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)

Some of the symptoms and signs of hypothyroidism and hyperthyroidism in elderly patients may be mistakenly attributed to "old age." Weight loss, muscle weakness, tremor, angina, congestive heart failure--all signs of hyperthyroidism--are also concomitants of aging. Fatigue, sluggishness, withdrawal behavior, senile atrophic skin changes--all signs of hypothroidism--are also a part of the normal aging process. Although screening elderly people for thyroid disease is economically unsound, the physician should maintain a high index of suspicion of its presence. Laboratory tests must be interpreted with extra care. Values of 131I uptake, serum T4 and T3, thyroid-stimulating hormone, and thyrotropin-releasing hormone are all helpful in diagnosis. Thyroid disease is easily treated in elderly patients, and results often are dramatic. Propranolol is effective in thyrotoxic patients when symptoms require prompt relief. The definitive treatment, however, is 131I; antithyroid drugs are difficult to manage. Hypothyroidism is easily treated with T4.
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PMID:How thyroid disease presents in the elderly. 2 76

A patient with sick sinus syndrome (SSS) presented with episodic lightheadedness and weakness. The electrocardiographic features were marked supraventricular bradyarrhythmias and paroxysmal atrial flutter. The symptoms lasted for four years and disappeared with the onset of stable atrial flutter which has persisted for the past seven years. Over the 11-year period of observation, there has been progressive involvement of the His-Purkinje system manifested by the development of left anterior fascicular block, right bundle-branch block, and prolongation of the HV conduction time. The patient has refused pacemaker implantation. In the absence of angina and in the presence of a normal heart size, the etiology of his SSS is postulated to be idiopathic fibrosis of his conduction system.
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PMID:Symptomatic improvement in a patient with sick sinus syndrome after the onset of stable atrial flutter. 9 40

The effects of the beta-adernergic blocking drug acebutolol were studied in 23 patients with angina pectoris and angiographically documented coronary artery disease. Patients were evaluated clinically, by graded treadmill testing and by 24-hour Holter monitoring in the control state, after 2 weeks treatment with placebo, and after 2 weeks treatment with 600 mg. and then 1,200 mg. of acebutolol. Acebutolol (in a daily dose of 600 mg.) was an effective antianginal drug: the number of clinical attacks of angina pectoris (p less than 0.001) and the consumption of sublingual nitrate decreased (p less than 0.01), there was a significant increase in the treadmill effort tolerance as measured by the time to appearance of ischemic ECG changes (p less than 0.001) and the total work performed (p less than 0.001), and there was also a significant decrease in ischemic ST segment depression on 24-hour Holter monitoring. Treatment with 1,200 mg. acebutolol was associated with a further decrease in heart rate and a further improvement in effort tolerance on treadmill testing (p less than 0.05). On the large dose of the drug, however, there was no further clinical improvement, and no further improvement on 24-hour ECG monitoring; several patients complained of weakness and fatigue. Graded treadmill testing was an excellent objective method for assessing physical effort tolerance and its improvement after treatment with the beta-blocking drug. Twenty-four-hour Holter monitoring was a useful and complementary test, especially in patients who stopped exercising on the treadmill because of fatigue or weakness, and especially for assessing the efficacy of beta-blockade in controlling emotionally induced tachycardia and ischemia in the patient's own daily environment.
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PMID:Evaluation of the beta-blocking drug acebutolol in angina pectoris. 49 6

Autoimmune hemolytic anemia often develops in patients with chronic lymphocytic leukemia, particularly elderly women. It is heralded by a drop in the hematocrit, elevation of reticulocytes, development of jaundice, or a rise in the indirect fraction of serum bilirubin. Evidence of hemolysis supports the diagnosis, and a positive result of the Coombs test confirms it. Survival time is considerably shorter in patients who have both diseases than in those with chronic lymphocytic leukemia alone. Presenting symptoms in patients with the two diseases may include weakness, dizziness, fever, or hemorrhagic phenomena. If the anemia is severe, palpitations, otic pulsations, and cardiac decompensation are common. Physical examination may show enlargement of reticuloendothelial structures. On the other hand, some patients may be essentially asymptomatic. The hemolytic process must be treated as a separate entity, as even vigorous treatment of the leukemia often does not control it. Corticosteroid therapy is preferred, with splenectomy as a second line of defense. If the patient is not a good surgical risk, chemotherapy should be considered. Transfusions are usually incompatible but should be risked if progressive congestive failure, neurologic disturbance, angina, or signs of an impending infarct are present.
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PMID:When autoimmune hemolytic anemia complicates chronic lymphocytic leukemia. 63 66

