Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 38-year-old man with a colonic carcinoma experienced cardiogenic shock during continuous intravenous treatment with 5-fluorouracil (5-FU), without clinical or electrical signs of coronary insufficiency and with a normal coronary angiogram. His symptoms resolved after eight days of inotropic and vasodilator therapy. Because of the severity of the shock, rechallenge was not performed. This is the first case of acute cardiac failure without coronary ischemia, associated with 5-FU monotherapy. Experimental studies suggest that this adverse effect could be due to myocardial accumulation of 5-FU leading to depletion of high energy phosphate compounds. This might also explain the more frequently seen acute coronary insufficiency due to 5-FU.
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PMID:Acute myocardiotoxicity during 5-fluorouracil therapy. 235 81

It is widely known that other causes than recent coronary thrombosis may precipitate acute myocardial infarction in the presence of coronary atherosclerosis. A 48 year old male patient was admitted due to acute coronary insufficiency. The ECG showed anterolateral necrosis and lateral ischemia. Despite medication angina persisted and he died immediately after coronary angiography. At autopsy, established coagulation necrosis was observed in the internal half and the subendocardium of the lateral and posterior walls, of the left ventricle. Early coagulation necrosis occupied the inner half of the anterior, posterior and septal walls. Severe atherosclerotic coronary lesions were found in all major coronary trunks. An extensive panarteritis, involving extra and intramyocardial branches, consisting of mononuclear cells and prominent edema, was observed. A mixed mechanism may be invoked to explain the extensive myocardial necrosis: panarteritic infiltrates and extensive edema and humoral-induced coronary spasm.
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PMID:Panarteritis precipitating extensive circumferential acute myocardial infarction. A case report. 260 69

A dog heart isolated according to Langendorf was used to study the effect of verapamil, used as a preventive measure, on the contractile function of the heart, its work and oxygen consumption, and the coronary blood flow in modelled coronary insufficiency and after restoration of blood supply to the myocardium. The results provide evidence that verapamil prevents significant decrease of the efficacy of myocardial functioning in ischemia, owing to which the heart maintains a higher level of performance under conditions of inadequate blood supply, the development of acidosis is prevented, and reperfusion disorders of cardiac function are removed completely. This effect is mediated to a great measure by maintenance of high economy of heart performance due to verapamil.
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PMID:[Mechanisms of verapamil prevention of disorders of cardiac contractile function during ischemia and reperfusion]. 261 10

The authors reviewed 1474 consecutive selective coronary arteriograms performed on patients with suspected coronary insufficiency for the diagnosis of obstructive coronary disease and found 281 (19.1%) cases of apparently normal coronary arteries. These patients presented mean age of 47 +/- 10 years; they were 135 (48%) males and 146 (52%) females. The objective of this study was to obtain the hemodynamic profile of these patients for the following parameters: a) aortic and left ventricular pressures; b) volumes, ejection fraction, segmentary contraction, wall thickness and mass of left ventricle; c) morphology, mobility and competence of the mitral valve. Eight groups of patients were selected: 1) without hemodynamic alterations - 18.9%; 2) with systemic arterial hypertension - 48.7%; 3) with abnormal myocardial contraction - 16.7%; 4) with idiopathic left ventricular hypertrophy - 6.4%; 5) with mitral valve prolapse - 2.5%; 7) with myocardial bridge of the left anterior descending coronary artery - 1.8%; 8) with coronary arterial microfistula of the left ventricle - 0.4%. It is desirable to determine before situations of cardiac emergencies, whether provoked ischemia, as detected by noninvasive stress testing, is present before the performing coronary arteriography in patients, specially females, with systemic arterial hypertension, left ventricular hypertrophy, disorders of ventricular contraction or mitral valve prolapse.
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PMID:[Hemodynamic profile of patients with normal coronary cineangiography]. 261 88

There is a number of factors in favor of a different effect between the two main calcium-blockers causing bradycardia. The effects of 3 doses of verapamil 120 mg and 3 doses of diltiazem 60 mg, were compared in a double-blind study with cross-over, in 12 patients with coronary insufficiency diagnosed by coronary angiography. Four stress tests were performed in each patient, two with placebo before each treatment period and two after treatment, according to the Bruce protocol, using a computerized ECG reading system. As compared with the placebo, the two products decrease the myocardial oxygen needs, increase the duration of the stress and improve the baseline offset of the ST segment. The ischemia, demonstrated by the baseline offset of the ST segment, appears significantly less with verapamil than with diltiazem.
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PMID:[Cross-over double-blind study of verapamil versus diltiazem in effort myocardial ischemia]. 273 40

