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

The antecedents of myocardial infarction have been reviewed in 102 patients (117 episodes) undergoing a program of rehabilitation. The year prior to the first attack was characterized by business and social problems, with some weight gain; in the week before the attach there was added tiredness, poor general health and, in some cases, increasing anginal pain. Heavy lifting and/or unusual exercise were common immediately before or during an attack; five attacks were related to the shovelling of wet snow.Both bed and the normal place of work were uncommon sites for an attack. More than 50% of patients had 30 minutes' warning of infarction. The relevance of these findings to a safe program of therapeutic exercise is discussed.
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PMID:The immediate antecedents of myocardial infarction in active men. 471 86

We have reviewed the histories of 320 patients in whom a diagnosis of coronary heart disease was ultimately established and traced the symptoms back to their first appearance. In 51% the first symptom was effort angina. Difficulties in recognition arose when the symptom was localized to an unusual site, when its occurrence was dependent on a combination of exercise with cold or a recent meal, or when it was induced by excitement rather than by effort. In a quarter of the cases the onset of angina was abrupt, and in these there was usually evidence of acute infarction.In 43% of cases the first symptom was an attack of pain or discomfort in the torso occurring without any discernable precipitating factor. Again, diagnosis was difficult when the pain was in an atypical site and also when it was of brief duration associated with skeletal or abdominal disease which could cause pain at the same site, or if the patient was able to undertake strenuous exertion. In four patients cardiac pain was first experienced during a paroxysm of tachycardia. In 6% of cases the onset was marked by a symptom other than pain-most frequently dyspnoea, tiredness, faintness, or syncope.Clinical examination was of no direct value in diagnosis. Its importance lay in disclosing factors which had to be taken into account in interpreting the electrocardiogram. The electrocardiogram was invaluable, though by no means infallible. In over half of the patients the first tracing showed major abnormalities of coronary type, and nearly a quarter more showed minor S-T/T depression consistent with coronary disease. Ten per cent. showed miscellaneous abnormalities, such as left ventricular hypertrophy or bundle-branch block, and 15% no definite abnormality.There is as yet no completely reliable objective method of diagnosing early coronary heart disease, so that the recognition of symptoms remains of paramount importance.
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PMID:Earliest symptoms of coronary heart disease and their recognition. 502 16

Timolol is a new beta blocker with cardioselective properties. A single blind controlled study was performed to assess the efficacy of timolol maleate in doses of 10 to 30 mg per day in 20 patients affected by stable angina pectoris. The patients received a placebo for a baseline period of 2 weeks, followed by 12 weeks of timolol. The number of anginal attacks dropped from 14.9 attacks per week in the baseline period to a minimum of 4.6 attacks per week in the sixth week of treatment (P less than 0.01). The number of tablets of nitroglycerin taken per week was reduced from 6.5 during the baseline period to 2.3 in the sixth week of treatment. Resting heart rate decreased from a baseline mean value of 72 beats per minute to 51.7 and 53.7 per minute at weeks 6 and 12 respectively (P less than 0.01). Blood pressure both at rest and during exercise was significantly reduced. The mean work index measured during bicycle ergometry was 127 units before treatment; it increased by 29.4 units and 36.1 units during week 6 and week 12 respectively (P less than 0.05). There was a marked symptomatic improvement in 50% of the patients. Mild fatigue was a common side effect but it disappeared following reduction of dose. We concluded that timolol maleate significantly reduces the number of anginal attacks and increases the work capacity of patients affected by stable angina pectoris
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PMID:The beneficial effect of the beta blocker timolol in stable agina pectoris. 610 80

