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

An appreciation of the natural history of angina pectoris is important when deciding on the place of new and potentially dangerous forms of treatment. During 1950-1975, 268 patients with angina were diagnosed and followed up in my London general practice. The annual incidence, in adults over 40, was five per 1,000 and increased with age.During the period of follow-up, half the patients died, an annual mortality of 4.6 per cent. However, among the survivors one third ceased to suffer anginal symptoms spontaneously and without specific therapy. Of those who continued to suffer from angina, in 71 per cent the condition was graded as minor, in 27 per cent as moderate, and in only two per cent were the attacks severe and disabling. Usually the angina was primary (77 per cent) and it was secondary, after myocardial infarction, in 23 per cent.Of the 134 deaths, three quarters were from a cardiovascular cause. This group of angina patients had a 2:1 times greater observed, than expected, risk of dying (O/E ratio). The O/E mortality ratio fell progressively with age. It was highest in the 40-49 decade (4.0) and lowest in the over 80s, when the observed mortality rate was less than expected (0.9). The O/E mortality ratio was higher in men (2.3) than in women (1.7).From this survey I conclude that angina does not have a uniformly bad prognosis, and that with the advent of beta-adrenergic blockers, the proportion considered for angiocardiography and aorto-coronary bypass grafting should be less than five per cent of all patients with angina.
J R Coll Gen Pract 1976 Sep
PMID:The natural history of angina in a general practice. 97 40

The aim of this prospective study was to determine the delay between the onset of symptoms and arrival in the coronary care unit of patients with suspected acute myocardial infarction, and the relative contribution to the total delay of patient delay, method of referral (self referral or general practitioner referral) and delay in the hospital before reaching the coronary care unit. All patients admitted with chest pain to the coronary care unit at Dudley Road Hospital, Birmingham, over the six month period April-September 1989 were included in the study. Ninety five patients were referred by their general practitioner and 107 patients attended the accident and emergency department directly or arrived by ambulance without contacting their general practitioner. The proportion of self referred and general practitioner referred patients with acute myocardial infarction, angina and non-cardiac chest pain were not significantly different. The total delay was significantly longer for patients who had been referred by their general practitioner (median 5.3 hours) than for self referrals (3.2 hours, P less than 0.001), with a significantly higher proportion of self referrals arriving at the coronary care unit within six hours of the onset of symptoms (77% versus 54%, P less than 0.01). Among general practitioner referrals, initial patient delay accounted for a median of 2.5 hours and the general practitioner's response time for a median of 1.1 hours. The delay in hospital was similar for both groups of patients. In inner city areas, self referral may result in considerably less delay than general practitioner referral allowing a greater proportion of patients to receive effective thrombolytic therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
Br J Gen Pract 1992 Apr
PMID:Patients with suspected myocardial infarction: effect of mode of referral on admission time to a coronary care unit. 145 65

The primary aim of the study was to evaluate practice differences in reported morbidity in the second and third national morbidity surveys (1970/71, 1981/82) and to discuss their cause. A secondary aim concerned the validation of trends identified from analysis of the data from the total populations in the practices. Altogether 19 practices participated in both surveys. Annual prevalences (that is, the number of patients attending the general practitioner with a condition per 1000 persons at risk) were examined for: all conditions; each of three categories of seriousness of disease; diseases aggregated by chapter of the International classification of diseases; and each of 130 rubrics of the disease classification. Annual prevalence for 'all conditions' was approximately the same for males in both surveys, whereas for females there was an increase. In both sexes, annual prevalence for 'serious conditions' increased slightly and for 'trivial conditions' increased substantially. For 'intermediate conditions', there was a modest decrease in males. In the analysis at ICD chapter level, substantial increases in prevalence occurred in infectious diseases, nervous system diseases, circulatory diseases, genitourinary diseases, musculoskeletal diseases, symptoms, signs and ill-defined conditions, injuries and poisonings. Decreases were found in blood diseases, mental disorders and digestive diseases. Among 130 individual conditions examined, increased annual prevalence was found for mumps, fungal infections, hypothyroidism, diabetes, gout, senile dementia, angina, left heart failure, catarrh, hay fever and asthma, orchitis, acne, osteoarthritis and for some symptoms. Decreases were found for iron deficiency anaemia, anxiety state, refractive errors, haemorrhoids, chronic bronchitis, functional disorders of the stomach, carbuncle and skin infections.(ABSTRACT TRUNCATED AT 250 WORDS)
Br J Gen Pract 1991 May
PMID:Changes in practice morbidity between the 1970 and 1981 national morbidity surveys. 187 71

Oxypangam is a substance applied therapeutically against a number of diseases, such as chronic liver damages, angina pectoris, and psychosomatic disturbances. The mode of action of oxypangam has not yet conclusively been described. The only well-known properties of this substance are its intensive methylating and lipolytic effects. The present paper serves to elucidate the influence of oxypangam on the induction of the tyrosine aminotransferase, on the NAD content and on the activity of the ADPR transferase in the liver. Our studies showed that in normal animals, increasing doses of oxypangam support the induction of tyrosine aminotransferase. Up to a concentration of 100 mg/kg oxypangam enhances also the induction of tyrosine aminotransferase by tryptophan. In both cases, however, it does not work in adrenalectomized animals. Under the influence of oxypangam the NAD content of the liver remained unchanged, while the activity of the ADPR transferase was influenced only slightly.
Gen Pharmacol 1987
PMID:Influence of oxypangam upon the induction of tyrosine aminotransferase, the NAD content and the ADPR transferase activity in several organs of the rat. 288 34

