segment changes on the ECG monitoring. Resuscitation was successful by cardiac massage, pacing and administration of catecholamine. Thereafter the same episodes occurred several times. At the 6th attack on postoperative day 7, we confirmed the ST-segment elevation using 12-lead-ECG, thus coronary artery spasm was diagnosed. Thereafter calcium channel blocker and coronary vasodilator were administered continuously. There has been no attack since postoperative day 13. Though postoperative coronary arteriography showed no anatomical changes compared with preoperative study, direct injection of ergonovine made the right coronary artery spastic, but not the left. We emphasized that perioperative coronary artery spasm may happen not only in the coronary artery surgery but in any other cardiac operations.
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PMID:[Coronary artery spasm after aortic valve replacement: a case report]. 200 62

A case of rare congenital anomaly of quadricuspid aortic valve and coexisting coronary artery occlusive disease of a 60-year-old female was presented. She was admitted to our hospital for heart murmur and angina pectoris. The echocardiography and aortography showed quadricuspid aortic valve and aortic valve regurgitation. The coronary arteriography revealed the presence of triple vessels disease. Successful aortic valve replacement and Coronary bypass grafting were performed simultaneously.
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PMID:[A case of concomitant repair of aortic regurgitation due to congenital aortic quadricuspid valve and coronary artery occlusive disease]. 223 Mar 89

We reviewed 123 consecutive patients who underwent esophageal function testing to determine the prevalence and clinical characteristics of the syndrome of high-amplitude peristaltic contractions (HAPC). Twenty-eight patients (23%) were found to have HAPC, including 16 males and 12 females with a median age of 54 years. Barium esophograms yielded no evidence of motility disorders, while 35% of those tested had pathologic gastroesophageal acid reflux. Twenty (71%) were initially referred for evaluation of angina-like chest pain, and 8 were referred with other symptoms. Of those with chest pain, 19 initially underwent extensive evaluation for coronary artery disease before the diagnosis of HAPC. Symptoms of heartburn, regurgitation, and dysphagia were absent or minimal in most patients. Lower esophageal sphincter pressure was normal in 27 patients, and lower esophageal sphincter relaxation was normal in all patients. Mean distal esophageal peak peristaltic pressure was 147.8 mm Hg, while the highest peak peristaltic pressure for each patient averaged 193.2 mm Hg. Seven patients had mean peristaltic wave durations of more than 7 seconds. Patients with atypical chest pain or those with typical angina in whom coronary artery disease is eliminated as a possible cause should be evaluated for HAPC with esophageal manometry. Patients with symptoms are usually successfully treated with smooth muscle relaxants, and surgical intervention is rarely necessary.
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PMID:Angina-like chest pain associated with high-amplitude peristaltic contractions of the esophagus. 317 68


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