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)

The cardiac complications of radiotherapy have been reviewed in the light of 46 case histories collected from 16 treatment centres in France. They are usually found after radiotherapy for Hodgkin's disease and carcinoma of the breast. Although histologically there may be diffuse fibrosis involving the endocardium, myocardium and pericardium, it is pericarditis which is the usual clinical feature. It often occurs late, and takes many forms. The dry constrictive fibrous type of pericarditis is the most severe because of the amount of myocardial fibrosis usually associated with it. It is rare for there to be clinical features of myocardial fibrosis, and if present they are variable: isolated disorders of repolarisation or of conduction, or true cardiomyopathies. Lesions of the coronary arteries are exceptionally rare after radiotherapy, and involve fibrosis of the intima or atherosclerosis.
Arch Mal Coeur Vaiss 1978 Apr
PMID:[Cardiac complications of thoracic radiotherapy]. 9 62

Combined surgery on the valves and on the coronary arteries by bypass grafts has been carried out on 27 consecutive patients (1970 to 1976) and involved 18 aortic valve replacements, 8 mitral valve replacements, and one double mitro-aortic replacement; the mean duration of extra-corporeal circulation (145 mn) was significantly higher than that for valve replacements alone carried out during the same period (p less than 0.01). The five deaths occurring in hospital (18.5%) all occurred in the aortic valve group, and were amongst the first 15 cases operated on (1970 to 1974). The 4 post-mortem studies carried out showed similar findings, namely myocardial infarction and significant coronary lesions which had not been bypassed. Two secondary deaths due to infective complications occurred in the first six months. The 17 patients who were followed up after surgery and had a mean follow-up period of 24 months, were all substantially improved by comparison with their pre-operative state, despite certain complications affecting either the valves (1 requiring re-operation) or the coronary arteries (3 infarcts). The indications for coronary arteriography, which are related to the indications for surgery, are being enlarged so that they will include the majority of patients operated on excluding those of more than 65 to 70 years of age and also those aged less than 40 years who have no risk factors for atherosclerosis and no clinical or electrocardiographic signs suggesting a coronary lesion. A study of the operative risk factors has shown the importance of unsuspected coronary lesions, and would appear to indicate correction of all valvular and coronary lesions seen at the time of operation.
Arch Mal Coeur Vaiss 1978 Aug
PMID:[Valve replacement and aorto-coronary bypass]. 10 Nov 61

Not every case of angina pectoris occurring in a hypertensive patient is indicative of coronary atherosclerosis. Nine patients with essential hypertension of moderate degree had attacks of angina of sufficient severity to require investigation by arteriography. In these patients, the coronary arteriogram was normal but ventriculography showed hypertrophy of the walls of the left ventricle of restrictive or obstructive type. These appearances were confirmed by echocardiography which also showed hypertrophy of the septum and, in certain cases, confirmed the involvement of the ventricle, while by contrast the electrocardiogram and radiological appearances of the heart were essentially normal. The beta-blockers may have an important part to play in such conditions, and echocardiography is suggested as part of the routine investigation in cases of hypertension.
Arch Mal Coeur Vaiss 1978 Jul
PMID:[Angina pectoris in a hypertensive patient with left ventricle hypertrophy: echo-angiographic comparisons]. 10 Nov 81

The association of idiopathic hypertrophic subaortic stenosis (IHSS) with significant coronary atherosclerosis is little known, only 43 cases being available in the literature, 2 of which are personal ones. But the incidence of this association has certainly been underestimated. It is especially found from the sixth decade onwards, and at least 20% of patients with IHSS in and above the age group have stenosing lesions of the coronary artery. It is almost impossible to establish the presence of associated coronary abnormalities from the clinical features of from electrocardiogram. It does however seem worthwhile looking for this condition in IHSS when there is refractory chest pain, especially to beta-blockers, particularly if the patient is aged over 50 and has risk factors for ischaemic heart disease. It is also good to find IHSS associated with known coronary artery disease by using simple non-invasive techniques such as phonomechanocardiography and especially echo-cardiography; it is important not to miss the myocardial lesion and to treat concurrently if there is likely to be an indication for dealing with the coronary arteries surgically. The beta-blockers are the treatment of choice for both conditions, together with anticoagulents. If they fail, myectomy or myotomy together with aorto-coronary bypass graft should be considered.
Arch Mal Coeur Vaiss 1978 Sep
PMID:[Obstructive cardiomyopathy and associated coronary atherosclerosis. Review of the literature and report of 2 personal cases]. 10 92

Three years after radiotherapy to the mediastinum for Hodgkin's disease, a 28 year old female presented with incapacititating angina. The presence of severe disease in the proximal arteries on coronary arteriography, with obliteration of the anterior descending artery and, of the right coronary artery, together with an unstable collateral circulation, constituted an indication for a double aorto-coronary bypass graft. A review of the literature suggests that early development of atherosclerosis may be produced by the synergistic action of radiotherapy and lipid disorders. Fifteen similar cases have been described, eight of them in patients of less than 40 years of age; three were discovered at post-mortem examination in patients aged under 21.
Arch Mal Coeur Vaiss 1978 Nov
PMID:[Severe coronary insufficiency in a young woman after mediastinal radiotherapy]. 10 86