The authors conducted a population-based case--control study to determine the risk of myocardial infarction in patients who reported angina-like symptoms. The cases studied were those of patients who had high blood pressure and had sought treatment in 1984 with myocardial infarction as the first manifestation of coronary artery disease. Controls, a random sample of patients who had hypertension, were frequency-matched to cases by age and gender. Blind to case--control status, the authors reviewed the medical records of the 32 cases and 64 controls for reports of angina-like symptoms. While controls reported such symptoms at a constant rate, the events for the cases clustered near their infarctions. When a patient with hypertension sought medical advice for angina-like symptoms, the risk of infarction within 30 days was 14.2 (95% confidence interval, 2.8 to 71), and after 30 days it fell to 1.03. Among patients who have high blood pressure but no history of angina, presentations with prodromal symptoms in the primary care setting are so common that only about one in 100 such visits actually heralds myocardial infarction.
J Gen Intern Med
PMID:The relative risk of myocardial infarction in patients who have high blood pressure and non-cardiac pain. 369 97

We have previously shown that plasma vasoactive intestinal polypeptide (VIP) is increased in normal subjects by low-frequency transcutaneous nerve stimulation. The latter may also increase short-term physical performance in athletes (running, swimming and ergometer cycling). The present study examines whether the plasma VIP level is similarly increased in short-term ergometer exercise in seven healthy volunteers. A group of four patients with angina pectoris were included, since a lowered concentration of VIP is found in diseased heart tissue. In the group of healthy subjects, ergometer exercises with progressive increases in workload until exhaustion, lasting from 16 to 32 min (mean 26 min) and with a corresponding maximum energy output of 1500 to 5100 W (mean 3560 W), resulted in an increase in plasma VIP concentration from a pre-stimulatory level of 3.3 pmol . l-1 to 5.3, 5.2 and 5.6 pmol . l-1, measured 3, 10 and 20 min respectively, following termination of the exercise, i.e. a maximal 70% increase. In the patients with angina pectoris there was no significant VIP increase (cycling time 7-15 min, work performed 400-1350 W). Possible triggering mechanisms for VIP release and its source are discussed.
Gen Pharmacol 1986
PMID:Increase in plasma vasoactive intestinal polypeptide (VIP) in muscular exercise in humans. 372 Nov 87

Over a five-year period, 162 patients with coronary disease joined a physical rehabilitation course at a community sports centre gymnasium under the supervision of a general practitioner. One hundred and forty-seven patients had suffered a recent or old myocardial infarction and 15 suffered from angina pectoris. One hundred and thirty-eight patients (85 per cent) completed a three-month course of exercises, 16 (10 per cent) defaulted and eight (5 per cent) were withdrawn. One patient died at home during the three-month course. There were no changes in weight, blood pressure or blood fat measurements during the course but predicted maximum oxygen uptake increased by 26.9 per cent and the double product after effort (which is proportional to myocardial oxygen uptake) decreased by 13.6 per cent.We believe that the rehabilitation of patients in community sports centres is safe and effective and should be more widely practised.
J R Coll Gen Pract 1983 May
PMID:Coronary rehabilitation in the community. 630 51

This paper considers the literature on factors found to be associated with angina and pseudoangina, and attempts to delineate those psychosocial characteristics that might distinguish angina patients from either nonanginal CAD patients or from non-CAD normals. A cluster of characteristics emerges from both retrospective and prospective studies suggesting greater affective lability, "neuroticism," and perhaps physiologic reactivity than in either comparison group. The literature also suggests that learning and suggestion may play important roles in generating specific precipitants for anginal attacks. The literature on psychosocial intervention in anginal syndromes is almost entirely anecdotal, allowing few firm conclusions to be drawn, but suggesting the possible efficacy of certain behavioral, didactic, and supportive-psychodynamic interventions.
Gen Hosp Psychiatry 1984 Oct
PMID:Psychotherapeutic intervention in angina: I. A critical review. 648 43

The practice of mindfulness meditation was used in a 10-week Stress Reduction and Relaxation Program to train chronic pain patients in self-regulation. The meditation facilitates an attentional stance towards proprioception known as detached observation. This appears to cause an "uncoupling " of the sensory dimension of the pain experience from the affective/evaluative alarm reaction and reduce the experience of suffering via cognitive reappraisal. Data are presented on 51 chronic pain patients who had not improved with traditional medical care. The dominant pain categories were low back, neck and shoulder, and headache. Facial pain, angina pectoris, noncoronary chest pain, and GI pain were also represented. At 10 weeks, 65% of the patients showed a reduction of greater than or equal to 33% in the mean total Pain Rating Index (Melzack) and 50% showed a reduction of greater than or equal to 50%. Similar decreases were recorded on other pain indices and in the number of medical symptoms reported. Large and significant reductions in mood disturbance and psychiatric symptomatology accompanied these changes and were relatively stable on follow-up. These improvements were independent of the pain category. We conclude that this form of meditation can be used as the basis for an effective behavioral program in self-regulation for chronic pain patients. Key features of the program structure, and the limitations of the present uncontrolled study are discussed.
Gen Hosp Psychiatry 1982 Apr
PMID:An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theoretical considerations and preliminary results. 704 57

Serum amlodipine levels were determined in 18 patients with vasospastic angina. Patients were divided into two groups: Group A (n = 9) received amlodipine 5 mg by single daily administration, and Group B (n = 9) received 10 mg given by single daily administration for the first 3 days, then 5 mg from the 4th day on. The serum amlodipine concentration in Group A took 7 days to reach a steady state of around 8 ng/ml. The level in Group B was 8.9 ng/ml at 3 days. From these results, the optimal dosage of amlodipine in the treatment of angina pectoris is 10 mg for the initial 3 days followed by 5 mg thereafter.
Gen Pharmacol 1996 Mar
PMID:Clinical evaluation of serum amlodipine level in patients with angina pectoris. 891 32


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