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)

A 44-year-old trained marathon runner collapsed after completing 24 miles of the 1973 Boston Marathon. He was resuscitated from ventricular fibrillation. Death occurred after 50 days of coma. Extensive transmural anterior myocardial infarction was documented on electrocardiogram and proved at autopsy, yet the coronary arteries were free of significant atherosclerosis. We believe this report to be the first documentation of a myocardial infarction in a trained athlete while participating in a marathon. We emphasize that the relation between exertion and infarction is unknown. Advocates of long distance running for prevention of, or rehabilitation from, ischemic heart disease should be aware of this possible complication.
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PMID:Fatal myocardial infarction in marathon racing. 93 83

Heparins are a heterogenous group of naturally occurring glycosaminoglycans characterized by anticoagulant activity and a wide range of molecular weights (low molecular weight or fractionated heparins evolving within the past two decades). Cofactors for endogenous inhibitors of coagulation (antithrombin III and heparin cofactor II), heparin administration results in a hypocoagulable state. Various platelet activities, including inhibition of activity induced by platelet-derived growth factors on vascular smooth muscle, also have been noted. Divorced of anticoagulant nature, novel applications may include a role in atherosclerosis prevention, acceleration of collateral coronary as well as peripheral circulation (i.e., angiogenesis), and continued (chronic) post-myocardial infarction therapy. Established indications include treatment of various thrombotic diseases, unstable angina, and thrombosis chemoprophylaxis in medical/surgical patients. The antithrombotic potential of the heparins is used also in thrombosis management related to extracorporeal circulatory assistance or dialysis devices. Heparin's therapeutic potential in the postphlebitic syndrome as well as in acute treatment of myocardial infarction (primarily and adjunctively with various thrombolytic agents) continues to undergo evaluation; however, early data review shows favorable trends for its inclusion in situations that favor thrombus generation (e.g., anterior myocardial infarction). Although associated with thrombocytopenia or hypertransaminasemia, the heparins are relatively well tolerated. In a small subset of patients, a severe thrombocytopenia may ensue, which generally resolves on medication withdrawal. As this class of glycosaminoglycans becomes better characterized, new indications may emerge for both native and the newer fractionated heparins.
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PMID:Pharmacodynamics, clinical indications, and adverse effects of heparin. 132 34

The aim of this study was to find out the contributing factors for cardiac rupture in the course of acute myocardial infarction (AMI). Past medical histories and autopsy data of 80 patients were analyzed. The first group consisted of 30 patients who died due to heart rupture in the course of AMI and the control group of 50 patients who died from the other, more common complications of AMI. There was no difference between the groups according to age and sex of the patients. All patients who died from the rupture of the heart had a history of heavy chest pain, while it was lacking in 30% of the patients of the control group (p less than 0.01). All the first group patients showed electrocardiograms diagnostic for AMI, while it was lacking in 14% of the second group patients (p less than 0.05). Almost a half of the second group patients (47%) were in the class I of the Killip's classification, while only 20% of the control group did not developed left ventricular failure. Pathological study showed that the rupture of the heart most commonly occurred in the course of an anterior myocardial infarction. There was no difference according to the size of infarctions between observed groups, but the thickness of the left ventricular wall was significantly less (p less than 0.05) in the control group, and the heart weights were higher (p less than 0.05) in the control group. There was advanced atherosclerosis of the coronary arteries and about two thirds of the first group patients showed acute coronary thrombosis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Factors contributing to the onset of heart rupture in acute infarct]. 189 Sep 17

An 18-year-old woman presented with a large anterior myocardial infarction. Her cardiovascular risk factors were cigarette smoking in moderation and oral contraception with a synthetic oestroprogestative pill prescribed a few months previously. Coronary angiography showed occlusion of the left anterior descending artery but no other lesions. Biological investigations excluded an abnormality of coagulation. Antibodies to synthetic steroids (ethinylestradiol and progesterone) and circulating immune complexes were found in the serum. The role of antiethinylestradiol antibodies in the mechanism of myocardial infarction is discussed. These antibodies are present in 30 per cent of women taking oral contraceptives and their titres are significantly higher in 90 per cent of women who develop vascular thrombosis unrelated to atherosclerosis. The mechanism of the thrombogenic action of the antibodies and circulating immune complexes is also considered.
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PMID:[Myocardial infarction and anti-ethinylestradiol antibody. Apropos of a case in an 18-year-old woman]. 211 46

A 14-year old girl taking oral contraceptives (OCs) for menstrual disorders was admitted with an acute anterior myocardial infarction and underwent immediate coronary arteriography and intracoronary thrombolysis (urokinase 350,000 units) within 4 hours of the onset of symptoms. A segmental occlusion of the left anterior descending artery with no evidence of coronary atherosclerosis elsewhere was shown. A successful recanalization was documented after fibrinolytic therapy. The present is the 1st reported case in a patient of this age, with an angiographic demonstration during the acute phase of the tromboembolic pathogenesis of myocardial infarction in contraceptive users. The potential benefit of early thrombolytic treatment in this rare clinical setting is thus suggested. (author's)
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PMID:[Acute myocardial infarct in a 14-year-old girl treated with contraceptives. Coronary arteriography and immediate thrombolytic therapy]. 276 75

