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

In a series of 4000 patients subjected to coronary arteriography, 12 were found to have complete obstruction of three major coronary arteries, an incidence of 0.3 p. 100. The clinical manifestations did not follow a typical pattern. Although 9 had a previous myocardial infarction or heart failure, only 6 were incapacitated by angina or dyspnea. Except for one patient, the resting EKG was abnormal. Half had a markedly elevated resting end-diastolic pressure and gross abnormalities of left ventricular contraction. In spite of surgery in 7, with only one operative death, a yearly mortality rate of 20 p. 100 has been recorded during a 3-year follow-up. This extremely low survival rate, the severe functional impairment in half of the survivors, and the subsequent high yearly mortality rate, all suggest that surgery be considered before complete obstruction occurs in patients with significant disease of three coronary arteries. A 10 p. 100 yearly mortality rate reported in patients with triple vessel obstructions, also favours surgery in such patients with the hope of prolonging life, providing good distal runoff and satisfactory left ventricular contraction are present.
Arch Mal Coeur Vaiss 1975 Jul
PMID:[Profil and course of complete obstruction of 3 coronary trunks]. 81 16

The authors report five cases of stenosis of the trunk of the left coronary artery following cannulation of the coronary artery, and discuss the types of lesion, and whether they exist as an entity. The morbidity of these lesions, and the threat of sudden death which they pose, indicates an aggressive treatment plan: - definite angina occurring 2 to 6 months after aortic surgery (under coronary artery perfusion) is an indication for urgent coronary arteriography; - this investigation must be followed by a revascularization procedure within a few days if it shows a tight stenosis of the coronary trunk. The constant finding of a good vascular bed distally would seem to presage good long-term results.
Arch Mal Coeur Vaiss 1975 Dec
PMID:[Post-cannulation stenosis of the left coronary artery trunk. 5 operated cases]. 81 89

140 patients underwent atrial stimulation and a triangular exercise test on the bicycle ergometer; coronary arteriography was carried out on 80 of them. Atrial stimulation is slightly more sensitive (74% compared with 68%) and significantly less specific (57% compared with 74%) than bicycle ergometry. It is valuable to combine the two tests as at least one of them is positive in 84% of subjects with a significant coronary lesion (larger than or equal 70%). "False positive" responses during the stimulation test occur especially where the ECG at rest shows evidence of the non-specific repolarisation disorders of coronary insufficiency; but these "false positives" are accompanied by angina during the test significantly less frequently than the true positives. It may be possible, on the basis of the accounts in the literature and on the present analysis, to establish a methodology for the atrial stimulation test which will increase its sensitivity slightly, but which will also increase, more importantly, its specificity. It may also be possible to reach, by progressive 2-minute steps, a rate which is slightly greater than the maximum rate according to Astrand's law, and to take less account of ST depression as a positive criterioe, and more of the appearance of pain; the fact that this pain is angina could be confirmed by a dual test using placebo and trinitrin.
Arch Mal Coeur Vaiss 1976 Jan
PMID:[Diagnostic significance of atrial stimulation in coronary insufficiency. Correlation with the exercise test and/or coronary angiography]. 82 85

The immediate and medium term (3 years) of unstable angors was specified by the study of 100 hospitalized patients. The cases selection was based on the existence of angina pain which had appeared or reappeared less than a month before, during more than fifteen minutes and/or repeated, which were more and more frequent, less and less sensitive to nitroglycerine, and in the absence of recent myocardial infarction signs. The immediate course seemed relatively favorable; during the initial hospitalisation there were only nine myocardial infarctions and three deaths. The alarming factors of initial prognosis are essentially the persistence or recurrence under medical treatment of angina pain hardly relieved by nitroglycerine. The course over three years was bad; 23.6% of deaths, especially of cardiac origin (14/17) were noted; more than 80% or the surviving patients kept enduring more or less severe pains; persistence of electric signs on the ECG during the initial course was the only significant pronostic factor that was regularly noted. As regards the 16 patients treated by surgery, operative death rate remained high (3/16), but remote functional results were good (8/12 asymptomatic). Only randomized studies on homogenous groups, carried out during an enough long course, will enable us to specify therapeutic indications better.
Arch Mal Coeur Vaiss 1976 Dec
PMID:[Course and prognostic factors of unstable angina. Apropos of 100 cases]. 82 59

The authors report four new cases of hyperthyroidism associated with prolonged treatment with amiodarone. Massive doses of beta-blockers were required to deal with the severely disordered rhythm in one of the patients. Amiodarone, which is an effective treatment for angina, is not free from risk, even at the doses which are currently accepted. Hyperthyroidism, which may occur even in patients who have had no past history of any thyroid troupble at all, remains a most unusual complication.
Arch Mal Coeur Vaiss 1976 Oct
PMID:[Hyperthyroidism caused by amiodarone. Apropos of 4 clinical cases]. 82 1

