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)

Carotid plaque is a marker of subclinical atherosclerosis that predicts the presence of coronary artery disease and cardiovascular events. The patient complained of chest discomfort accompanied by ECG abnormalities. Treadmill test demonstrated horizontal ST segment depression, however, coronary angiography did not show any significant stenosis. Carotid plaque was detected by carotid ultrasonogram, despite of the absence of any traditional and non-traditional cardiovascular risk factors, especially normal lipid profiles. This case suggests that unknown determinants of carotid atherosclerosis that we cannot elucidate from the history, physical examination, and common laboratory tests may play a role in the development of carotid plaque.
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PMID:Carotid plaque in absence of traditional and non-traditional cardiovascular risk factors. 1932 38

A 67-year-old woman presented with symptoms of exertional chest discomfort and dyspnea that had been progressive over the past few days. Her initial evaluation was significant of a mildly elevated troponin-T level and T-wave inversion in leads V(1)-V(2) on an electrocardiogram (ECG). Initial suspicion was for acute coronary syndrome. However, a transthoracic echocardiogram showed normal left ventricular systolic function, moderate right ventricular enlargement with moderate decrease in systolic function, possible left atrial mass or thrombus, and a possible right atrial mass or thrombus versus a prominent Chiari network. ECG-gated comprehensive cardiothoracic computed tomography (CT) with a 64-slice multidetector CT was done to assess for pulmonary embolism or acute coronary syndrome and to further evaluate the possible right and left atrial masses. This showed large bilateral pulmonary embolism, interatrial thrombus in transit through a patent foramen ovale, and minimal coronary atherosclerosis. Dynamic imaging showed right ventricular enlargement with severe systolic dysfunction. The patient underwent successful pulmonary thromboembolectomy, removal of intracardiac thrombus, and closure of patent foramen ovale.
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PMID:Pulmonary embolism, right ventricular strain, and intracardiac thrombus-in-transit: Evaluation using comprehensive cardiothoracic computed tomography. 1932 64

Female sexual dysfunction (FSD) is a prevalent problem, afflicting approximately 40% of women and there are few treatment options. FSD is more typical as women age and is a progressive and widespread condition. Common symptoms associated with FSD include diminished vaginal lubrication, pain and discomfort upon intercourse, decreased sense of arousal and difficulty in achieving orgasm. Only a small percentage of women seek medical attention. In comparison to the overwhelming research and treatment for erectile dysfunction in males, specifically with the development of phosphodiesterase type 5 inhibitors, significantly less has been explored regarding FSD and treatment is primarily limited to psychological therapy. Several cardiovascular diseases have been linked with FSD including atherosclerosis, peripheral arterial disease and hypertension, all of which are also pathological conditions associated with aging and erectile dysfunction in men. Using animal models, we have expanded our understanding of FSD, however a tremendous amount is still to be learned in order to properly treat women suffering from FSD. The aim of this review is to provide the most current knowledge on FSD, advances in basic science addressing this dysfunction, and explore developing therapeutic options.
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PMID:Female sexual dysfunction: therapeutic options and experimental challenges. 1953 61

Intermittent claudication (IC) is one of the most frequent forms of lower extremity peripheral arterial disease (PAD) and is most commonly caused by arterial atherosclerosis. Its clinical manifestation includes fatigue, discomfort, or pain occurring in limb muscles due to exercise-induced ischemia, thus limiting the ability of IC patients to walk and exercise. In addition to lifestyle changes (diet, exercise, and smoking cessation), pharmacological treatments are needed. Pathologically, atherosclerotic lesions cause a mismatch in oxygen supply and metabolic demand in the leg muscles during walking/exercise. This subjects the muscles to repeated ischemia and reperfusion injury that can alter structure and oxidative metabolism, resulting in insufficient utilization of oxygen supply. Despite extensive research efforts, cilostazol and pentoxifylline are the only drugs indicated for relieving the symptoms of IC, with cilostazol demonstrating significant improvement in walking distance and quality of life in these patients. Originally developed as a PDE3 inhibitor, cilostazol was later found to have several other pharmacological actions, and its success has been attributed to its multifactorial actions on platelets, endothelium, smooth muscle, and lipid profiles. Using cilostazol as an example, we discuss the rationales and pitfalls of targeting PDEs in IC, and potential strategies for the development of new and more effective pharmacological treatments.
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PMID:Phosphodiesterases as targets for intermittent claudication. 2169 42

