Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Coronary artery aneurysms were found in 16 men between 37 and 62 years of age, mean 51 years. Aneurysms were of two types: saccular and fusiform. They involved the right coronary artery in 13 (87 per cent), the circumflex artery in eight (50 per cent) and the left anterior descending artery in five (31 per cent). In some patients, more than one vessel was involved. Twelve patients presented with angina pectoris, three with congestive heart failure and one with both. Five were in functional class II, eight were in class III and three were in class IV at the beginning of the study. The electrocardiogram showed evidence of previous myocardial infarction in four patients; four patients had left ventricular hypertrophy, one had left axis deviation, one had left bundle branch block, one had right bundle branch block, two had first degree atrioventricular block and seven had abnormalities in the S-T segment and T wave. Obstructive coronary disease was present in all; the obstruction score was from 1 to 4 in three patients, from 5 to 9 in four patients and from 10 to 14 in the remaining nine. Similar aneurysms were found in the pulmonary artery of one patient and in the abdominal aorta of three patients; in seven of 14 patients with adequate venous angiograms, varicosities of the coronary venous tree were observed. Left ventricular dysfunction and angina pectoris were noted in patients with significant obstructive coronary disease (greater than 70 per cent) and also in patients without obstruction but with coronary aneurysms. Ten patients were treated surgically; nine underwent aortocoronary bypass and one mitral valve replacement. Criteria for bypass was the presence of obstructive disease and medically unresponsive angina pectoris. All but one surgically treated patient showed improvement. The functional class in medically treated patients was unchanged. Fourteen patients were still alive at the completion of the study. The findings of this study suggest that angina pectoris and left ventricular dysfunction can occur with coronary artery aneurysm without coronary artery obstructions. Coronary aneurysms may be a subset of atherosclerosis, and this process may involve other vascular territories. The prognosis in those patients appears to be no worse than in patients with obstructive coronary disease and no aneurysms.
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PMID:Coronary artery aneurysms: study of the etiology, clinical course and effect on left ventricular function and prognosis. 30 May 67

A transvenous left ventricular endocardial pacemaker catheter is a potential source of systemic arterial embolization. The case of a woman who presented with left-eye amaurosis fugax is reported. The patient had a history of contralateral carotid atherosclerosis; however, the digital subtraction angiography of the carotid arteries was not sufficiently abnormal to account for her present symptoms. The patient had a history of two myocardial infarctions and the tachycardia-bradycardia syndrome for which she was treated with a demand ventricular pacemaker. The chest x-ray and electrocardiogram suggested pacemaker catheter malposition. By M-mode and two-dimensional echocardiography, the catheter was shown to cross the atrial septum and the mitral valve to implant in the left ventricular endocardium. The approach to diagnosis and therapy that led to surgical removal of the pacing catheter is presented. The causes of the electrocardiographic right bundle branch block pattern in cardiac pacing and the usefulness of echocardiography in evaluating pacing catheters are discussed.
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PMID:Amaurosis fugax in a patient with a left ventricular endocardial pacemaker. 620 Aug 59

A review of the electrocardiograms (ECG) of 108 patients with sickle cell anemia found only 3 with patterns consistent with myocardial infarction. Two of the 3 patients with ECG infarct patterns had postmortem examination confirmation of the infarction. These two patients had no significant coronary atherosclerosis nor did the other six autopsied patients in the present series. Literature reports of postmortem examinations on patients with sickle cell anemia confirm the scarcity of coronary atherosclerosis and myocardial infarction in these patients. Forty of the 108 ECGs showed signs of left ventricular hypertrophy and 20 others had nondiagnostic ST and T wave abnormalities. Nine showed first degree AV block and four right bundle branch block.
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PMID:Myocardial infarction in sickle cell anemia. 623 6

A 74-year-old patient was referred for a rapidly increasing pacing threshold 9 months after DDD pacemaker implantation because of symptomatic total atrioventricular (AV) block. She had a history of hypertension, diabetes with micro-angiopathy and a recent transient ischaemic attack. The paced electrocardiogram on admission had a right bundle branch block pattern and 3-dimensional transoesophageal echocardiography demonstrated passage of the lead through an atrial septal defect with a left ventricular position in addition to moderate atherosclerosis of the ascending aorta. No thrombus could be detected on the lead. Percutaneous extraction is usually not recommended because of the risk of mobilization of thrombus material. However, the risk of stroke during removal using cardiopulmonary bypass in this patient was considerably increased because of the presence of multiple independent risk factors. Therefore, percutaneous extraction using a locking device was selected and performed without complications: follow-up was uneventful.
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PMID:Successful percutaneous extraction of an inadvertently placed left ventricular pacing lead. 1263 46

While acute coronary syndromes most commonly occur secondary to unstable atherosclerotic plaque, coronary aneurysms, also known as coronary artery ectasia (CAE), represent a less common etiology. Whereas coronary atherosclerosis accounts for about 50% of CAE, the remaining 50% are either congenital or secondary to a host of inflammatory and connective tissue disorders, with Kawasaki disease being a well-known association. Patients with CAE have worse outcomes than the general population regardless of the presence of associated atherosclerotic coronary artery disease. We report the case of a young male presenting with chest pain, a right bundle branch block on electrocardiography, an elevated troponin level, and a regional wall motion abnormality on echocardiography who is found to have diffuse coronary artery ectasia on coronary angiography and is managed medically with dual antiplatelet therapy.
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PMID:Coronary Artery Ectasia Presenting as a Non-ST Elevation Myocardial Infarction in a Young Adult: Case Presentation and Literature Review. 3022 48

Participation in regular exercise of moderate intensity is associated with a plethora of systemic benefits, including a reduction in risk factors for coronary atherosclerosis; however, intensive exercise may paradoxically culminate in sudden cardiac arrest among individuals harbouring arrhythmogenic substrates. The precise mechanism for arrhythmogenesis is likely multifactorial, however, surges in catecholamines, electrolyte shifts, acid-base disturbances, increased core temperature and demand myocardial ischaemia are potential contributors. Although most deaths occur in middle aged and older males with atherosclerotic coronary artery disease, a significant proportion also affect young athletes with inherited or congenital cardiac abnormalities. The impact of such catastrophes on society, particularly when a young high profile athlete is affected could be considered a justified reason for identifying individuals who may be at risk. Given the rarity of deaths in young athletes, only the simplest screening test, such as the 12-lead ECG may be considered to be cost effective. The ECG is effective for detecting serious electrical diseases in young athletes such as congenital electrical accessory pathways and ion channel diseases but can also identify athletes with potential life threatening structural diseases such as hypertrophic and arrhythmogenic cardiomyopathy. One of the concerns about ECG screening is that regular intensive exercise results in several physiological alterations in cardiac structure and function that are reflected on the athlete's ECG. Sinus bradycardia, first-degree atrioventricular block, incomplete right bundle branch block, minor J-point elevation and large QRS voltages are common. Conversely, some repolarisation anomalies affecting the ST segment, T waves and QT interval may overlap with patterns observed in patients with serious cardiac diseases. The situation is complicated further because age, sex and ethnicity of the athletes also influence the ECG and there is a risk that erroneous interpretation could have serious consequences. This review will describe the normal electrical patterns of the "athlete's heart" and provide insights into differentiation physiological electrical patterns from those observed in serious cardiac disease.
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PMID:Electrocardiographic interpretation in athletes. 3305 98