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Query: UMLS:C0004153 (
atherosclerosis
)
77,401
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
49 cases of
myocardial infarction
during pregnancy are reviewed from the literature, considering the frequency, pathogenesis, clinical findings, prognosis, treatment, obstetrical conduct including whether abortion is indicated, and finally 17 cases of pregnancy in women with previous heart attacks are summarized. A
myocardial infarction
is rare, about .01-.075%, more frequent in late pregnancy or the postpartum, and in older women. This series averaged 32.9 years. 88% were due to
atherosclerosis
. Other risk factors were usually not reported systematically. 56% of the incidents were the 1st
heart attack
; 44% were preceded by angina; 68% were anterior. Pregnancy affects the EKG and white blood count, but serum enzymes are the same as in nonpregnant women. 29% of these women died, 23 went to term, and 7 gave birth prematurely. 13 labors were spontaneous, 7 required forceps, and 10 were Caesarean births. Fetal loss was 27%. Treatment is the same as that in any
heart attack
patient, except for lignocaine and use of anticoagulants. Abortion is only necessary in cardiac insufficiency. Delivery should probably involve forceps, epidural anesthesia, and anticoagulatns immediately after delivery, but oxytocin should be avoided. The 17 cases of pregnancy after a
heart attack
resulted in 1 abortion, 15 term deliveries, 3 new infarctions, and 1 death due to antoher
heart attack
at term.
...
PMID:[Myocardial infarct and pregnancy]. 103 53
A comparison of cold pressor response with coronary arteriography and left ventriculography was made in 26 consecutive patients having chest pain suggesting coronary heart disease. Patients with normal coronary arteriograms and normal left ventriculograms showed normal cold pressor responses. Patients with coronary
atherosclerosis
and normal left ventricular performance showed an exaggerated cold pressor response, whereas patients with severe coronary
atherosclerosis
and poor left ventricular performance did not exhibit an exaggerated cold pressor response. In patients with inferior wall
myocardial infarction
having dyskinesia or akinesia of the inferior wall, the cold pressor response was not impaired. In contrast, patients with anterior wall
myocardial infarction
and dyskinesia or akinesia of the anterior wall showed a marked impairment of the left ventricular performance and no exaggeration of the cold pressor response.
...
PMID:Correlation of cold pressor response with coronary atherosclerosis and left ventricular performance. 105 63
There appears to be a need to protect our young from an atherogenic way of life. The average male child today has one chance in three of a cardiovascular catastrophe before age 60.
Atherosclerosis
and the conditions which predispose appear to have their onset in childhood. Correctable precursors of cardiovascular disease have been identified, and their contribution to risk has been estimated not only for adults but for college students as well. An analysis of the combined impact of atherogenic risk factors indicates that they exert greater force early in life than later. Although the optimal time to begin prophylaxis is not established, there is evidence to suggest that measures instituted late in life when lesions are advanced is of only limited value. Prevention of
atherosclerosis
is best viewed as a family affair since the propensity to disease and contributing factors tend to be shared by family members. It is also difficult to implement effectively preventive measures which include dietary changes, weight control, exercise and restriction of cigarettes for one family member without involving the rest of the family. Optimal levels of the correctable precursors of cardiovascular disease are not established for children. However, the rise in serum lipids, blood pressure, weight and blood sugar observed in transition from childhood to adult life is not inevitable, or desirable. Paediatricians can alter the appalling cardiovascular mortality statistics by not allowing the process or the habits and conditions which promote it to reach an irreversible stage. Cardiovascular disease may well begin in childhood with "medical trivia" such as a tendency to obesity, moderate cholesterol and blood pressure elevations, lack of exercise and the cigarette habit. In some respects a
heart attack
at age 45 can be regarded as a failure of the paediatrician. Awaiting proof of the efficacy of the indicated prophylactic measures is not acceptable since this will be a long time in coming. We must learn how to correct risk factors effectively in childhood as soon as they appear. We must establish goals based on optimal as distinct from usual levels of risk factors. Paediatricians' resolve about prevention of
atherosclerosis
in childhood needs to be strengthened and we must develop a sense of urgency about this.
...
PMID:Prospects for prevention of atherosclerosis in the young. 107 69
A detailed pathological study was made in 10 patients dying up to 13 months after aortocoronary saphenous vein bypass grafting for coronary
atherosclerosis
. The coronary arteries and vein grafts were investigated by injection with a radio-opaque mass, radiography, dissection, and histology. The report is to some extent historical since the patients died during a period when the operation was first being introduced into two cardiothoracic hospitals. About 80 operations were performed during the time the 10 deaths occurred, a mortality of 12-5 per cent (including cases followed up to 13 months after operation). Seven of the patients were operated on for intractable angina and 3 with a view to aneurysmectomy. All the patients selected for operation were severely disabled despite medical treatment. The main cause of death was extremely severe coronary artery disease and its effects on the left ventricle; in one case, over two-thirds of the left ventricle had been destroyed by infarction before operation. Other causes or contributing causes of death were pulmonary embolism,
myocardial infarction
complicating angiography (ostial stenosis), and cerebral damage. Ten of the 14 vein grafts (71%) were patent at necropsy. A free flow of injection medium usually occurred between patent grafts and coronary arteries. Thrombosis of a graft was thought to have contributed to death in 3 patients, but not in a fourth who died of pulmonary embolism. Since thrombosis of grafts was usually secondary to poor run-off blood into severely atheromatous coronary arteries, this was also an indirect effect of the advanced coronary arterial disease. In one case, thrombosis followed severe chronic intimal thickening of a graft in place for 13 months. The study of these deaths emphasizes that in some patients the pathological changes in the coronary arteries and left ventricle are too severe for them to benefit from surgery. Vein grafts cannot be expected to distribute blood effectively through grossly narrowed coronary arteries. In addition, when a large part of the left ventricle is infarcted or scarred, it is almost certain that improving the blood supply by grafting will not result in significant regeneration of cardiac muscle. Since the time when this study was made, there have been few deaths among the many vein graft operations subsequently carried out in the hospitals involved. The two most important factors thought responsible for the improvement are the selection of cases more suitable for surgery by continued improvement of diagnostic techniques, and also the employment of more radical surgical procedures in the form of coronary endarterectomy and the insertion of more grafts per patient.
