Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A man with known coronary heart disease underwent treadmill exercise testing to determine his functional capacity. The test was negative for ischemia. Ventricular ectopic activity was noted at rest and in the recovery period. On the same day, while viewing a sporting event at home, the patient died suddenly. An ambulatory electrocardiographic recording documented ventricular fibrillations as the terminal mechanism. Ventricular ectopic activity and heart rate increased in the two hours prior to death, and ischemic ST-segment depression was noted at the time of the terminal arrhythmia. It is postulated that myocardial ischemia and catecholamine response lowered the threshold to ventricular fibrillation, thus facilitating the emergence of the fatal arrhythmia.
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PMID:Sudden death during ambulatory monitoring. Clinical and electrocardiographic correlations. Report of a case. 83 Feb 11

ST segment depression in 12-lead resting and single-lead or multi-lead exercise ECGs is a useful screening criterion for detection of coronary heart disease (CHD). The recommended minimum frequency specification for direct-writing ECG recorders is 0.05-100 Hz (-3 dB). ST segment distortion by unintention low- and high-side frequency filtration could possibly weaken this screening capability. Consequently, one low- and two high-side potential filtration causes of such distortions were investigated in resting and exercise recordings of normal and both J-junction and ST-depressed ECGs. Of 4,914 filtered ST segments, 365 ST category changes were observed. Of these changes, approximately 15% was produced by filtration of the 0.05-0.1 Hz (amplifier function) and 45-100 Hz (60-Hz "noise" filtering) frequency bands. The remaining 85% was attributable to filtration of the 23-45 Hz (stylus overpressure) band. An optional remedy is discussed.
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PMID:ST segment distortions by high-side frequency filtration in direct-writing ECG recorders. 85 56

Variations in clinical noninvasive systolic pressure at the point of symptom-limited exercise on a treadmill were examined in six groups of subjects: 5,459 men and 749 women classified into three categories each. Among the men, 2,532 were asymptomatic healthy, 592 were hypertensive and 1,586 had clinical manifestations of coronary heart disease (that is, typical angina pectoris, prior myocardial infarction or sudden cardiac arrest with resuscitation). Among the women, 244, 158 and 347 were in the corresponding clinical categories. None had had cardiac surgery; all had follow-up status ascertained by periodic mail questionnaires. Reported deaths were reviewed and classified by three cardiologists; 140 deaths were attributed to coronary heart disease, 118 of them in the men classified as having coronary heart disease. The majority of maximal systolic blood pressure readings were reported to the nearest centimeter rather than millimeter of pressure. Retesting of 156 persons from 1 to 32 months later showed that pressure values agreed within 10 percent in two thirds, the overall mean difference was only 8.6 mm Hg and the correlation at maximal exercise was superior to that of the resting observations just before exercise. Hypertensive patients had a significantly greater body weight than normotensive persons. Among men, the lowest maximal systolic pressure was observed in the group with coronary heart disease; among women, the lowest mean pressure was found in the healthy group. Patients with coronary heart disease were slightly older, and only the women showed a significant correlation in maximal pressure with age. Only 5 percent of the variation in maximal systolic pressure in the patients with coronary heart disease was due to a shortened duration of exercise. Maximal systolic pressures correlated fairly well (r equals 0.46 to 0.68 for the various groups) with resting systolic pressure, and this relation was independent of the diagnosis of cardiovascular disease in both men and women. Relations between pressure and the number of stenotic coronary arteries and imparied ejection fraction at rest were examined in 22 men without and 182 men with coronary artery disease. Lower maximal systolic pressures were often associated with two or three vessel disease or reduced ejection fraction, or both. The prognostic value of maximal systolic pressure for subsequent death due to coronary heart disease was examined in the men with coronary heart disease. The annual rate of sudden cardiac death decreased from 97.9 per 1,000 men to 25.3 and 6.6 per 1,000 men as the range of maximal systolic pressure increased from less than 140 to 140 to 199 and to 200 mm Hg or more, respectively. Cardiomegaly, Q waves in the resting electrocardiogram and persistent postexertional S-T depression were more common in men with the lowest systolic pressure at maximal exercise.
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PMID:Variations in and significance of systolic pressure during maximal exercise (treadmill) testing. 87 Nov 10