The long-term efficacy of once-daily atenolol cardioselective beta-blockade therapy for chronic stable angina pectoris was studied in nine coronary disease patients. After a placebo-controlled single-blind dose-ranging trial with 2-week drug periods of 25, 50, 100, and 200 mg, they continued on 100 or 200 mg daily for 1 year. Treadmill exercise test (ET) were performed at times at peak and trough serum atenolol concentrations and 24-hour ECG ambulatory recordings were obtained after placebo, after 2 weeks of 100 and 200 mg atenolol, and after 2 weeks of 100 and 200 mg atenolol, and after 3, 6, 9, and 12 months of 100 or 200 mg atenolol. During early and chronic atenolol therapy, angina frequency and nitroglycerin consumption were decreased (p less than 0.01 to less than 0.001). Twenty-four hour ECG and ET showed sustained heart rate suppression. Exercise duration until angina onset was prolonged during all periods of atenolol administration. Maximal improvement in exercise tolerance and angina relief was not reached until 3 months of atenolol therapy despite stable serum drug concentrations. During the 14 months fatigue occurred in three patients which was dose-limiting in only one. Thus atenolol 100 or 200 mg given once daily, proved well-tolerated and potent anti-ischemic myocardial actions which were effectively maintained during chronic therapy of angina pectoris.
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PMID:Long-term benefit of cardioselective beta blockade with once-daily atenolol therapy in angina pectoris. 611 Dec 12

A single-blind study of prenalterol 20-200 mg daily in a slow-release tablet preparation and a placebo was performed in 15 patients with moderate to severe congestive heart failure (NYHA II-IV) to evaluate the haemodynamic and clinical effects of oral prenalterol. Non-invasive parameters in the measurement of cardiac output, stroke volume, pre-ejection period index (PEPI), PEP/LVET ratio, ejection fraction and mean Vcf were significantly improved, indicating beneficial effects of prenalterol on cardiac contractility. Systolic blood pressure, heart rate and rate-pressure product were slightly increased at rest but were considerably lower during exercise. Arrhythmogenecity was not seen in the patients studied. Subjective improvement was noted in the majority of patients as evidenced by a decreased frequency of dyspnoea, fatigue and angina. Unwanted effects, such as palpitations and transmitted arm pulsations, were transient and disappeared with dose adjustment, while the inotropic effect of the medication was maintained. The clinical response appeared to be sustained for up to 2 weeks of treatment, indicating non-development of tachyphylaxis.
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PMID:Effects of prenalterol administered orally in patients with congestive heart failure. 612 90

Within the general population people destined for myocardial infarction are found to be more obsessional and greater worriers than others. Moreover, in the year before their infarction they display high levels of sadness, anxiety-related symptoms, loss of libido, and fatigue, unrelated to angina and other physical discomforts. They also claim, more so than others, to have no fear of having an incurable illness. Derived optimum weightings to responses to items in the Crown-Crisp Experimental Index permit the development of a simple scoring system which in the present study allows a two-thirds correct identification of those due for imminent infarction and an overall 81.5% correct classification of infarct/non-infarct cases. This apparent capacity of the instrument now needs to be tested in a prospective study. In the year after infarction survivors in the present study show very high levels of dysphoria and social withdrawal.
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PMID:Myocardial infarction and the emotional climate. 614 17

The cardiocirculatory actions of the oral vasodilator prazosin were evaluated by cardiac catheterization, forearm plethysmography, echocardiography, treadmill exercise, and symptoms in patients with advanced long-standing congestive heart failure. The administration of oral prazosin (2-7mg) reduced forearm venous tone and forearm vascular resistance. Concomitantly, mean systemic arterial pressure and left ventricular filling pressure decreased, and the cardiac index increased. These effects of a single dose of prazosin on left ventricular function were rapid in onset, maximal at 1 h, and sustained for the entire 6-h period of observation. After 2 weeks of outpatient therapy with 2-7 mg of prazosin four times daily, echographic end-diastolic dimension decreased, whereas the duration of treadmill exercise increased. Symptoms (dyspnea, fatigue, angina) were diminished throughout the course of prazosin therapy, and there was an improvement in the New York Heart Association functional class from 3.7 to 2.2. Thus, prazosin possesses sustained nitroprusside-like balanced dilator actions on the systemic arterial and venous beds, which are effectively translated into the beneficial hemodynamic effects of augmenting cardiac output and relieving excessive left ventricular end-diastolic pressure. The delayed vasodilator tolerance that occurs in 30% of the patients is prevented by the prior use of aldosterone antagonists, and is easily treated when present. Subacute hemodynamic suppression of beneficial prazosin vasodilator actions is transient and does not preclude successful sustained prazosin therapy of severe heart failure.
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PMID:Importance of neuroendocrine regulators of vascular tone and integral adrenoreceptor interaction during oral vasodilator therapy of severe congestive heart failure with prazosin. 617 36

