Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0008031 (chest pain)
 17,248 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Six patients (2 males and 4 females, mean age of 46 years) with X syndrome were reported in this paper. All patients presented with typical exertional angina pectoris. In 4 patients the angina had a variable threshold of onset, it often occurred at rest and occasionally nocturnally. The electrocardiogram during chest pain showed ST segment depression of more than 0.05-0.1 mV in all 6 patients. The treadmill or bicycle ergometer exercise test was positive in 4 cases (ST segment depression > 0.1 mV), equivocal in 1 (ST segment < 0.1 mV) in whom the 201Tl exercise myocardial perfusion scan showed sign of ischemia, and negative in 1 in whom atrial pacing at heart rate of 135 beats/min induced angina and ST segment depression of 0.1-0.15 mV. Echocardiograms and X ray chest films revealed no sign of ventricular hypertrophy or enlargement. The 201Tl exercise myocardial perfusion scan was performed in 5 patients, which showed signs of ischemia in 4 patients and suspected to have ischemia in 1. Left ventriculograms and coronary angiograms were normal in all 6 patients. Ergonovine provoking test (total dose of 0.4 mg) was negative in 5 patients, it was not performed in 1 in whom there was no evidence of coronary artery spasm by angiogram during appearance of electrocardiographic ischemic changes and chest pain. Left ventricular endomyocardial biopsy was performed in 1 patient, which showed significant smooth muscle cell proliferation in the medial layer of a small artery with diameter of 62.5 mu which produced narrowing of the lumen.(ABSTRACT TRUNCATED AT 250 WORDS)
Zhonghua Xin Xue Guan Bing Za Zhi 1992 Oct
PMID:[X syndrome--report of six cases]. 130 21

The efficacy and safety of intravenous administration of recombinant tissue-type plasminogen activator (rt-PA, made by Boehringer Ingelheim Corp.) was investigated in 10 patients with acute myocardial infarction (AMI). The rt-PA was given as a bolus dose of 10 mg followed by an infusion of 50 mg, 20 mg and 20 mg in successive hours. Heparin and aspirin were given to all the patients. The time interval from the onset of chest pain to thrombolysis was from 2.3 to 6.1 h with mean of 3.9 h. Coronary angiography, performed before administration of rt-PA and every 30 minutes thereafter, demonstrated total coronary occlusion (grade O) in 9 patients and grade 1 in 1 at baseline study. The infarct-related coronary artery were LAD in 5, RCA in 3 and LCX in 2. At 90 minutes after infusion of rt-PA reperfusion of the infarct-related artery was observed in 7 patients, the success rate was 70%. In one case the infarct-related LCX was not opened at 90 minutes, but it was reperfused at 170 minutes, after intracoronary administration of 10 mg of rt-PA. The total dose in this case was 130 mg. During 30 days of hospitalization death occurred in only one case with cardiogenic shock, in whom the infarct-related RCA was not reperfused by rt-PA but was successfully recanalized by PTCA. The patient died from rupture of the left ventricle on the 4th day. No patient had clinical evidence of reinfarction. Follow-up angiography in 2 patients showed that the arteries reperfused initially were patent.(ABSTRACT TRUNCATED AT 250 WORDS)
Zhonghua Xin Xue Guan Bing Za Zhi 1991 Aug
PMID:[Intravenous recombinant tissue-type plasminogen activator in acute myocardial infarction]. 181 88

Using the standard 12-lead electrocardiographic QRS scoring system modified by Nancy (1985), 99 ECGs of 52 patients with acute myocardial infarction were used for estimating myocardial infarct size (MIS). One point was designed to represent 3% of the left ventricle. Each patient had the first score of ECG at the day ranged from 7 to 12 and the second 25-32 days post acute chest pain except 5 cases died before the second scoring. The results showed that the averaged score was 6.7 +/- 3.1 points accumulated from all 99 ECGs and 11.0 points from 5 cases died. There was no statistic difference between the points value of the first scoring 6.4 +/- 2.9 vs second 6.5 +/- 2.7 points, nor between the points received from Q waves 4.0 +/- 1.5 vs 3.9 +/- 1.4 points in 47 patients. There was nevertheless strong correlation both between the total points of the first and second scoring, r = 0.85 (P less than 0.0005), and those between the points related to Q wave, r = 0.81 (P less than 0.005). Furthermore, early serial serum CPK changes were determined for evaluating MIS in 25 patients, the results were compared to the first and second scores respectively, the correlations were significant, r = 0.58, P less than 0.0025 and r = 0.47, P less than 0.01.(ABSTRACT TRUNCATED AT 250 WORDS)
Zhonghua Xin Xue Guan Bing Za Zhi 1991 Aug
PMID:[A study on standard 12-lead ECG QRS scoring system for estimating myocardial infarct size]. 181 89