A 40 year old man with far advanced coronary heart disease consistently experienced pain and exhibited marked S-T segment depression after 44 crossings during a Master two-step test. When the number of times traversed was miscounted so that he exercised less, the pain occurred at the precise count of 44 and he showed the same marked degree of S-T depression. However, when the count was accurate, he had neither pain nor S-T segment deviation at the reduced exercise level. The possible basis for verbal conditioning provoking angina pectoris is explored.
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PMID:Verbal conditioning of angina pectoris during exercise testing. 91 Jul 28

Acute normavolemic hemodilution is a mean of autotransfusion and allow hepatitis prophylaxis in major surgical procedures which general require homologous blood transfusions. The dilutional drop in blood viscosity is followed by an increased cardiac output, while blood pressure and heart rate remain stable. The CO incerase compensates for the reduced oxygen capacity of the diluted blood. Hemodilution was applied in a total of 88 patients. In 46 cases thorough circulatory and laboratory investigations were performed. While an average of 1785 ml blood was withdrawn and replaced synchronically by plasma substitutes, hematocrit was lowered to 24.8% mean and CO rose from 4.4 to 6.01 l/min. In one half of the patients side reactions were observed that occurred in combination as a syndrome in 8 patients: rise in systemic blood pressure and pulmonary artery pressure, disproportional CO increase, peripheral vasoconstriction, and ST-depression in ECG. The possible pathomechanisms of these side reactions are discussed. A sympathetic adrenergic reaction could be excluded by catecholamine estimation. Hyposia may be assumed to be the more probable reason. Since severe side reactions only occured at hematocrit levels below 26%, the dilution waslimited lately to hct 27%. Patients with coronary heart disease, age greater than 70 years, and anemia less than 12 g% hgb were excepted. In 70% of major surgical procedures, e.g. colonic surgery, homologous blood becomes necessary, in 50% in the amount of 2-4 units. The corresponding blood loss of 1000-2000 ml may be compensated by acute normovolemic hemodilution and autotransfusion. In fact, only 15% of our patients required homologous blood transfusions.
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PMID:[Clinical experiences with the acute normovalemic hemodilution (author's transl)]. 96 Nov 42

Cardiac glycosides may cause in the exercise ECG of healthy persons S-T segment depressions, which imitate a coronary insufficiency. If this method of examination is to be carried out in diagnosing coronary heart disease, it is - therefore - recommended in many cases to discontinue, at all events, an eventual digitals therapy before the examination in order to avoid falsely positive results. 23 healthy men (average age 30.2 years) were applied digoxin of medially quick saturation over seven days. Exertion electrocardiograms at the bicycle ergometer were registered before and after digoxin application. In five further cases, plasma glycoside concentrations were evaluated by 86Rb erythrocyte assay; upon the degree of saturation used, these concentrations - on the sixth and seventh day - amounted to x = 1.03 ng/ml. The following items manifested after digoxin administration, under stress and after resting: Retardation of heart rate, declination of T amplitude, and individually to a very different extent - depression of the S-T segment. After application of digoxin, only 8 of the 23 test persons demonstrated S-T depressions that would have corresponded entirely to the conditions of a "coronary insufficiency". Thus, it appears to be justified to carry out - first of all and in order to exclude the possibility of a coronary insufficiency - an exertion electrocardiogram, without interruption of the glycoside therapy, also in patients who are undergoing a digitalis therapy. The reason for this measure is the fact that in healthy persons only one third of the cases must be expected to show a falsely positive result. If, however, significant S-T depressions occur, the examination has to be repeated after a sufficiently long-lasting glycoside-free interval.
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PMID:[Influence of digoxin upon the exercise ECG of healthy men (author's transl)]. 100 53

A new agent, Molsidomine, with anti-anginal effect was investigated in 43 patients with coronary heart disease by means of 121 exercise tolerance studies. A good effect was observed 1 hour after sublingual or enteral absorption of 2 mg, which was comparable to 20 mg of Isosorbiddinitrate administered sublingually. Recorded and evaluated were the depression of ST-segment in the ECG, heart rate, systolic and diastolic blood pressure as well as subjective parameters. In comparison to the controls there was a highly significant reduction of anginal pain and ST-depression equivalent to that obtained 1 hour after Isosorbiddinitrate. The effect of Molsidomine could be established already 10 min after sublingual administration and sustained 5 to 6 hours afterwards with a highly statistic significance after sublingual as well as after enteral absorption. Side effects were noticed in 3 out of 43 patients, 2 of them with headache. The remarkable advantages of the drug are to be seen in its simple dosage and administration, its good tolerability, and its intrinsic retard-effect. A combination with beta-blocking agents seems to be possible in the same way as with Isosorbiddinitrate.
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PMID:[Studies on the influence of Molsidomin on coronary heart disease (author's transl)]. 100 55

