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)

Heart rate and blood pressure responses during and after carotid sinus massage were examined in 66 patients just before coronary angiography. A significant relationship was found between heart rate and blood pressure responses and (1) angina pectoris class, (2) total coronary artery disease score and (3) presence of high-grade (> 90%) stenosis of any of the three major coronary arteries. Only patients with contraction abnormalities of the anterolateral left ventricular region had greater cardionhibitory responses than patients with normal left ventricular angiograms. Among patients with normal left ventricular angiograms, those with more than 50% stenosis of one or more vessels had significantly (p < 0.01) greater responses than those with no or minimal coronary artery disease. All 21 hypersensitive (asystole longer than 3 seconds) patients had significant multivessel coronary artery stenoses or single-vessel high-grade stenosis (greater than or equal to 90%) proximal to the atrioventricular nodal artery. None of the 11 patients with normal coronary arteries had an exaggerated response to carotid sinus massage. These data support the association of an exaggerated response to carotid sinus massage in the presence of symptomatic coronary artery disease and suggest that the magnitude of response is influenced by the severity of the disease.
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PMID:Carotid sinus reflex in patients undergoing coronary angiography: relationship of degree and location of coronary artery disease to response to carotid sinus massage. 740 42

Gallopamil is a methoxy derivative of verapamil. As is typical of the phenylalkylamine class of calcium antagonists, it acts on the vascular system, and on the heart and its nodal structures. In the treatment of stable angina pectoris, gallopamil is at least as effective as nifedipine and diltiazem, though apparently better tolerated than nifedipine. Typical of calcium antagonists there is little or no tolerance to the antiischaemic effects of gallopamil. Preliminary studies indicate that gallopamil, like other calcium antagonists, has cardioprotective potential. However, further investigation is required to explore the clinical relevance of the improved myocardial regional perfusion and free fatty acid utilisation in reversibly ischaemic regions, and the potential of delayed ischaemia during angioplasty that is observed during gallopamil administration. Gallopamil is well tolerated, exhibiting a low propensity for causing cardiovascular and gastrointestinal adverse effects, thus making it a suitable alternative to other calcium antagonists for the treatment of patients with ischaemic heart disease.
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PMID:Gallopamil. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in ischaemic heart disease. 751 Jun 24

The most important symptoms in bradycardia are vertigo, dizziness and syncopy due to diminished cerebral blood sypply. Cardial symptoms are cardiac insufficiency and angina pectoris. By means of ECG, especially Holter-ECG, carotid sinus massage, atropin test and invasive methods (atrial stimulation, His-bundle ECG) sinu-nodal dysfunction, carotid sinus syndrome, bradyarrhythmia absoluta and AV-block can be diagnosed. Pharmacological treatment is only useful in acute situations. For symptomatic bradyarrhythmias the implantation of a Pacemaker is the therapy of choice. Individual treatment of the various types of bradyarrhythmia and the patients special needs is possible through the evolution of pacemaker technology.
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PMID:[Differential diagnosis and therapy of bradycardic arrhythmias]. 782 27

The calcium antagonists currently available exert significantly different in vitro and in vivo electrophysiologic, hemodynamic, and contractile effects on cardiovascular function, mediated through differential cardiac and vascular smooth muscle responses to calcium channel blockade. These differences have important implications regarding choice of agent in specific clinical conditions, such as sinus or atrioventricular nodal disease, depressed left ventricular function, or congestive heart failure--conditions that may coexist with angina or hypertension. Recognizing and utilizing the properties of the different calcium antagonists is important to ensure maximally effective clinical outcomes. For example, in patients with hypertrophic cardiomyopathy and supraventricular arrhythmias, verapamil is singularly effective, whereas in post-myocardial infarction patients with pulmonary congestion, diltiazem may produce an added risk. Calcium antagonists of the dihydropyridine class, such as nifedipine and amlodipine, have the greatest peripheral vasoselective effects and thus the greatest potential to reduce afterload, minimizing direct left ventricular depression of contractility. Despite favorable effects of calcium antagonists, most of the agents currently available are not clearly safe in congestive heart failure and may adversely affect left ventricular function. However, newer calcium antagonists such as amlodipine are being investigated with regard to their safety in congestive heart failure.
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PMID:Hemodynamic and electrophysiologic effects of first- and second-generation calcium antagonists. 831 Sep 74

Ischemic heart disease (IHD) and systemic hypertension commonly coexist in a large number of patients, and the presence of hypertension is a risk factor for worsening IHD. A monotherapy that would effectively treat both is thus an attractive idea, and calcium antagonists have been evaluated in this role. Calcium antagonists exert therapeutic effects through a combination of actions, including systemic and peripheral vasodilation, negative inotropy, and reduced nodal conduction. In randomized, double-blind clinical trials, verapamil compares favorably with propranolol in the alleviation of angina and hypertension. Both diltiazem and nifedipine, as well as long-acting diltiazem, are also effective in treating the combined condition. In addition, each of these drugs enhances exercise tolerance and favors compliance with calcium antagonist therapy. Recent questions regarding the safety of this class of drug have tempered the enthusiasm for their use as first-line therapy in cardiovascular disease. In particular, short-acting dihydropyridine derivatives, including nifedipine and isradipine, may increase cardiovascular morbidity and mortality because of reflex sympathetic stimulation. The results of appropriately controlled, prospective clinical trials will provide more definitive conclusions. For now, we must be cautious in the use of calcium antagonist monotherapy for combined IHD and hypertension.
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PMID:Use of calcium antagonists in patients with ischemic heart disease and systemic hypertension. 918 65