Recognition of a pattern of elevations in commonly measured serum enzymes [creatine phosphokinase (CPK), lactic dehydrogenase (LDH), and glutamate oxalacetate transaminase (SGOT)] can facilitate the diagnosis of hypothyroidism, especially when muscle weakness is a symptom. Elevated levels of serum cholesterol, total protein, and albumin further contribute to a chemical profile of hypothyroidism, which can be observed in a routine chemistry screening test such as that obtained with the SMA 12/60 AutoAnalyzer. An illustrative case concerns a 50-year-old man who presented with angina pectoris and leg weakness. Subsequently he was found to have severe hypothyroidism. Special attention is given to the serum enzyme values which initially were elevated and fell to normal levels during thyroid replacement therapy. Isoenzyme fractionation of LDH and CPK indicated skeletal muscle as the source of the elevated enzyme activity. The literature on enzyme abnormalities in hypothyroidism is reviewed, with special reference to hypothyroid myopathy.
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PMID:Serum enzyme alterations in hypothyroidism before and after treatment. 85 6

Symptoms, signs, hemodynamic and electrocardiographic responses of 12 patients with acute myocardial infarction were studied before, during and after three activities: activity I, sitting upright; activity II, walking to the adjacent toilet; and activity III, walking on a treadmill set at 1.2 mph (1.9 km/hr) at 0, 3 and 6% successive gradients. The three activities were studied respectively at three, six and ten days (means) after infarction. Weakness was the most commonly occurring symptom. Mean systolic blood pressure fell 9 mm Hg upon assumption of the upright position (activity I) and was sustained for the five minutes of sitting. The systolic blood pressure drop was only 3.5 mm Hg with activity II. During activity III, one patient developed angina. Between rest and the 6% treadmill gradient, systolic blood pressure, heart rate and pressure-rate product rose 29 mm Hg, 26 beats/minute and 64 units, respectively. Electrocardiographic evidence of ischemia was observed in two patients during activity I, in two patients during activity II, and in one patient during activity III, but was insufficient for stopping the activities. Similarly, two patients developed minor arrhythmias, one with activity I and one with activity III. The use of this low-level treadmill test before discharging the patient from the hospital proved to be safe and feasible for obtaining objective data to assess the patients' ability to perform activities requiring equal exertion at home. Successful performance of these three activities before leaving the hospital should provide useful criteria for discharge of a patient with myocardial infarction.
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PMID:Progressive ambulation and treadmill testing of patients with acute myocardial infarction during hospitalization: a feasibility study. 87 Dec 37

There are many theories and hypotheses concerning with the pathogenesis of migraine. The clinical effectiveness of vasoactive drugs and many investigations on the cerebral blood flow in patients with migraine strongly support a vascular theory. In present paper we report a case of 26-year-old Japanese male, who suffered from hemiplegic migraine and coincidental coronary vasospasm, and discussed the pathogenesis of migraine. In October 1986, the patient developed the first attack of throbbing headache in the left temporal area with nausea and vomiting, following typical visual aura. One week later, he developed the second migrainous attack and then he felt his right extremities paralyzed and numb. Although the headache and weakness resolved within one hour, similar migrainous attack with transient hemiparesis repeated two or three times a month. Although the longest period required for resolving weakness was three days, the MRI, the CT and the electroencephalogram revealed no significant abnormality. In January 1987, during his stereotyped attack of hemiplegic migraine, he also developed oppressive feeling on his anterior chest and these symptoms resolved within fifteen minutes. Because the results of Holter electrocardiogram and ultrasound echocardiogram indicated angina pectoris, a coronary angiography was performed in February 1987. During the angiographical procedures, he began to complain of the oppressive feeling on his anterior chest, and the coronary angiography revealed the definite vasospasm in the anterior descending branch of the left coronary artery. Sublingual nitroglycerin administration resolved the vasospasm, but thereafter the patient developed his stereotyped hemiplegic migrainous attack.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Hemiplegic migraine complicated with coronary vasospasm]. 162 39

