Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An exercise test was performed in 306 patients who had had acute myocardial infarction one year previously. The five year cumulative coronary heart disease mortality was 40.0%, when the test had to be discontinued because of ventricular arrhythmias but only 13.0% if discontinued because of fatigue (P less than 0.05). If the maximum work load was less than 80 W the mortality was 30.7% compared with 16.6% in patients who exercised at least 80 W (P less than 0.01). If maximum systolic blood pressure was less than or equal to 150 mmHg mortality was 40.3% compared with 8.5% in patients with greater than 200 mgHg (P less than 0.001). The mortality was 38.2% in patients having single monoform ventricular ectopic beats at a rate of three or more per minute or multiform, paired or early cycle ventricular ectopic beats or ventricular tachycardias: this compared with 14.1% (P less than 0.001) in patients having no or only single monoform ventricular ectopic beats at a rate of less than three per minute. ST-segment depression in univariate testing had no prognostic value. When both exercise test and clinical variables were used in survival analysis (Cox's regression) the most important variable was heart volume and after that ventricular arrhythmias. In multivariate regression analysis ST segment depression also had additional prognostic value. Thus ventricular arrhythmias turned out to be the most important prognostic factor measured during exercise test.
 ...
PMID:Prognostic value of an exercise test one year after myocardial infarction. 260 37

To discover what questions nurses have been asking about cardiac rhythm responses, a literature search was conducted. A total of 57 nursing studies reported from 1964 through 1987 were identified. Research studies of cardiac rhythm responses could be grouped into four broad categories: (1) those that explored the phenomenon itself; (2) those that measured cardiac rhythm responses alone or in conjunction with other dependent variables as an index of another phenomenon such as fear, stress and anxiety, biologic (circadian) rhythms, pain severity and pain coping, sensory stimulation and overstimulation, fatigue, metabolic energy expenditure, and fetal well-being-fetal oxygen reserve; (3) those that measured cardiac rhythm responses to evaluate the safety or efficacy of various nursing interventions and routines; and (4) those that measured cardiac rhythm responses to evaluate recovery from acute myocardial infarction or cardiac surgery including evaluation of the success of cardiac rehabilitation programs. Four landmark studies that contributed new knowledge or changed practice are discussed. In addition, questions suggesting areas for future research are listed.
 ...
PMID:Cardiac rhythm responses. 2. Review of 22 years of nursing research. 264 80

Recent work has now clearly established that coronary arterial thrombosis is the direct cause of acute myocardial infarction. This thrombotic event occurs when a pre-existing atherosclerotic plaque ruptures or fissures, thereby exposing underlying thrombogenic material to the circulation. Platelets are thus activated and the clotting cascade is initiated. It is as yet unclear why a previously stable atherosclerotic plaque should fissure or rupture. However, suggested mechanisms include release of vasoactive substances from activated platelets, coronary arterial vasomotion, mechanical stress fatigue of the atherosclerotic plaque, and rupture of vasa vasorum within the atherosclerotic plaque. The resultant cessation of myocardial blood flow produces specific biochemical and physiological alterations secondary to myocardial ischemia. Intracellular acidosis, loss of high-energy phosphates, reduced sensitivity of contractile proteins to calcium, and accumulation of inorganic phosphate and lipid, all occur within the ischemic myocyte. Diastolic compliance is markedly reduced by ischemia followed by cessation of systolic contractile activity. Most of these alterations are reversible if ischemia is relieved promptly. Prolonged ischemia leads to delayed biochemical and physiological recovery and/or cell necrosis.
 ...
PMID:The pathophysiology of acute myocardial infarction. 266 57

Labetalol is a unique antihypertensive agent which is a competitive peripheral antagonist at both alpha- and beta-adrenoceptor sites. Clinically, it possesses about one fourth of the beta-adrenoceptor blocking activity of propranolol and one half of the alpha-adrenoceptor blocking activity of phentolamine with a beta- to alpha-blocking ratio of approximately 7:1. Nowadays, the clinical profile of labetalol is clearly defined. Perorally, it has often been used in the treatment of mild, moderate and severe hypertension and intravenously in the management of hypertensive emergencies. It offers many advantages over beta-blockers with no prominent side-effects. Hemodynamically, labetalol reduces blood pressure, heart rate and, first of all, peripheral resistance with almost no change in resting cardiac output or stroke volume. Labetalol appears to be useful particularly in patients whose blood pressure is not adequately controlled by beta-blockers alone or combined with a diuretic, but sometimes at the expense of postural hypotensive side-effects. It has proved to be safe in patients with coronary artery disease or after acute myocardial infarction and in pregnant patients, but in phaechromocytoma further clinical experience is needed. In induced hypotension during anesthesia and surgery no invasive blood pressure measurements are needed. The most frequent adverse effects include fatigue, postural hypotension, headache and gastrointestinal complaints. On the whole, labetalol expands the armamentarium of the practising physician in the treatment of hypertension of different origin.
 ...
PMID:Current status of labetalol, the first alpha- and beta-blocking agent. 286 49

