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)

Patients with heart disease may have myocardial ischemia or left ventricular (LV) dysfunction without symptoms. The exercise responses of 14 asymptomatic patients with valvular aortic stenosis (AS) were studied using treadmill testing, thallium-201 scintigraphy and radionuclide angiography. Compared with age- and gender-matched control subjects, patients with AS demonstrated reduced exercise tolerance (10.7 +/- 2.5 vs 13.3 +/- 4.2 min; p = 0.06) and maximal oxygen consumption (26.7 +/- 6.3 vs 36.3 +/- 9.5 ml O2/min/kg; p = 0.004) associated with decreased peak systolic blood pressure response to exercise (177 +/- 18 vs 214 +/- 42 mm Hg; p less than 0.004). Ten of 14 patients developed ST-segment depression during exercise, only 3 of whom had reversible thallium defects. Patients with AS tended to have greater LV ejection fractions at rest (65 +/- 11 vs 58 +/- 7; p = 0.08) and significantly decreased early peak filling rates (4.8 +/- 1.3 vs 6.1 +/- 0.6 stroke volume/s; p = 0.003) compared with those of control subjects. During maximal supine exercise, patients with AS had less of an increase in ejection fraction (2 +/- 9 vs 15 +/- 7%; p less than 0.001) associated with a decrease in end-diastolic (-7 +/- 15 vs +5 +/- 16%; p = 0.06) and stroke (-6 +/- 17 vs +30 +/- 13%; p less than 0.001) volumes from baseline measurements.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Systemic and left ventricular responses to exercise stress in asymptomatic patients with valvular aortic stenosis. 174 29

The author separated a group of 22 patients with ischaemic ST depression revealed by Holter-monitoring without symptoms, and compared it with the results obtained by ergonometry testing. Angina pectoris, a key symptom on which were based many epidemiological and clinical studies, could not be considered as a reliable criterion for the evaluation of patients with ischaemic heart disorder. Non-invasive diagnostic methods (ergometry testing and Holter-monitoring) used by the author in this study were particularly significant in the establishment of early diagnostic of cardiac ischaemic disorder and detection of symptomatic and asymptomatic episodes of myocardial ischaemia. Asymptomatic myocardial ischaemia during ergometry testing and Holter-monitoring has equal importance in surviving of patients as ischaemia followed with angina pectoris. For that reason, early ischaemia are of great importance for patients' fate.
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PMID:[Correlation between the stress test electrocardiogram and Holter monitoring in asymptomatic myocardial ischemia]. 179 81

Depression and chronic fatigue are frequently associated with heart disease. They may precede the onset of myocardial infarction, singly or together, and increase the morbidity and mortality of patients with a history of MI. Virtually all such patients have a transient depression, usually accompanied by anxiety, with onset soon after hospitalization. Although this depression is transient and usually abates spontaneously, it frequently warrants therapeutic intervention. Psychosocial and personality factors play a significant role in the recovery of a patient with a cardiac condition. The clinician must be alert for the effects of changing roles within the family and behaviors that may lead to chronic invalidism. Anxiety disorders, often combined with depression, may mimic cardiac disease and may result from it, leading to chronic fatigue and weakness. Proper diagnosis usually leads to considerable improvement. Cardiac drugs, in addition to many others, may produce depression and fatigue that may be misdiagnosed. Often, discontinuing or changing a medication will lead to marked diminution of such symptoms. Observational and listening skills are key ingredients of the "art" of medicine; they can lead to interventions that are not only therapeutic, but which improve the "quality" of life.
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PMID:Depression and chronic fatigue in the patient with heart disease. 187 16

Health-related questionnaires were administered to 742 high school seniors in small towns in rural West Virginia. Students tended to overestimate the immediate threat to their health from cancer, heart disease and AIDS. They recognized a threat from auto accidents to their life and health in the immediate future, but nevertheless indulged in high-risk drinking and driving behavior. A surprisingly high percentage were concerned about stress and depression (40 percent) and suicide (11 percent). One-third of students had either planned or attempted suicide, suggesting that appropriate health education for this age group should include more emphasis on psychosocial issues and stress management.
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PMID:Adolescent perceptions of teenage morbidity and mortality in a rural population. 187 78

Previous reports have found an association between coronary vasospasm and migraine. It has been speculated that migraine and variant angina might be manifestations of a generalized vasospastic disorder. To investigate this hypothesis, 74 patients with frequent attacks of migraine were studied using 24-h continuous ambulatory electrocardiography to identify the presence of coronary vasospasm. Control groups consisted of 19 patients with tension headaches, and 38 healthy individuals. All subjects were free of heart disease. One patient in the migraine group and one patient in the control group had symptomless episodes of ST-segment depression not indicative of coronary vasospasm. Our data do not support the hypothesis that migraine and variant angina are components of a generalized vasospastic disorder.
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PMID:Lack of association of migraine with coronary vasospasm. 194 Jul 82

