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

The aim of this study based on a series of 200 patients, was to define the outcome and the prognostic factors of patients presenting with unstable angina, according to Bertolazi's criteria [3] and at least one stenosis greater than 80% on a proximal segment of a main coronary trunc, and to determine which factors should eventually be taken into consideration in the discussion of surgical indications. 70 out of 200 patients (35%) were turned down for direct revascularisation surgery because of an ejection fraction less than 0,35 and/or a poor arterial run off. Coronary arteriography showed 30% patients with a menacing stenosis (greater than 80%) on all three vessels, 36% on two vessels and 22% on a single vessel. The distribution and the extent of the lesions was about the same as in the operated patients. 20% patients had an ejection fraction less than 0,35, 24% between 0,34 and 0,50, and 56% greater than 0,50. At patient, the follow up period ranges from 22 to 66 months (average 32 months). In this group, the hospital mortality was 2,9%, the secondary cardiac deaths 16% and the global mortality 19% compared to 12,6% for the operated patients in the same period. The incidence of secondary non-fatal infarction was low (9%). 52% of survivors have persistent angina, 39% severe (Class II or III). Two prognostic factors were detected from this study: the type of angina: the intermediary syndrome had a bad prognosis, 38,5% mortality compared to 13% for aggravated chronic angina; and the ventriculography: patients with ejection fractions less than 0,35 had 64% mortality compared to 7,3% for those with ejection fractions greater than 0,40. The number of menacing lesions, the extent of the lesions of the artery involved did not affect the prognosis when severe abnormalities of left ventricular function were absent.
Arch Mal Coeur Vaiss 1979 Sep
PMID:[Unstable angina with threatening coronary lesions turned down for surgery. Outcome and prognostic factors]. 4

Not every case of angina pectoris occurring in a hypertensive patient is indicative of coronary atherosclerosis. Nine patients with essential hypertension of moderate degree had attacks of angina of sufficient severity to require investigation by arteriography. In these patients, the coronary arteriogram was normal but ventriculography showed hypertrophy of the walls of the left ventricle of restrictive or obstructive type. These appearances were confirmed by echocardiography which also showed hypertrophy of the septum and, in certain cases, confirmed the involvement of the ventricle, while by contrast the electrocardiogram and radiological appearances of the heart were essentially normal. The beta-blockers may have an important part to play in such conditions, and echocardiography is suggested as part of the routine investigation in cases of hypertension.
Arch Mal Coeur Vaiss 1978 Jul
PMID:[Angina pectoris in a hypertensive patient with left ventricle hypertrophy: echo-angiographic comparisons]. 10 Nov 81

Twenty cases of myocardial infarction in 16 males and 4 females and less than 36 are reported. The number of heavy smokers was greater than in other age groups (86%), and an association between tobacco consumption and lipid abnormalities was found in 3/4 of cases. All the females were on contraceptive treatment, one recurring during pregnancy. The clinical features of the infarctions were an onset which was usually unexpected (n=14), ar attack which was sometimes precipitated by exercise (n=3), and the infrequency of residual angina. The exercise test (n=16) showed up an associated abnormality in only one case out of four, but the fact that the rate-pressure product was normal suggests that the coronary artery networks were in a satisfactory state of function. Ventriculography (n=14) was normal in 35% of cases. Coronary arteriography (n=18) showed significant lesions in 12 cases, one trunk being affected in 6, two trunks in 5, and 3 trunks in one; the lesion index was 1.6. In 6 cases there were few changes in the coronary arteries, and the probable mechanism of the infarct is discussed: besides the possibility of a recanalised thrombus, which appears to be the likely one in two of our patients, spasm played a possible role even though the ergonovine provocation test was negative. The mortality during the first month was zero; as a secondary event over a follow-up period of 38 months, there were two deaths and four recurrences, one of which occurred in a healthy coronary vascular tree.
Arch Mal Coeur Vaiss 1978 Jul
PMID:[Myocardial infarct before the age of 36: 20 cases]. 10 76

The clinical significance and mechanism for changes in the axis of the QRS complex during attacks of angina pectoris (excluding cases of Prinzmetal's angina) are unknown. Previous work has suggested that left anterior hemiblock under these circumstances is a sign of unstable angina indicating a lesion in the anterior descending artery. Two cases with left anterior hemiblock associated with frequent attacks of angina have been the subject of careful study. In case one, atrial stimulation tests showed that the left axis deviation was not related to tachycardia. It only occurred when atrial stimulation was carried out for long enough to induce myocardial ischaemia as witnessed by precordial pain and disorders of repolarisation. In case two, the left anterior hemiblock came on at first at the same time as the attacks of angina, and then became permanent. Bypass graft of the anterior descending artery restored the QRS axis to normal, and corrected the repolarisation disorders which were of ischaemic origin. These findings argue in favour of an ischaemic origin of this conduction defect. Unlike ischaemia of the left anterosuperior subbranch, anterior left hemiblock is indicative of extensive ischaemia of the anterior wall of the left ventricle relative to an obstruction in the anterior descending artery or in the main trunk of the left coronary artery.
Arch Mal Coeur Vaiss 1978 Jul
PMID:[Isolated left anterior hemiblock during attacks of angina pectoris]. 10 80

We have seen a case with spasm of the right coronary artery coming on during exercise ergometry in the course of a coronary arteriogram. The patient had angina pectoris spontaneously and on exercise. Bicycle ergometry was repeated four times by the same method, and was positive in three; in two of these there was angina and ST elevation in II, III, aVF, and ST depression in I, aVL and V2 to V5. On one occasion the test was negative, the patient having taken a trinitrin tablet one hour before the test. Repeating the exercise test during coronary arteriography showed spasm of the right coronary artery and elevation of the segment ST in II, III and aVF; this disappeared after trinitrin treatment.
Arch Mal Coeur Vaiss 1978 Jul
PMID:[Coronary spasm on exercise. Demonstration of a case by coronary angiography]. 10 83