The most significant results show the predominance of arteriolar lesions in the controlateral kidney, The most significant results show the predotients with unilateral renal artery stenosis. and parenchymal lesions of the kidney with stenosis in patients with atherosclerosis. These results do not seem to provide information which would alter the clinical management in any particular case.
Arch Mal Coeur Vaiss 1979 Nov
PMID:[Are surgical renal biopsies useful for clinical prognosis in renal artery stenosis?]. 11 8

The authors have made a retrospective study of the case notes of 200 patients with valvular disorders seen over the course of 35 months (excluding those due to constrictive endocardial fibrosis). The cases represent the frequency of cardiac failure, especially in the mitral group. The authors found 61% to have mitral valve disease, 28.5% aortic valve disease, and 9.5% disease of more than one valve. Mitral valve lesions were found most frequently in young females (average age 26 years); aortic valve lesions were found more commonly in an older age group of men (average age 47 years). The authors discuss the aetiology. Rheumatic fever was responsible in 60% of cases, and caused particularly mitral valve disease. Atherosclerosis and syphilis were the commonest causes in the aortic group. Indications for surgery were found in 74 cases (37%), and 28% of these were closed heart techniques. The course of the disease is best appreciated during the first hospital admission. The mortality rate was 5.5%, and most of the patients (65%) were stabilised on treatment.
Arch Mal Coeur Vaiss 1976 Jan
PMID:[200 valvular disorders seen in Abidjan]. 18 50

Thromboses are a classical complication of sickle cell disease in the severe homozygous form. In the heterozygous individual, although the risk of severe thromobotic episodes is small, it must nevertheless be recognised. The authors report two cases of myocardial infarction in patients whose coronary arteries were relatively free from atherosclerosis; they were young men, with the heterozygous form of sickle cell disease AS. The part played by inheritance, the factors favouring vascular occlusion, and the possibility of preventing such episodes are all discussed.
Arch Mal Coeur Vaiss 1977 Feb
PMID:[Myocardial infarction and heterozygous sickle cell anemia. Apropos of 2 cases]. 40 90

Resection of left ventricular tissue seems to be playing an increasing part in the treatment of the sequelae of myocardial infarction. In a total of 700 patients who underwent surgery for some aspect of coronary atherosclerosis, 40 underwent resection of left ventricular tissue. In the majority of cases, diagnosis rested on left ventricular cine-angiography and in 3 cases this had to be carried out as an urgent procedure with circulatory assistance using diastolic counter-pressure (DCP) from an intra-aortic balloon. A selective contrast technique for the two coronary arteries was used whenever possible. The surgical anatomy of the lesions indicates a difference between a localised dyskinesia and diffuse dyskinesia, the latter having a severe effect on left ventricular function. In a group of localised dyskinesias, the territory supplied by the anterior descending artery was by far the most frequently affected. Resection of left ventricular tissue was associated with a myocardial bypass revascularisation procedure in 9 cases, valve repair in 7 cases, and closure of a septal perforation in 3 cases. The total inpatient mortality rate is still quite high (23.1%) because of the severity and widespread nature of the coronary disease. However, the mid-and long-term results are good, the criteria being functional improvement and the actuarial 4-year survival rate.
Arch Mal Coeur Vaiss 1978 Feb
PMID:[Resections of the left ventricle in the surgical treatment of parietal sequelae of myocardial infarct]. 41 85

Report of an anatomical-clinical study concerning 173 patients with an average follow-up period of 5 and 1/2 years after the onset of myocardial infarction. They were subdivided into four comparable groups differing only in the quality of the long-term antivitamin K treatment which was administered. A survey of the coronary artery and myocardial lesions was performed for every heart. Acute occlusive coronary artery thromboses were four times less frequent in the correctly treated group then in the other three groups (p less than 0.001). There was no significant difference between the insufficiently treated groups and the untreated group. Recurrent myocardial infarctions were accompanied in 90 per cent of cases by acute occlusive coronary artery thromboses and were four times less frequent when treatment was efficient (p less than 0.001). These results confirm the part played by coronary artery thrombosis in the aggravation of coronary atherosclerosis and justify the attempts at long-term prophylaxis. The provide the proof that antivitamin K administration, at efficient dosage, maintained for a long time, has a significant influence on the cause of death in these patients, by decreasing the number of coronary artery thrombosis. Long-term anticoagulant treatment, in spite of its haemorrhagic complications and limits, should not be given up until a new efficient treatment is available.
Arch Mal Coeur Vaiss 1975 Feb
PMID:[Coronary thrombosis and long term anticoagulant treatment. Results of 173 autopsies after myocardial infarction]. 80 85


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