Plasma cardiac myosin light chain I(CMLCI) was quantified by competitive enzyme-linked immunosorbent assay(ELISA) using a monoclonal antibody in 42 patients with confirmed acute myocardial infarction (AMI). In comparison to the value from healthy individuals, plasma CMLCI levels were significantly elevated in 40 patients. In 28 of the 42 patients (66.7%), two major peaks were observed on time activity curves. The early peak (CMLCIp1) began a rapid rising within 4-12 hours and peaked at a mean of 25 hours following the onset of chest pain. The CMLCIp1 appeared statistically higher and earlier in patients with early infarct-related artery recanalization (IRAR) than those without IRAR, which was assessed by CPK peaking time, continuous ST segment monitoring on 12 lead ECG and symptoms. Thus, CMLCIp1 might be influenced by early IRAR. The late peak (CMLCIp2), which was composed of another gradual increase of plasma CMLCI level, occurred at a mean of 142 hours after AMI and remained elevated for about 7-10 days. The magnitudes of CMLCIp2 were correlated with the infarct size estimated by LVEF and LVWMS on cineventriculography and QRS scores on ECG. In the rest 14 patients only one peak was observed. It was suggested that CMLCIp1 could provide an early diagnosis of AMI and might be influenced by early IRAR after thrombolysis, while CMLCIp2 was a good later marker of extent of myocardial necrosis.
Zhonghua Xin Xue Guan Bing Za Zhi 1991 Oct
PMID:[Detection of cardiac myosin light chain I by monoclonal antibody in the patients with acute myocardial infarction]. 181 16

This study was designed to compare the two-dimensional echocardiography (2 DE), electrocardiography (ECG) with selective coronary arteriography in 68 patients with chest pain for the evaluation of coronary artery disease. The sensitivity of 2 DE and ECG was 86.7% and 63.2%, P greater than 0.05. The specificity of 2 DE and ECG was 76.7% and 63.3%, P greater than 0.05. In patients with coronary artery stenosis greater than 50% of the diameter, the sensitivity was relatively 93.9% and 69.7%. In patients with stenosis greater than 75% of the lumen, that was 100% and 80%. In patients with old myocardial infarction, both of the sensitivity was 100%.
Zhonghua Xin Xue Guan Bing Za Zhi 1991 Dec
PMID:[A comparative study of the two-dimensional echocardiography, ECG and selective coronary arteriography in detecting coronary artery disease]. 182 45

Clinical features of recanalization of infarct-related coronary artery during thrombolytic therapy or emergency PTCA and their correlation with immediate coronary angiography were analysed in 23 patients with acute myocardial infarction (AMI) to evaluate the predictive value of clinical criteria of reperfusion. The coronary angiography was performed before treatment and every 15 to 30 minutes during intravenous (rt-PA) or intracoronary (UK or SK) thrombolysis. Reperfusion was achieved in 16 cases by thrombolysis and in 4 cases by PTCA. The results revealed that in patients with reperfusion chest pain was relieved rapidly at least 70% in a period of 30 minutes, the ST segments fell by 50% or more from their elevated levels during a period of 30 minutes. Transient "paradoxical" increase of ST segment elevation followed by rapid falling was observed in 4 patients. This phenomenon was considered as a reliable marker of reperfusion. The changes in cardiac rhythm and conduction were noticed in 90% of the patients with reperfusion, among them accelerated idioventricular rhythm and disappearance of new-onset AVB and intraventricular conduction defects were useful bedside evidences of reperfusion, and transient significant sinus bradycardia or AVB with or without transient hypotension were useful markers of reperfusion in inferior myocardial infarction. When these clinical criteria were separately used as predictor of infarct-related coronary artery recanalization, the specificity was about 70% to 80%. Using the presence of all 3 criteria, the specificity and predictive value increased to 100% and the sensitivity was 70.6%. The time interval between onset of symptoms and peak CK and CK-MB were significantly shorter in patients with reperfusion than in those without persistent reperfusion.(ABSTRACT TRUNCATED AT 250 WORDS)
Zhonghua Xin Xue Guan Bing Za Zhi 1991 Jun
PMID:[Evaluation of clinical criteria of coronary artery recanalization in acute myocardial infarction]. 191 51

Fifty cases of clinically proven or suspected coronary artery disease (CAD) underwent dipyridamole-technetium-99m CPI (DP-99mTc. CPI) myocardial tomography imaging and coronary angiography. All cases with angiographically proven CAD had positive DP-99 mTc. CPI. The sensitivity was 100%. Six of 13 cases with normal coronary arteriogram showed false positive results (3 cases of hypertrophic cardiomyopathy and 3 cases of chest pain with unknown causes). Therefore, the specificity was 53.8% (7/13). The positive predictive accuracy of DP-99m Tc. CPI myocardial imaging was 88.0%. However, We do not consider it justified to apply this statistics to general population as our patients were highly selected. One hundred and twelve myocardial segments of left ventricle were shown to be infarcted or ischemic by either radionuclear imaging or ECG. In 108 segments with abnormal images, only 10 in patients with hypertrophic cardiomyopathy had normal coronary artery supply. Therefore, the reliability of DP-99 mTc. CPI myocardial imaging to display infarcted or ischemic segments was 91.0% (102/112). The ability for 99mTc. CPI imaging to differentiate between infarcted and ischemic lesions was somewhat indefinite, especially in case of localized infarction. The reason of this shortcoming was discussed. Ninety segments were shown to be infarcted or ischemic by ECG, 4 of which had no corresponding coronary artery stenosis. However, in 12 of the 22 segments with normal ECG pattern the corresponding coronary arteries were either occluded or stenosed, resulting in 54.5% (12/22) false negativity. Most of these false negatives were found in posterior and septal walls. Angina pectoris after dipyridamole infusion occurred in 4 of our 50 patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Zhonghua Xin Xue Guan Bing Za Zhi 1990 Dec
PMID:[The value of dipyridamole-technetium-99m carbomethoxyisopropylisonitrile (CPI) myocardial tomography imaging in diagnosing coronary artery disease]. 209 54