One hundred and fifty-three men with angina were studied to determine the risk of death over a 5-year period. Multivariate analysis using age, systolic and diastolic pressure, and six electrocardiographic variables (QRS axis, PR interval, the sum of S in V1 and R in V5, T-wave and ST segment anomalies and incomplete left bundle branch block) identified sub-groups having very different prognoses. An analysis using only six variables (omitting diastolic pressure, ST segment anomalies and PR interval) retained a good discriminatory value, and this same discriminant function calculated from half of the sample had good prognostic value in the other half. A prognostic index based on this function (designed to simplify the calculations in clinical use) identified a sub-group (24% of the total group) in which no mortality occurred, while another sub-group (16% of the total group) suffered a mortality of 67%. The logical use of the blood pressure and ECG leads to a more precise prognosis in angina and should help in determining the indications for myocardial revascularisation.
Arch Mal Coeur Vaiss 1978 Sep
PMID:[Prognosis of adult angina pectoris by means of blood pressure and the electrocardiogram]. 10 94

One hundred and fifty-nine patients with aortic valve disease (86 cases), mitral valve disease (58 cases) or mitral and aortic disease (15 cases) underwent a pre-operative haemodynamic study, including coronary arteriography either as a routine (age greater than 50 years) or because of chest pains. Coronary arteriography is easy to do during left heart catheterisation and nowadays carries minimal risk. In the cases of chest pains, it showed stenotic lesions of the coronary vessels in 22% of patients with aortic valve disease and in 35% of those with mitral disease. In the absence of angina, coronary arteriography showed no evidence of coronary artery disease in the cases of mitral regurgitation and of aortic valve disease. In contrast, it showed stenotic lesions in three cases of mitral stenosis. In the whole of the series, coronary artery disease proved a contra-indication to surgery in three cases, and was an indication for aorta-coronary by-pass grafting, in addition to valve surgery, in seven other cases. In the absence of angina, coronary arteriography has only a slight influence on the decision to operate. It does however give additional security, which justifies its routine use in patients over 50 years of age, particularly those with mitral valve disease.
Arch Mal Coeur Vaiss 1978 Nov
PMID:[Coronary angiography in the preoperative exploration of non-ischemic acquired valve diseases]. 10 77

Three years after radiotherapy to the mediastinum for Hodgkin's disease, a 28 year old female presented with incapacititating angina. The presence of severe disease in the proximal arteries on coronary arteriography, with obliteration of the anterior descending artery and, of the right coronary artery, together with an unstable collateral circulation, constituted an indication for a double aorto-coronary bypass graft. A review of the literature suggests that early development of atherosclerosis may be produced by the synergistic action of radiotherapy and lipid disorders. Fifteen similar cases have been described, eight of them in patients of less than 40 years of age; three were discovered at post-mortem examination in patients aged under 21.
Arch Mal Coeur Vaiss 1978 Nov
PMID:[Severe coronary insufficiency in a young woman after mediastinal radiotherapy]. 10 86

The results of echocardiography and phonomecanography were compared in 55 cases of adult valvular aortic stenosis. Although the most reliable echocardiographic sign of the severity of stenosis is the systolic separation of the aortic valve echos, it should be amphasised that: -- this cannot be measured in 25 % cases; --in 10 % cases the values obtained vary with the angle of the transducer. In these cases, the finding of a left ventricular posterior wall thickness greater than or equal to 15 mm is specific for severe aortic stenosis. On the other hand, the left atrial, left ventricular and aortic internal dimensions and the morphology of the mitral leaflets do not help in the estimation of the severity of adult aortic stenosis. The best correlations between echo and phonocardiography are the values of aortic valve opening and : --hemi-ascension time (r = 0.67); --left ventricular ejectiontime (r = 0.93) when patients in cardiac failure are excluded. The complementary nature of these two investigations is notable, and should, in pure aortic stenosis without angina, spare patients who are often elderly and fragile from heamodynamic investigation.
Arch Mal Coeur Vaiss 1978 Dec
PMID:[Comparison of echocardiography and phonomecanography in adult aortic valve stenosis. 55 cases]. 10 89

31 patients presenting with Prinzmetal variant angina were divided into three groups according to their angiographic appearances. Group I comprised 9 patients with normal or coronary arteries with lesions less than 50% narrowing. Group II comprised 12 patients with single vessel disease. Group III comprised the other 10 patients with significant lesions on two or all three principal arteries. No clinical or electrocardiographical differences were found between the groups as to age, sex or the clinicapresentation of the chest pain. Most patients with normal or nearly normal coronary arteries had normal electrol cardiogrammes between attacjs (8 out of 9) and electrical changes mainly over the inferior wall (8 out of 9). Exercise electrocardiography reproduced ST elevation in 4 of the 9 patients but, in contrast to the patients in the other two groups, never ST depression. However, these features are not specific for patients in Group I as they were observed in 4 patients in the other two groups. Spontaneous or induced coronary spasm were observed in 27 patients, confirming its role as the mechanism of Prinzmetal angina, whatever the anatomical appearance of the coronary tree.
Arch Mal Coeur Vaiss 1979 Jan
PMID:[Clinical and angiographic study and pathogenic mechanism of Prinzmetal's angina. Apropos of 31 cases]. 10 80


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