Human recombinant erythropoietin (r-HuEPO) improves quality of life in patients on maintenance haemodialysis, but the haemoglobin (Hb) level necessary to achieve this improvement is unknown. In this study, quality of life, functional capacity and symptoms of 28 haemodialysis patients with an initial Hb of 67 +/- 2 (mean +/- SEM) g/L were assessed after 0, 6 and 12 months of r-HuEPO, the dose of which was titrated to achieve a stable Hb of between 90 and 100 g/L. At six and 12 months Hb was 97 +/- 2 and 93 +/- 2 g/L, and mean r-HuEPO dose between three and six, and between nine and 12 months was 88 +/- 6 and 62 +/- 9 U/kg/week intravenously respectively. There was a significant improvement in level of activity and satisfaction with various aspects of life, and a reduction in fatigue, weakness, dyspnoea, angina and restless legs. Patients were able to walk 50% further in six minutes. The improvement in quality of life and function was similar to that reported from other centres whose target Hb was between 100 and 120 g/L, and where the r-HuEPO dose was 75% higher than in this study. Costs of r-HuEPO therapy were assessed. The drug itself costs +A3681/yr/patient, to which was added the estimated cost of additional dialyses and medications, bringing the total to +A5177/yr/patient. There was, however, a reduction in both hospitalisation by 8.3 days/yr/patient and medical consultation by 3.9 hours/yr/patient. Five patients commenced full-time work, one took up full-time study aimed at finding work, three transferred to home haemodialysis and six fewer patients drew social security benefits. The net cost saving from using low dose r-HuEPO was more than +A1,000/yr/patient.
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PMID:Low dose erythropoietin in maintenance haemodialysis: improvement in quality of life and reduction in true cost of haemodialysis. 175 17

Examined were 54 patients with different disorders of the cardiac rhythm with an implanted programmed electrocardiostimulator (ECS-200). The authors worked out methods and criteria of choosing individual regimes of electrostimulation, evaluated their effect on the severity of stenocardia and grade of circulatory insufficiency. The threshold frequency of stenocardia is of major significance in determining the optimal frequency of electrostimulation for patients with stable atrioventricular block. For patients with sinus node weakness and transitory atrioventricular blocks the criteria of choice of electrostimulation parameters is maximum maintenance of the sinus node rhythm with a frequency of not less 50/min.
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PMID:[The use of multiprogrammable cardiac electrostimulators for treating brady- and tachyarrhythmias in patients with ischemic heart disease]. 209 77

A retrospective study of 44 patients who were involved in combination with chronic sinusitis and bronchiectasis provided better understanding of the etiology in the relationship between upper air ways tract and lower air way tract. The incidence of bronchictasis was found in 5%, 3 out of 60 cases with chronic sinusitis and that of chronic sinusitis in 45%, 44 out of 98 cases with idiopathic bronchiectasis. Both side involvements of the paranasal sinus and the lung were statistically high in sinobronchiectasis compared to chronic sinusitis or bronchiectasis involved alone. The past history of the patients with sinobronchiectasis showed high occurrence of bronchial asthma or allergic rhinitis, habitual angina of the throat, acute otitis media and pneumonia. A chest X. Ray evaluation of 70 patients with chronic sinusitis alone revealed relatively high incidence of abnormal fibro-nodular shadow in the lung compared to 70 patients without chronic sinusitis. It was thought that weakness of air-way tract to infection in the patients with sinobronchiectasis might play some role on break down of sino-bronchial syndrome, a combination disease of chronic sinusitis and chronic bronchitis.
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PMID:[Correlation between upper airway tract and lower airway tract in the break down of sinobronchiectasis]. 229 49


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