To elucidate the pathophysiological role of diabetes mellitus in determining the left ventricular regional function of the noninfarcted area, 55 patients with acute Q wave anterior myocardial infarction (MI) were studied. The regional ejection fraction of the noninfarcted area was obtained by radionuclide angiocardiography and was used to estimate the left ventricular regional function of the noninfarcted area. Multiple regression analysis was performed to determine the important variables contributing to the regional ejection fraction based on 10 clinical variables: age, sex, QRS score, diabetes mellitus, hypertension, smoking, postinfarction angina, body mass index, serum cholesterol, and coronary atherosclerosis. A high QRS score (P less than .001) and the association of diabetes mellitus (P less than .05) were the important factors contributing to regional left ventricular dysfunction. The regional ejection fraction and QRS score had an inverse linear relationship in the diabetic and nondiabetic groups, and the regional ejection fraction was significantly lower in diabetic patients at every QRS score (P less than .05). The association of hypertension, severity of coronary atherosclerosis, serum cholesterol level, age, and body mass index did not differ between diabetic and nondiabetic patients, which indicates that diabetes mellitus was not mediated through these atherogenic traits. Thus, diabetes mellitus is another discrete cause of regional left ventricular dysfunction of the noninfarcted area after acute MI.
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PMID:Left ventricular regional function after acute anterior myocardial infarction in diabetic patients. 279 25

Two-dimensional echocardiography was used to study the state of the proximal part of the left coronary artery (LCA) in 106 males: 39 patients after anterior myocardial infarction, 28--after posteroinferior myocardial infarction, 11 patients with angina pectoris without infarction, and 28 healthy persons. The comparison of the results of coronary radiography and echocardiography in 21 patients showed that the sensitivity and specificity of echocardiography in the diagnosis of stenosis of the left main coronary artery was 80 and 100%, respectively. Methods of assessment of echographic density of the LCA walls on the basis of comparison of their density with echographic density of the walls of the aorta and aortic valve showed that in the CHD patients LCA wall density was increased as compared to that of the healthy persons, and in the patients after anterio myocardial infarction it was increased as compared to that of the healthy persons and other CHD patients. The method permitted the detection of an increase in LCA wall echographic density which was typical of arterial atherosclerosis, and the assessment of a degree of arterial wall atherosclerotic density.
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PMID:[The left coronary artery in ischemic heart disease patients (data from 2-dimensional echocardiography)]. 342 88

Death directly related to selective coronary arteriography in 5 patients with a history of unstable angina pectoris during the period 1975-1985 is reported. Four different cardiologists were involved. A feature common to all the cases was the presence of significant ostial stenosis of the left mainstem coronary artery (LMCA); 2 patients had haemodynamically important obstruction of a dominant right coronary artery (RCA) ostium, while 2 others had total occlusion in the proximal part of a dominant RCA. The RCA in the last case was angiographically normal and non-dominant. Collateral coronary blood flow was fairly sparse in most cases and in 4 left ventricular dysfunction of varying degree was present. All patients developed severe hypotension and electromechanical dissociation after arteriography while still in the cardiac catheterization laboratory. Resuscitation efforts were uniformly unsuccessful. Autopsy on 1 patient demonstrated extensive obstructive coronary atherosclerosis with a massive acute anterior myocardial infarction. Cardiac catheterization poses an extremely high risk for this subgroup of patients with LMCA disease, as does selective coronary arteriography. The possible role of catheter-provoked coronary vasospasm of the LMCA is suggested; a recently introduced soft-tipped cardiovascular catheter may be more appropriate in this setting.
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PMID:Left mainstem coronary artery ostial stenosis--death after angiography. A report of 5 cases. 379 73

Five patients with lymphoma and Vincristine induced myocardial infarction are described in the medical literature. We report two new cases, in whom an anterior myocardial infarction developed few hours after the second administration of the drug. In the reported cases a strict cause-to-effect relationship between the drug and acute myocardial infarction seems indicated by: the striking temporal coincidence between Vincristine administration and onset of chest pain; the additional myocardial infarctions in patients in whom the treatment was continued after the first event; the nearly constant absence of important coronary risk factors and the young age of the patients, making preexisting coronary atherosclerosis unlikely. The mechanism for the described association is still unknown: the possible causes are discussed.
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PMID:[Myocardial infarction induced by vincristine in patients with Hodgkin's lymphoma. Description of 2 cases and review of the literature]. 400 46

A 27-year-old man had inferior myocardial infarction following superficial chest trauma. Coronary arteriography documented an isolated total occlusion of the right coronary artery, probably caused by localized extra-coronary compression, and no other evidence of intrinsic coronary disease. The left anterior descending artery later developed a localized proximal stenosis, most likely due to mural thrombus, which progressed rapidly to cause anterior myocardial infarction despite coronary artery surgery. The etiology of this lesion is discussed and support given to the "encrustation" hypothesis of human atherosclerosis. Exercise thallium scintigraphy proved helpful in the management of this case.
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PMID:Early occlusion and late stricture of normal coronary arteries following blunt chest trauma. 696 61


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