22 patients with atheromatous narrowing of the left coronary trunk underwent surgery between 1969 and 1974. Most of these patients had severe and incapacitating angina pectoris. The clinical features are readily explained by the size of the diffuse anatomical lesions, which are to be found on the left coronary trunk as well as on the three coronary vessels themselves. This series has not confirmed the serious risk of surgery in such cases, as there were no operative deaths. Secondary mortality was low (9%), and the 20 survivors (average length of follow-up: 26 months) were mostly (18/20) in an excellent condition functionally. These facts have lead us to advise surgery whenever possible.
Arch Mal Coeur Vaiss 1976 Mar
PMID:[Atheromatous stenosis of the left coronary trunk. 28 surgical cases]. 82 9

Statistics on the frequency of coronary insufficiency in patients with gout are contradictory. Nevertheless, it is shown that a correlation often exists between attacks of gout and attacks of angina or acute ischaemic episodes. Finally, these anatomo-clinical studies prove the reality of the gouty heart if only because of the discovery of deposits of intracardiac urates.
Rev Rhum Mal Osteoartic
PMID:[Coronary insufficiency in patients with gout]. 117 28

Prostaglandins seem to be involved in all stages of the atheromatous process, especially coronary artery disease. This condition is associated with decreased prostacyclin synthesis. Prostacyclin, by the intermediary of cAMP, regulates cholesterol metabolism in the smooth muscle cell by mobilising intracellular cholesterol. Thromboxane is liberated in great quantities in acute coronary syndromes such as myocardial infarction (especially when fibrinolysis is performed) and unstable angina. It is also found in high concentrations in coronary sinus blood during stress tests inducing transient ischaemia in patients with stable angina. There is a relationship between the degree of ischaemia and plasma concentrations of thromboxane whereas prostacyclin levels remain unchanged, causing an imbalance between these two substances during ischaemia. Thromboxane is also responsible for the acute pulmonary vasoconstriction induced by the neutralisation of heparin by protamine. The introduction of molecules modifying the synthesis of these prostaglandins or inhibiting their effects by specifically blocking their receptors should open up new therapeutic possibilities.
Arch Mal Coeur Vaiss 1992 Sep
PMID:[Vascular action of prostaglandins: atheroma, vasoconstriction and ischemia]. 128 1

Forty three men and 3 women, with an average age of 59 years (13 to 78 years) underwent aorto-coronary bypass surgery despite severe left ventricular dysfunction (ejection fraction < 35%); 96% of the patients had previous infarction; 60% (N = 28) had unstable angina, 52% (N = 24) had had pulmonary oedema or an episode of congestive cardiac failure. The average ejection fraction was 29 +/- 4%, range 17 to 35%. Thirteen patients had ventricular aneurysms, 4 had grade 3 or 4 mitral regurgitation. The coronary lesions were usually multivessel left main coronary (6), triple vessel disease (27), double vessel disease (12), single vessel disease (1). The average number of bypass grafts per patient was 2.3. The average aorting clamping time was 63 minutes (range 26 to 133 minutes). There were 4 mitral valve replacements, 4 resections of ventricular aneurysms and 1 double procedure (aneurysmectomy and valve replacement). The operative mortality was 2.1% (1 death). During an average follow-up period of 27 months (range 3 to 90 months), there were: 2 recurrent infarctions, 13 episodes of cardiac failure and 8 cardiac deaths (cardiac failure: 5, sudden death: 2, recurrent infarction: 1). Two patients underwent cardiac transplantation. The regression of angina (90% of operated patients were asymptomatic) and the low operative risk, justify aortocoronary bypass surgery despite left ventricular dysfunction in patients with severe symptoms (unstable angina, chronic, invalidating angina). The medium-term results indicate a high risk of cardiac failure which is partially responsible for the secondary mortality rate of 17% at 2 years.
Arch Mal Coeur Vaiss 1992 Nov
PMID:[Can patients with severe left ventricular dysfunction be treated by coronary artery bypass surgery?]. 130 Sep 51

Cardiac involvement in Takayasu's disease is well documented. This is often the result of severe hypertension. However, severe clinical manifestations of aortic regurgitation and coronary insufficiency are much less common. The authors report a case in which post-infarction angina and severe left ventricular failure led to a double valve replacement and an aorto-right coronary bypass graft procedure. The diagnosis of Takayasu's disease was suspected before surgery and was confirmed by histological examination.
Arch Mal Coeur Vaiss 1992 Dec
PMID:[Heart valvular and coronary manifestations of Takayasu disease. Apropos of a surgically-treated case]. 136 95


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