Resting ST segment depression has been identified as a marker for adverse cardiac events in patients with and without known coronary artery disease. To correlate this with exercise testing, coronary angiography, and how it impacts on long-term prognosis, a retrospective study was performed on 476 patients, of whom 223 had no clinical or electrocardiographic evidence of prior myocardial infarction while 253 were survivors of an infarction. All patients performed a standard exercise test and underwent diagnostic coronary angiography within an average of 32 days of their exercise test (range 0 to 90 days). Exclusions were women, those with left bundle branch block, left ventricular hypertrophy, use of digoxin, previous revascularization procedures, or significant valvular or congenital heart disease. Long-term follow-up was carried out for an average of 45 months (+/- 17). Of the patients without prior infarction, 23 (10%) had persistent resting ST segment depression, and of those with a prior history of infarction, 37 (15%) also had resting ST segment depression. Patients with resting ST segment depression and no prior myocardial infarction had a higher prevalence of severe coronary disease (three-vessel and/or left main) (30%) than those without resting ST segment depression (16%) (95% confidence interval [CI] for observed difference -5.0% to 33.9%, p = 0.12). The criterion of greater than or equal to 2 mm of additional exercise-induced ST segment depression was a particularly useful marker in these patients for the diagnosis of any coronary disease (likelihood ratio 3.35, 95% CI 0.56 to 19.93, p = 0.06). Patients with resting ST segment depression and a prior myocardial infarction had a 2.5 times higher prevalence of severe coronary artery disease compared with patients without resting ST segment depression (43% versus 17% prevalence, respectively, 95% CI for observed difference 9.38% to 42.8%, p less than 0.001) and also had larger left ventricles postinfarction (left ventricular end-diastolic volume index 102 ml/m2 compared with 96 ml/m2, p less than 0.001).(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Correlation between resting ST segment depression, exercise testing, coronary angiography, and long-term prognosis. 195 57

This is a retrospective study of cardiac patients with noncardiac chest pain referred for evaluation of esophageal motility. Sixty-eight patients with heart disease were compared with 210 patients without heart disease according to findings from symptom questionnaires and a psychologic test (Brief Symptom Inventory). More than 70% of each group qualified for an anxiety or depressive diagnosis on the symptom questionnaire. These diagnoses were supported by significant elevations of scores on the anxiety and depression scales of the Brief Symptom Inventory. Male gender and a diagnosis of panic disorder occurred significantly more often in the patients with heart disease. "Stress" was cited as the cause of illness in about half the sample, but this led to less than satisfactory rates of psychiatric evaluation or pharmacotherapy. This is of particular concern for the cardiac patients because of the known adverse effect of anxiety and depression in those with heart disease.
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PMID:Noncardiac chest pain in patients with heart disease. 206 24

Exercise testing and prescription appear to play an important role in promoting health maintenance strategies for women. Multistage exercise tolerance testing provides invaluable information in assessing the patient's functional capacity. The diagnostic significance of exercise-induced ST-segment depression is tenuous, however, in women with a low likelihood of heart disease. Research suggests that numerous physiologic mechanisms act to increase fetal tolerance to the circulatory and respiratory challenges of moderate maternal exercise. Moreover, appropriately prescribed endurance exercise programs for women are associated with the same salutary effects as men. Even more encouraging is the fact that these benefits can be attained at moderate levels of exercise--if long-term compliance is maintained.
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PMID:Exercise and fitness. 209 44

Among 1150 ambulatory 24-hour ecg recordings, those taken from 67 persons no more than 40 years old, suffering from paroxysmal unconsciousness or maladies suggesting paroxysmal arrhythmias, without clinical signs of ischaemic heart disease, valve defects, cardiomyopathies or myocarditis, were chosen for further analysis. Echocardiographic signs of mitral valve prolapse (MVP) were found in 33 persons (23 females), whereas in the next 34 persons (20 females) no evidence of MVP was noted. There were no statistical differences between ages, mean heart rates and incidences of the ST segment depression greater than or equal to 2 mm in these two groups. Prolongation of the QT interval greater than 440 ms was found in 8 persons with MVP and in 3 without MVP. Appearance of the single ventricular extrasystoles, sporadic or frequent, was almost identical in both groups. Whereas polymorphic extrasystoles and/or ventricular couplets were significantly more frequent in the MVP group. Our study shows that MVP is present in about a half of persons no more than 40 years old referring to Holter ecg because of symptoms suggesting arrhythmias, without other signs of heart disease; and that complex ventricular arrhythmias in these patients with MVP are significantly more frequent than in persons with similar complaints without MVP.
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PMID:[Evaluation of 24-hour ambulatory ECG recording in patients with mitral valve prolapse]. 209 22

Blood pressure, heart rate and electrocardiographic responses to exercise were compared in a group of 125 subjects with antibodies to Trypanosoma cruzi and in 153 seronegative subjects, randomly selected from persons with no evidence of heart disease in a resting electrocardiogram during a cross-sectional survey among apparently healthy manual workers. The mean heart rates and diastolic and systolic blood pressures of those in each group did not differ statistically at different phases of the exercise test and there was no evidence of a difference in physical fitness between those in the 2 groups. An abnormal test was recorded in 26.2% of seropositive, and in 16.1% of seronegative, subjects (odds ratio adjusted for age, sex and body mass index [OR] = 2.0, 95% confidence interval [95% CI] = 1.1-3.8). No significant difference was observed between the 2 groups in the occurrence of hypertensive response to exercise (6.4% among seropositives and 5.9% among seronegatives), ST depression greater than 1 mm (0.8% and 2.0%), supraventricular premature beats (4.8% and 2.6%) or conduction defects (0.8% and 1.3%). Complex ventricular premature beats were recorded more often in seropositive subjects (12.8% and 3.9%; OR = 3.7, 95% CI = 1.4-9.8, P less than 0.01). The risk of an abnormal test increased with age in both groups. A history of cardiovascular symptoms, gender and body mass was not associated with the risk of an abnormal response in the test. The findings suggest that exercise testing might be a routine procedure when subjects with antibodies to T. cruzi are being assessed for participation in potentially high risk activities, such as heavy manual work.
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PMID:Exercise electrocardiogram tests in manual workers with and without antibodies to Trypanosoma cruzi: a population-based study. 212 80


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