We investigated exercise capabilities of the elderly patients with significant coronary artery lesions and angina pectoris. The heart rate increased according to workload, but there were few cases in which maximal heart rate was obtained. There was a marked increase in VO2 at endpoint before sufficient work load was achieved. It suggested an increase in O2 demand of the myocardium and entire body. Left ventricular dysfunction from skeletal muscle fatigue and work load-induced myocardial anoxia were also suggested. The conditions of coronary arteries of aged patients and the method of treatment were studied on the basis of coronary angioplastic findings and exercise tolerance. We reviewed percutaneous transluminal coronary angioplasty (PTCA) performed in 49 aged patients (older than 70 years) with angina and investigated long-term results. In this group including 18 patients (43%) with multivessel disease, there was a high success rate (90%), and significant improvements in workload responses were achieved in early stages after PTCA. The rate of recurrence was higher in this group than non aged patients, however, angioplasty was repeated successfully in all of the patients. Dilated sites were recognized as patent in a majority of patients. Late cardiac events occurring six months after PTCA were acute myocardial infarction in only one case (2.2%) and unstable angina in three cases (6.8%). There was no cardiac death. The five-year cumulative survival rate was high (97%). During a follow-up interval of averaged 32 months, chest pain disappeared in 70% of patients and 48% enjoyed daily life without restriction. Since the quality of life appears to be improved and long term results are sufficiently acceptable, we concluded that PTCA is highly recommended for the elderly patients.
 ...
PMID:[Clinical characteristics of ischemic heart disease in the aged: significance of coronary revascularization and role of PTCA]. 327 11

Twenty-eight patients younger than age 40 years, treated for Hodgkin's disease with mediastinal irradiation, were examined no less than 5 years after the irradiation in order to evaluate the frequency of cardiac abnormalities. Twelve patients (43%) had had some pericardial event after radiation: a diagnosed pericarditis, remarkably increased heart volume, or a conspicuous change of cardiac silhouette, suggesting pericardial fluid. On evaluation, 50% of the patients complained of symptoms, and 13 patients had to stop the exercise test on a low level because of chest pain, dyspnea, or general fatigue. In 13 patients some of the following abnormalities in the electrocardiogram (ECG) was found: right bundle branch block (four), first-degree atrioventricular block (four), abnormal P terminal force (five), or a low voltage (two). In ten patients (38%) an increase of the pericardial fluid was seen in the echocardiogram, and in nine patients the right ventricle wall thickness had increased. In two patients a severe coronary artery disease was found. One died suddenly after an acute myocardial infarction (AMI), and the other had a large anterior AMI. Two patients with chronic pericardial fluid underwent partial pericardectomy. Two cases of mild pulmonary valve stenosis, one pulmonary subvalvular stenosis and two aortic valve deformities were discovered. Eight patients went through cardiac catheterization, and in all but one case the pressures were slightly elevated suggesting diminished diastolic compliance. In summary, 19 of 28 patients had some abnormal cardiac findings, but only three of them were serious ones.
 ...
PMID:Late cardiac effects of mediastinal radiotherapy in patients with Hodgkin's disease. 358 Oct 32