...
PMID:Pathology of hearts after aortocoronary saphenous vein bypass grafting for coronary artery disease, studied by post-mortem coronary angiography. 108 91
The prevalence of complicated and calcified lesions and coronary stenosis, the mean heart weight, and the extent of
atherosclerosis
in the aorta and coronary arteries were greater in the "sudden heart death" group than in the high
atherosclerosis
group. In the "other sudden death" group, which included sudden deaths without
myocardial infarction
or coronary occlusion, all the above variables, except heart weight, were found to be lower than in the low
atherosclerosis
group and were close to those in the standardized average
atherosclerosis
group. The mean heart weight in the "other sudden death" group was lower than in the "sudden heart death" group but significantly higher than in the three reference
atherosclerosis
groups.
...
PMID:Atherosclerosis and sudden death. 108 91
The extent of aortic
atherosclerosis
in subjects with rheumatic heart diseases was similar to that in the standardized average
atherosclerosis
group of subjects. The extent of coronary
atherosclerosis
, particularly in men, was similar to that in the low
atherosclerosis
group. In the aorta, this finding was accounted for by the greater extent of complicated and raised lesions; in the coronary arteries, it was accounted for by the lesser extent of fibrous plaque. Coronary stenosis, fresh
myocardial infarction
, and large myocardial scar occurred much less frequently in rheumatic subjects than in the high
atherosclerosis
group. There was no difference in the frequency of stenosis between the rheumatic and low
atherosclerosis
groups.
...
PMID:Atherosclerosis and rheumatic heart disease. 108 96
Atherosclerosis
of the aorta and coronary arteries and
myocardial infarction
were studied post mortem in 390 males and 190 female cirrhotic subjects in the 5 towns. Comparison with the reference groups revealed that calcification of the aorta and coronary arteries was more frequent (in the case of males) and more extensive (in the case of males and females) in cirrhotics than in noncirrhotics. Raised and complicated lesions were not increased. Coronary stenosis (in females), fresh
myocardial infarction
(in both sexes), and large myocardial scar (in both sexes) were less frequent in cirrhotics. "Obesity" was similar in cirrhotics and non-cirrhotics.
...
PMID:Atherosclerosis and cirrhosis of the liver. 108 97
Aortic and coronary
atherosclerosis
and the frequency of coronary stenosis and myocardial lesions were studied in subjects with peptic ulcer, in two subgroups with acute and chronic peptic ulcer, and in subjects who had undergone a stomach operation. In all these respects the groups were similar to each other. Men with peptic ulcer had the same amount of aortic
atherosclerosis
as the standardized average coronary
atherosclerosis
group but less coronary
atherosclerosis
, while women with peptic ulcer had less aortic and much less coronary
atherosclerosis
. The prevalence of coronary stenosis, fresh
myocardial infarction
, and myocardial scar was very low in those with peptic ulcer, especially in women.
...
PMID:Atherosclerosis and peptic ulcer. 108 98
Aortic and coronary
atherosclerosis
and the prevalence of coronary stenosis and thrombosis were studied in subjects who had died of fresh or recurrent
myocardial infarction
or had suffered from
myocardial infarction
in the past. In general, severe
atherosclerosis
of the coronary arteries with stenosis and calcification was almost a prerequisite for the development of coronary heart disease. The frequency of coronary heart disease varied widely both in different countries and in different towns in the same country. Considerable variations were found among the various towns in the frequency of stenosis and thrombosis in those who had died of coronary heart disease. This finding indicates that although
atherosclerosis
is indeed a prerequisite for the development of
myocardial infarction
, other factors may play a significant role in its occurrence. The weight of the heart in persons (excluding hypertensives) with coronary stenosis or a first fresh
myocardial infarction
was considerably greater than that in the low
atherosclerosis
group.
...
PMID:Atherosclerosis of the aorta and coronary arteries in coronary heart disease. 108
In a large autopsy series the relation between various measures of body build and aortic and coronary
atherosclerosis
, coronary stenosis, and myocardial lesions was studied. Stature was not associated with any of these variables. Various measures of obesity all showed an association between obesity and the above-mentioned variables. Obese people were found to have more coronary
atherosclerosis
, coronary stenosis, and myocardial lesions than thin people, a difference that persisted, in a reduced form, when hypertensives and diabetics were excluded. When compared with the standardized average
atherosclerosis
group to exclude the effect of "wasting diseases", and when hypertensives and diabetics were excluded, neither the extent of atherosclerotic lesions nor the prevalence of coronary stenosis were increased in obese subjects. Obese men but not obese women, however, had more myocardial lesions, especially fresh
myocardial infarction
.
...
PMID:Atherosclerosis and body build. 108 3
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