Our patient had a left chest and back pain for more than 2 months, which had worsened during the previous month. Arteriae aorta CT angiography (CTA) diacrisis was as follows: (1) the aorta pectoralis protruded in local and parts of interparietal blood tumor emerged, the arterial canal paries calcified, may be the aortic atherosclerosis penetrating ulcer; (2) the low density of the abdominal aorta change, may be the interparietal blood tumor. During the surgery, according to the digital subtraction angiography (DSA) angiography, the aorta descendens penetrating ulcer emerged and the dissection of aorta formed at the remote end of the left subclavian artery, and an anabrosis also emerged 13 cm away from the remote end. The celiac axis also had an anabrosis, and combined with CTA, we decided to perform an isolation surgery, inserting the intracavitary bracket in the aorta pectoralis intracavitary. During the 6-month follow-up period, there was no pain or discomfort, with CTA re-examination, the bracket could be found at the range from the aortic arch to the inferior segment of aorta pectoralis.
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PMID:Multiple aortic atherosclerosis penetrating an ulcer. 2174 15

Atherosclerosis is a chronic disease which mainly represents an inflammatory response in the vessels. Myocardial ischemia manifested by angina pectoris can be either acute or chronic and usually is a result of imbalance between myocardial oxygen supply and myocardial oxygen demand. Chronic stable angina is chest discomfort attributed to myocardial ischemia without the presence of necrosis and is the most common symptom encountered by emergency room physicians. A growing amount of data has shown that endothelial dysfunction, is now considered an important early event in the development of atherosclerosis, while in the absence of angiographically obstructive coronary artery disease, anginal chest pain is often attributed to microvascular coronary dysfunction. Moreover, atheroma formation and in turn, atherosclerotic plaques seem to affect coronary flow, given that multivessel flow-limiting obstructions are observed in patients with chronic coronary syndrome. Morphological changes of diseased arteries related to significant atherosclerosis, such as vascular remodeling may also result in stable angina or claudication. However, several issues with respect to the comprehension of the pathophysiology of the chronic coronary syndrome have not been fully elucidated.
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PMID:Insight to the pathophysiology of stable angina pectoris. 2301 15

Recurrent angina in patients who underwent percutaneous coronary intervention is defined as recurrence of chest pain or chest discomfort. Careful assessment is recommended to differentiate between non-cardiac and cardiac causes. In the case of the latter, recurrent angina occurrence can be related to structural ('stretch pain', in-stent restenosis, in-stent thrombosis, incomplete revascularization, progression of coronary atherosclerosis) or functional (coronary micro-vascular dysfunction, epicardial coronary spasm) causes. Even though a complete diagnostic algorithm has not been validated, ECG exercise testing, stress imaging and invasive assessment of coronary blood flow and coronary vaso-motion (i.e. coronary flow reserve, provocation testing for coronary spasm) may be required. When repeated coronary revascularization is not indicated, therapeutic approaches should aim at targeting the underlying mechanism for the patient's symptoms using a variety of drugs currently available such as beta-blockers, calcium-channel blockers, ivabradine or ranolazine.
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PMID:Recurrent angina after coronary angioplasty: mechanisms, diagnostic and therapeutic options. 2406 4