Ipsilateral axillary lymph node visualization due to extravasation of Tc-99m MDP intravenous injection has been well documented. A patient with suspected angina underwent Tc-99m MIBI myocardial SPECT who had extravasation of Tc-99m MIBI in the antecubital region resulting in ipsilateral axillary lymph node uptake. This finding should not be misinterpreted as lymphatic nodal metastasis in a patient with breast cancer or lung cancer.
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PMID:Axillary lymph node uptake of Tc-99m MIBI resulting from extravasation should not be misinterpreted as metastasis. 1051 Aug 85

Single coronary artery anomaly is very rare. The reported manifestations include angina pectoris and congestive heart failure. Here we describe a case of single coronary artery anomaly presenting as sick sinus syndrome, which has no literature precedence. A 47-year-old woman had complained of intermittent dizziness for years. A Holter electrocardiogram showed sinus bradycardia and junctional or ventricular rhythm with a maximal ventricular pause of up to 3.2 seconds. Electrophysiologic study revealed prolonged corrected sinus nodal recovery time. Coronary angiography showed that the left anterior descending artery had a long course with a side branch originating from the proximal part and coursing anteriorly to the territory of the proximal portion of the right coronary artery. The sinus node is usually supplied by the sinoatrial branch via the right coronary artery. Aortography showed that the right coronary artery ostium was absent. A permanent pacemaker was implanted and the patient was discharged in good condition. The present case suggests that coronary artery anomaly may lead to compromised blood supply to the sinus node, and hence sick sinus syndrome.
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PMID:Sick sinus syndrome in a patient with single coronary artery anomaly. 1106 Oct 76

Drugs classified as calcium channel blockers (CHBs) are now among the most frequently prescribed drugs for the treatment of cardiovascular disease. Although the currently available CCBs have major differences in their structural and cardiovascular effects, they share the common property of blocking the transmembrane flow calcium ions through voltage gated L-type channels. These drugs have been approved for the treatment of hypertensive heart disease: they reduce left ventricular hypertrophy and improve its sequelae, such as ventricular dysrhythmias, impaired filling and contractility, and myocardial ischemia. Long-acting CCBs have been shown to reduce mortality and morbidity in elderly patients with systolic hypertension, appear to be extremely useful in patients with cyclosporin-induced hypertension, and can be used as alternatives to ACE inhibitors in patients with hypertension and concomitant diabetes mellitus, renal disease, Raynaud's phenomenon or migraine. Long-acting dihydropyridine have been shown to be effective and safe in the treatment classic angina pectoris and vasospastic angina, supraventricular arrhythmias, particularly reentrant AV-nodal tachycardia, others to be beneficial in patients with congestive heart failure, and all of them have potential for decreasing atherogenesis.
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PMID:[Calcium channel blockers in the treatment of cardiovascular disease]. 1157 40

Symptomatic bradyarrhythmia occurs most often in aged patients. Most of these patients have multiple coronary risk factors and present with angina-like symptoms. The coexistence of CAD not only has major effects on their prognosis but also influences the long-term care. This study was designed to evaluate the incidence of coexistent CAD in patients with symptomatic bradyarrhythmias and its relationship to conventional coronary risk factors in Chinese people. From May 1996 to April 1998, we prospectively studied all consecutive patients admitted to our institution for symptomatic bradyarrhythmias requiring permanent pacemaker implantation. Coronary angiographies were performed non-selectively at the same session of pacemaker implantation. Based on the presence or absence of CAD, patients were divided into two groups for analysis. Multivariate logistic regression analysis was performed to determine independent predictors of CAD including sex, age, diabetes mellitus (DM), hypertension, hypercholesterolemia, and smoking. The odds-ratio (OR) and 95% confidence interval (CI) were determined. A total of 113 patients [68 males and 45 females, mean age 70.4+/-8.2 years old (range 45-86)] were included in our study. The diagnosis was sick sinus syndrome in 69 patients (61%) and atrioventricular block in 44 patients (39%). The incidence of CAD based on coronary angiography was 20%. The nodal-related artery was seldom involved among patients with coexistent CAD and symptomatic bradyarrhythmias (9%), and most patients had significant stenosis over LAD (74%). The baseline characteristics and presenting symptoms were not different statistically between patients with or without CAD. Hypercholesterolemia (OR 6.6, 95% CI 2.0-22.2, p=0.002) and DM (OR 4.7, 95% CI 1.3-17.2, p=0.020) were the two most significant independent predictors of CAD. In our patients with symptomatic bradyarrhythmias requiring permanent cardiac pacing, the incidence of CAD was 20% as determined by coronary angiography (CAG). Hypercholesterolemia and DM were the two most significant independent predictors for CAD in these patients. The nodal artery was seldom involved in patients with coexistent CAD and symptomatic bradyarrhythmias.
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PMID:The incidence of coronary artery disease in patients with symptomatic bradyarrhythmias. 1169 78

A 75-year-old male with angina and a squamous carcinoma of the left lower lobe underwent a single-stage procedure for the treatment of these lesions. Through a left postero-lateral thoracotomy, a left lower lobectomy was performed with systematic nodal dissection including the subcarinal and paraaortic lymph nodes. A reversed saphenous vein segment was used to bypass the left anterior descending artery from the ascending aorta without cardiopulmonary bypass.
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PMID:Off-pump coronary artery bypass grafting and left lower lobectomy simultaneously performed via a left postero-lateral thoracotomy. 1269 63


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