The relation between exercise left ventricular ejection fraction and blood pressure (BP) responses after an acute myocardial infarction (AMI) was investigated. Twenty-eight to 37 days after an uncomplicated AMI, 224 consecutive patients underwent exercise radionuclide angiography in the 40 degrees semisupine position. In 180 patients (group A, 80%), BP increased more than 5 mm Hg every stage; in 44 patients, BP responses were abnormal; in 33 (group B, 15%), BP did not increase during 2 stages; in 11 (group C, 5%), it decreased more than 5 mm Hg after an initial increase. Ejection fraction did not differ significantly among the 3 groups at rest (51 +/- 13 in group A, 50 +/- 18 in group B, 47 +/- 13 in group C [difference not significant]) or at peak exercise (51 +/- 16% in group A, 46 +/- 19% in group B, and 43 +/- 16% in group C, [difference not significant]). Exercise-induced left ventricular failure or hemodynamic decompensation occurred in 22 patients. In these patients, ejection fraction at rest was 44 +/- 19% and decreased to 35 +/- 16% (p less than 0.05) with exercise. Only 9 of these patients (41%) had abnormal BP responses, with the other 13 (59%) showing a normal BP responses. The The 35 patients with abnormal BP responses in the absence of hemodynamic decompensation were asymptomatic, terminating exercise because of fatigue. The ejection fraction at rest and during exercise in these patients was similar to that in patients with normal BP responses.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Significance of abnormal blood pressure response during exercise-induced myocardial dysfunction after recent acute myocardial infarction. 359 78

This investigation was undertaken in patients who had an acute myocardial infarction 12.6 +/- 0.4 months earlier to determine, using conventional methods, the nature of stroke volume changes during training regimens. Twenty-seven patients (mean age 52 +/- 2 years; rest ejection fraction 49 +/- 2%; New York Heart Association functional class I or II) and 9 normal, age-matched sedentary control subjects (mean age 50 +/- 1 years) exercised in the upright position on a bicycle ergometer. Stroke volume was measured by impedance cardiography at rest and after each workload. Ten patients (group A) had a stroke volume response similar to that of the normal sedentary subjects. In 8 patients (group B) the stroke volume increased initially, then decreased (more than 15%) at heart rates (HRs) greater than 100 to 105 beats/min. Nine patients (group C) had a flattened stroke volume response throughout exercise. Training HR determined by conventional methods corresponded to a maximal stroke volume in the normal subjects. Training HR in group A corresponded to a stroke volume that was maximal or near-maximal. Training HR in group B corresponded to a maximal or diminishing stroke volume. In group C, the training HR corresponded to a stroke volume no different from that at rest. Thus, training HR determined by conventional methods based solely on the chronotropic responses to exercise may place patients who have abnormal stroke volume responses to upright exercise in a situation during training sessions in which an inappropriately high HR, excessive fatigue or silent ischemia may develop.
 ...
PMID:Importance of considering ventricular function when prescribing exercise after acute myocardial infarction. 377 45

The Beta-Blocker Heart Attack Trial was a multicenter, randomized, double-blind, placebo-controlled trial of propranolol therapy in 3837 men and women with acute myocardial infarction. The patients began their treatment 5-21 days after hospital admission (mean 13.8 days). During an average follow-up of 25 months, there were statistically significant reductions in total mortality (26%), cardiovascular mortality (26%), arteriosclerotic heart disease (27%), sudden death (28%) and coronary incidence (definite nonfatal reinfarction plus coronary heart disease mortality) (23%). There was no group difference in incidence of congestive heart failure. Of the many potential side effects that were monitored, broncho-spasm, cold hands and feet, and fatigue occurred more frequently in the propranolol group. Propranolol not only reduced coronary mortality and morbidity, but also was administered with a great degree of safety. Based on these results, its use is recommended for at least 3 years in patients with no contraindications to beta blockade who have had a recent myocardial infarction.
 ...
PMID:Propranolol therapy in patients with acute myocardial infarction: the Beta-Blocker Heart Attack Trial. 634 40

One hundred and twenty patients underwent a symptom limited submaximal exercise test (SSET) 8-40 days after acute myocardial infarction. No complications occurred during the exercise test. Sixty-two patients (52%) showed a normal SSET. ST-segment depression (greater than or equal to 1 mm) was detected in 21 (17.5%). Dyspnea, fatigue, inadequate blood pressure response and angina pectoris without changes in ST-segments were the end-point in 33 patients (27.5%). Furthermore, significant premature ventricular contractions occurred in four cases (3%) and limited the SSET. An SSET soon after myocardial infarction can be performed without risk. High specificity of ST-segment depression in lead V5 was confirmed by the coronary angiographic findings. Apart from ST-segment depression there were other, more frequent nonspecific end-points of SSET which require further examination regarding their prognostic value.
 ...
PMID:[Early ergometry following acute myocardial infarction?]. 665 9


<< Previous 1 2 3 4 5 6 7 Next >>