Recent clinical observations have extended our classification of unstable angina to include new groups of patients now recognized at high risk of subsequent infarction. Patients with non-Q wave myocardial infarction and those with early postinfarction ischemia share a prognosis similar to that of patients with crescendo angina or with acute coronary insufficiency. Unstable angina after coronary angioplasty and after coronary artery surgery also form particular subsets of patients. Pathologic, coronary angiographic, and coronary angioscopic studies have extended the role of the obstructive atherosclerotic plaque to include a dynamic component to explain the unstable state. Recognized dynamic components are rapid progression of the disease, active vasomotion, plaque fissuring, and thrombus formation. Activation of platelets and blood coagulation factors may play a major role in triggering the syndrome. Our therapeutic approach has also become more specific for the correction of the cause of the disease. Our understanding of unstable angina now appears to be at a turning point, and a pathophysiologic basis for its clinical classification and for its management may soon be available.
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PMID:A pathophysiologic basis for the clinical classification and management of unstable angina. 288 69

The effect of hypertension, hyperlipidemia, and the combination of both on acute and chronic myocardial ischemia were evaluated in a total of 30 male rabbits. After preliminary hypertension and/or hyperlipidemic load by loading of the abdominal aorta and/or cholesterol feeding, acute ischemia was produced by clipping of the left coronary artery. The banding produced elevation of carotid arterial pressure and left ventricular hypertrophy. Cholesterol feeding resulted in severe atheromatous changes in all sizes of coronary arteries. The intimal thickening was due to foam cell accumulation in all arteries examined. Animals pretreated with the combination of hypertension and hyperlipidemia displayed the most severe cardiolmegaly with advanced coronary atherosclerosis and chronic ischemic lesions of the myocardium, i.e., perivascular patchy fibrosis in the subendocardial area. Furthermore, electron microscopic detection of ultrastructural myocardial damage, involving glycogen depletion, sarcoplasmic edema, mitochondrial swelling, and contractile abnormalities, was also most frequent in this group. These changes were quantitated using the ischemic score. These results confirm the hypothesis that fatal ischemic injuries may occur clinically in human hearts with coronary insufficiency due to coexistence of hypertensive cardiomegaly and severe coronary atherosclerosis. They offer a model for further study of these combined effects.
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PMID:An ultrastructural study on ischemic lesions in rabbits' hearts with pressure overload and hyperlipidemia. 315 60

The long-term results of ten patients (nine male, one female) are reported, who during their initial examinations (1977) complained of the classical symptoms of a "walk-through phenomenon" (WTPH). All patients showed typical signs of coronary insufficiency in the exercise-ECG and in the wedge pressure response during exercise. Nine patients (mean age 49 years) had documented myocardial infarctions, one suffered from coronary heart disease without infarction. In seven patients coronary angiography was performed. 10 months after the beginning of the WTPH, four patients continued to show signs of ischemia during exercise after anginal symptoms had disappeared. In the other six patients the ischemia disappeared together with the loss of AP. 10 years after the first examination nine patients are still alive. One patient died in 1981 due to a subsequent infarction of the posterior wall. Three of four patients who underwent aorto-coronary bypass operation (ACB) are now without signs of ischemia during exercise. The fourth patient with ACB suffered a re-infarction in 1982. None of the other five patients are still suffering from WTPH. Exercise tolerance decreased in one and increased in three patients, all being limited by typical AP showing signs of ischemia. In the group of WTPH-patients, the low morbidity and mortality is remarkable. However, in all patients WTPH appears to be apparent only in the first few months after onset. Thereafter, WTPH changes to classical stable AP.
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PMID:[Walk-through phenomenon in angina pectoris: long-term study (10 years) of 10 patients]. 338 54

Some of the patients who suffer from cerebral ischemia may at the same time have coronary insufficiency. For such cases, not only extracranial-intracranial (EC-IC) bypass but also cardiac revascularization is considered to be necessary. One-stage surgery of both carotid endarterectomy and coronary artery bypass grafting (CABG) has not infrequently been published. However, the combination of EC-IC bypass and CABG is rarely reported in the literature. The indication of EC-IC bypass and/or CABG for such patients above stated has been searched for. In fact, CABG runs the risk of aggravating cerebral ischemia and/or intracranial hemorrhage by inevitable hypotension, hypothermia and heparinization of a large amount, while EC-IC bypass may safely be carried out so long as cardiac conditions are carefully controlled during the operation. It is consequently presumed that the preliminary EC-IC bypass followed by CABG seems to be the method of choice for simultaneous carotid and coronary ischemia. Two cases underwent the staged revascularization, first for the brain and next for the heart, with a successful result are reported in the present paper.
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PMID:[Revascularization for simultaneous carotid and coronary ischemia]. 350 Oct 72

Ion transport properties and some components of lipid structure in myocardial sarcolemma were studied under conditions of short-term acute ischemia simulated in rabbits by means of intravenous administration of vasopressin at a dose of 0.2 U/kg. The acute coronary insufficiency was accompanied by distinct alterations in the parameters specific for calcium metabolism and transport: activity of Na+, K+-ATPase and the rate of Na+Ca2+ turnover were decreased, while 45Ca-binding ability and content of Ca2+ were increased in the myocardial sarcolemma. Alterations in lipid structure, phospholipid composition of membranes and accumulation of free fatty acids appear to be responsible for the phenomenon observed. The increased rate of calcium ions transport found may occur due to alterations in the sarcolemma structure.
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PMID:[Ion-transport system and various components of sarcolemma structure during acute myocardial ischemia]. 357 53


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