Peripheral arterial disease (PAD) is defined as an atherosclerotic disease in the lower extremities and is characterized by its symptom of intermittent claudication with discomfort and pain at posterior cruris. Various abnormalities of vascular endothelial cells, smooth muscle cells and platelets induced by risk factors of PAD are involved in its pathogenesis. The most important risk factors are ageing, smoking and diabetes mellitus. Dyslipidemia and hypertension are also classical risk factors of PAD. A lesion of PAD in the lower extremity is prone to be more distal in patients with diabetes than in non-diabetics and to be more proximal in smokers than in nonsmokers. In addition, race/ethnicity, increased inflammatory marker levels, homocysteinemia and abdominal obesity are known to be risk factors of PAD. Light-to-moderate alcohol drinking has been demonstrated to reduce the risks of coronary artery disease and ischemic type of stroke, while excessive alcohol drinking increases the risks of hemorrhagic type of stroke (cerebral hemorrhage and subarachnoid hemorrhage), hypertension, cardiac arrhythmia and sudden cardiac death. In most previous epidemiological studies, the risk of PAD has been shown to be lower in light-to-moderate drinkers than in abstainers. Moreover, drinkers with PAD reportedly showed lower mortality than did nondrinkers with PAD. On the other hand, heavy drinking has been reported to be positively associated with the risk of PAD. Increase in HDL cholesterol, decrease in LDL cholesterol, inhibition of platelet aggregation, decrease in blood coagulability, increase in blood fibrinolitic activity, and increase in insulin sensitivity are known as mechanisms for suppression of atherosclerosis by alcohol drinking. These mechanisms are also thought to contribute to reduction of the risk of PAD by alcohol drinking. Further studies are needed to clarify pathophysiological mechanisms for dose-dependent diverse effects of alcohol on the risk of PAD.
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PMID:[Alcohol drinking and peripheral arterial disease of lower extremity]. 2481 55

Numerous studies have demonstrated that platelet-rich preparations applied to surgical sites, injuries, or wounds are a safe and effective way to promote soft tissue healing and bone growth. Various protocols have been developed for preparing platelet-rich preparations, with subtle but important differences between them. Unfortunately, only a minority of clinicians use platelet-rich preparations, such as platelet-rich plasma and platelet-rich fibrin, in their practice, possibly due to confusion about the different methods and their advantages and disadvantages. Therefore, the different types of preparations are described to help guide the selection of the best method for any size practice. Classic methods generally require large volumes of blood and can be expensive, complicated, and time-intensive. Simpler protocols have been developed recently, which require relatively inexpensive equipment and small blood volumes and, thus, may be more applicable for small clinical practices. Platelet-rich preparations accelerate healing at earlier time points to reduce discomfort and the potential for adverse outcomes, including infection, poor wound closure, and delays in forming strong bone for subsequent procedures (such as implants). However, platelet-rich preparations may also improve long-term outcomes in patients expected to have impaired healing, such as with lifestyle choices (eg, smoking), medications (eg, steroids), diseases (eg, diabetes, osteoporosis, atherosclerosis), and aging, by supplementing the deficient wound environment to restore proper healing. Therefore, both large and small clinical practices would benefit from utilizing platelet-rich preparations to enhance healing in their patients.
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PMID:Platelet-rich preparations to improve healing. Part I: workable options for every size practice. 2510 16

Coronary vasospasm can lead to myocardial injury and even sudden cardiac death. It has generally been overlooked as a diagnosis since atherosclerosis is a more common cause of acute coronary syndromes and because of the dilemma involved in its diagnosis. A middle-aged man with a history of smoking and cocaine use presented to the emergency department with left-sided arm/chest discomfort and diaphoresis. The electrocardiogram showed anterior ST elevation and hyper-acute T waves, which completely resolved shortly after sublingual nitroglycerin was administered. Subsequent angiogram revealed a 70% focal stenosis in the mid-left anterior descending artery. Coronary vasospasm occurs more commonly in arteries with underlying atheromatous disease, although normal vessels are not excluded. Cigarette smoking and cocaine use are among the major culprits that have been implicated as risk factors for the occurrence of coronary vasospasm. Eventually, the patient had percutaneous coronary intervention of his left-anterior descending artery and remained asymptomatic.
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PMID:Coronary artery spasm: An often overlooked diagnosis. 2511 75


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