ST-segmental depression below the isoelectric line in the ECG occurring under a therapy of sub-therapeutical and therapeutical digitalising doses, very often involves an increase of pre-existent stress stenocardia with cardiovascularily compensated patients having a coronary heart disease. For this purpose, 13 patients of both sexes with latent coronary insufficiency were examined. The patients were treated with beta-Acetyldigoxin i.v. and were controlled under bicycle ergometric test-conditions before as well as during the different saturation phases with digitalis (0.66 +/- 0.03 mg, 1.20 +/- 0.07 mg and 1.54 +/- 0.10 mg beta-Acetyldigoxin) in a miximum of 4 functional tests alltogether. Dose-depent depression of the ST-segment accurred regularly accompanied by a reduction of the T-wave amplitude. A comparative valuation of myocardischemic and glycoside conditioned repolarisation disorders in the ECG demonstrated formalanalytically no differences concerning differential diagnosis. With the appearance of digitalis conditioned ST-T-changes an increase of angina pectoris could be proved. There were hints that the so-called adhesive signs of digitalis are an expression of myocardial ischemia and therefore principally of diagnostic value.
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PMID:[ST-line and T-wave changes unter influence of different digitalis doses within the therapeutic range (studies of patients with stress coronary insufficiency)]. 101 99

In 17 patients with coronary heart disease the effects of the beta-active agent L-3-(beta-hydroxy-alpha-methyl-phenethyl-amino)-3'-methoxy-propiophenone (oxyfedrine, Ildamen) were proved at rest and during atrial pacing by measurements of coronary venous O2-saturation, myocardial lactate extraction, angina threshold and ST-segment depression. In 88% oxyfedrine had antianginal effectivity with rise in angina threshold (+11%), reduction of ST-segment depression (--48%) and reduction of lactate production(--63%). The rise in coronary venous O2-saturation ("35%) and the electrocardiographic and metabolic reduction of hypoxic reaction indicate the improvement of nutritional coronary flow. Therefore improvement of myocardial O2-balance is derived from the reduced energy requirement by decrease of heart size and ventricular wall tension and the rise of myocardial O2-supply by coronary dilation in spite of the increased energy requirement by ascending contractility. Conclusively the application of oxyfedrine is preferred in coronary heart disease with simultaneous congestive heart failure.
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PMID:[The effect of oxyfedrine on cardiac performance in coronary patients. Tests using electrocardiographic and metabolic parameters in atrial stimulation]. 110 98

Measurement of the sinus node recovery time has been proposed as a diagnostic tool for recognition of the sick sinus syndrome. The latter is most frequently encountered in elderly patients with hypertension, coronary heart disease, and atherosclerosis. In order to provide normal values for the sinus node recovery time in this particular population group, atrial pacing studies were carried out in 30 subjects over 50 years of age, all with peripheral vascular disease and some with angina pectoris (10), residua of infarction (6), or hypertension (7). On stimulation, 7 patients maintained a I:I atrioventricular conduction up to the rate of 180/min. Second degree atrioventricular block developed in all other cases. On six occasions, Wenckebach's periods appeared at the relatively slow pacing rate of 120/min. The maximum postoverdrive pause ranged from 680 to 1600 ms with an average of 1100 ms plus or minus 190 (10). For each pacing speed, a correlation was found between the duration of the pause and the control intrinsic cardiac rate, longer pauses being associated with longer resting PP intervals. Beyond 120/min, the duration of the pause was seen to shorten progressively as the driving rate was increased. Finally, the behavior of the sinus node pacemaker following interruption of pacing showed individual variations. After pacing at relatively slow rates, a prompt return to near control values was consistently observed, whereas, after fast rates of driving, a phase of secondary depression developed in about one-half of the studied cases.
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PMID:Sinus node recovery time in the elderly. 112 18


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