Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020473 (hyperlipidemia)
 15,891 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Between 1977 and 1990, 64 premenopausal women, under 50 years of age (42 +/- 5.6 years), were admitted for typical acute myocardial infarction with pathological Q waves. Twenty one patients had attempted myocardial revascularisation either by intravenous thrombolysis or primary angioplasty (n = 3). All patients underwent coronary angiography with selective left ventriculography during their hospital admission. This group of 64 women was characterised by the association of coronary risk factors (2.8 per patient): smoking (89%), hyperlipidaemia (67%), diabetes (45%) and oral contraception (35%). Coronary angiography showed single vessel occlusion in 86% of patients receiving oral contraception, multiple vessel disease in 36.5% and single or double vessel disease in 31.7% of the other patients. There were 3 deaths during the hospital period (4.6%), 12 cases of left ventricular failure, 2 ventricular aneurysms, 2 operated ischaemic mitral regurgitations and 9 recurrences of pain treated by angioplasty. During follow-up (36.5 +/- 4 months), 22 patients were readmitted to hospital and there were 3 further deaths, 12 cases of persistent cardiac failure, 10 cases of latent ventricular dysfunction and 9 ischaemic reoccurrences treated by angioplasty or surgery. The results in this group of patients suffering from myocardial infarction at an unusually early age for women showed that although the mortality was similar to that observed in men of the same age (9%) there was a very high morbidity and a high risk of cardiac failure. The prognosis of myocardial infarction in women, though better than 10 years ago, should improve with immediate revascularisation, the correction of cardiovascular risk factors and the rapid application of all techniques of modern cardiology.
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PMID:[Myocardial infarction in non-menopausal women. Coronary lesions and prognosis]. 764 94

A 62-year-old man with diabetes mellitus, hypertension, and hyperlipidemia was admitted to our hospital because of sudden onset of left chest pain. He was diagnosed with unstable angina with left heart failure and underwent intra-aortic balloon pumping (IABP) immediately. On the 3rd day after removal of the IABP (7th hospital day), he developed sudden paraplegia with pain. Spinal MRI on the 12th hospital day revealed a spinal swelling (Th11-L2). He was died of cardiac shock on the 19th hospital day. Autopsy examination of the spinal cord revealed a large infarct from the lower thoracic segment to the sacral segment. Microscopic examination of these areas disclosed occlusive emboli most frequently of the anterior spinal arteries including posterior spinal arteries. These emboli were found in two different forms, one consisting of new cholesterol emboli and the other of old atheromatous emboli. On autopsy, the aorta exhibited severe atherosclerosis with multiple ulcerative plaques, and there was infarction of the spleen. In our case, spinal cord infarction was caused by a massive amount of cholesterol crystals from the aorta related to IABP.
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PMID:[Spinal cord infarction due to cholesterol emboli complicating intra-aortic balloon pumping (case report and review of the literature)]. 1551 3

Although most patients with left main coronary artery stenosis undergo urgent coronary artery bypass grafting, limited information is available regarding the risk factors that might lead to cardiac events between angiographic diagnosis and surgery. We retrospectively reviewed 1,731 cases of coronary artery bypass grafting at our institution, 97 of which were performed in patients with significant (> or = 50%) left main coronary artery stenosis. These patients were placed in 1 of 2 groups: eventful waiting or uneventful waiting. We analyzed multiple preoperative variables, and the incidence of serious cardiac events (death, myocardial infarction, unstable angina, left ventricular failure, and life-threatening ventricular arrhythmias) during the waiting period between angiography and surgery Four patients (4.1%) experienced serious cardiac events while awaiting surgery (1 had non-ST-elevation myocardial infarction; 3 had life-threatening ventricular arrhythmias); none died. All the events occurred more than 24 hours after cardiac catheterization. Of the preoperative variables analyzed (acute coronary syndrome, age, history of diabetes, hypertension, hyperlipidemia, smoking, renal failure, severity of left main stenosis, right coronary artery involvement, ejection fraction, and use of intra-aortic balloon pump), only acute coronary syndrome predicted the incidence of preoperative cardiac events (P=0.001). The occurrence of severe cardiac events while patients await coronary artery bypass grafting is rare. Carefully selected patients with severe left main coronary artery stenosis can safely await surgery. Concomitant acute coronary syndrome and severe left main coronary artery stenosis indicate a high risk for cardiac events. Therefore, in patients with these conditions, emergency coronary artery bypass may be preferable.
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PMID:Left main coronary artery stenosis: factors predicting cardiac events in patients awaiting coronary surgery. 1657 64