The relationship of low-back pain (LBP) to other diseases and to cardiovascular risk factors was studied in a random sample of 940 men from 40 to 47 years of age. The life-time incidence of LBP was 61%, the prevalence 31%. The prevalence of other diseases was the same as in previous studies in the same region. In a univariate analysis nine variables were found to be correlated to LBP; angina pectoris, calf pain, breathlessness on exertion, smoking, physical activity at work and during leisure time, worry and tension, fatigue at the end of the workday, and perception of stress. When the influence of other variables was assessed by analysis of covariance, four of the variables maintained a direct association with LBP, viz, calf pain on exertion, smoking, a high physical activity at work, and a frequent feeling of worry and tension.
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PMID:Low-back pain in relation to other diseases and cardiovascular risk factors. 622 18

The cardiocirculatory actions of prazosin (PZN) orally were evaluated by cardiac catheterization, forearm plethysmography, echocardiography, treadmill exercise, and symptoms in patients with advanced long-standing congestive heart failure (CHF). PZN orally (2 to 7 mg) reduced forearm venous tone and decreased forearm vascular resistance. Concomitantly mean systemic arterial pressure declined, left ventricular filling pressure (LVFP) decreased, and cardiac index (CI) was raised. These effects of a single dose of PZN on LV function were rapid in onset, maximal at 1 hour, and sustained for the entire 6 hours of observation. After 2 weeks of outpatient therapy with 2 to 7 mg PZN four times daily, echographic LV end-diastolic dimension decreased and the duration of treadmill exercise increased. Symptoms (dyspnea, fatigue, angina) were diminished throughout the course of PZN therapy, and New York Heart Association functional class improved for III to II. Thus PZN possesses sustained nitroprusside-like balanced dilator actions on the systemic arterial and venous beds, which are effectively translated into beneficial hemodynamics of augmenting lowered cardiac output and relieving excessive LVFP. Delayed vasodilator tolerance, occurring in 30% of patients, is prevented by prior use of aldosterone antagonists and is easily treated. Subacute hemodynamic suppression of beneficial PZN vasodilator actions is transient and does not preclude successful sustained PZN therapy of severe chronic CHF.
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PMID:Management of refractory congestive heart failure with prazosin. 626 22

Heart rate and blood pressure responses to low-level exercise tests in patients immediately before and after coronary artery bypass graft surgery lack sufficient documentation. This study documents heart rate, blood pressure, electrocardiographic responses and symptoms during low-level treadmill tests (LLTT) of 19 patients in two subgroups (A and B) before surgery, and again the day before hospital discharge. Preoperatively, the most common reason for stopping the treadmill test early was onset of angina. Postoperatively, patients stopped due to fatigue (4), dyspnea (6), and dizziness (2). Mean resting heart rate responses increased 37% in group A (n = 9) and 40% in group B (n = 10) from the preoperative to postoperative test. Mean postoperative resting pressure rate product responses increased 16% in group A and 38% in group B compared to preoperative values. Mean resting systolic blood pressure responses were 15% lower postoperatively for group A. This LLTT proved to be a clinically feasible tool which provided objective information about the patient's readiness for discharge and exercise prescription.
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PMID:Low-level exercise testing before and after coronary artery bypass surgery. 633 62


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