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

A 29-year-old man had a febrile illness accompanied by chest pain and tachycardia. The ECG suggested either myocarditis or acute ischemia. Heart muscle enzymes were normal, the peripheral blood count showed absolute and relative lymphocytosis, and an echocardiogram disclosed a small pericardial effusion. After defervescence, splenomegaly was noted and the SGPT level was elevated to four times normal. There was a greater than fourfold rise in titer of IgM antibodies to cytomegalovirus. This is only the second report in detail of perimyocarditis caused by cytomegalovirus mononucleosis. An interesting aspect of the case was an afebrile prodrome that lasted for more than one week, during which prostration, palpitations, and breathlessness on exertion were present and the sole physical finding was tachycardia.
 ...
PMID:Perimyocarditis. Report on an unusual cause. 253 10

We describe the case of a 23 years old male, who suffered a 45 bullet wound in the arm and upper right hemithorax. He walked after his injury and 10 minutes later presented dizziness, cough and tachycardia. On admission a minor haemothorax was seen on a chest X ray, but the bullet was not seen. Even without symptoms, an X ray of abdomen showed the missile lying above the left sacroiliac joint. A chest tube was placed, the patient had an excellent recovery and was discharged a week later. After several months he presented hemoptysis and a moderate pain on his right chest and was treated as an acute bronchitis. Six months after his initial injury he developed a florid picture of acute pulmonary embolism (chest pain, dyspnea, hemoptysis, tachycardia, severe cough). A new chest X ray was done and the bullet was shown lying in the right chest. A pulmonary arteriography located it in a lower basal branch. Through a posterolateral thoracotomy the slug was obtained. The recovery was uneventful and he has remained well since. We discuss the possible mechanisms to explain the entrance of the bullet into the vascular system and conclude that in cases of gunshot wounds: a) An exit wound must be always searched for; if not found exploratory X ray are mandatory, b) If the bullet is not found, specially after thoracic injuries, bullet embolism should be contemplated, c) If there are signs of regional ischemia arteriography is mandatory.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Embolism caused by a bullet. Report of a case and review of the literature]. 265 26

In the group of 85 patients with coronary artery disease the exercise and 24-hour ambulatory electrocardiograms were recorded in order to analyse the frequency of asymptomatic episodes of myocardial ischemia and to determine differences between symptomatic and asymptomatic episodes of myocardial ischemia. All patients had ischemic ST-segment depression (greater than or equal to 1 mm) on the exercise electrocardiogram. During exercise testing, 23 (27%) patients had ST-segment depression without anginal pain or dyspnea. On the 24-hour ambulatory electrocardiogram transient episodes of myocardial ischemia were found in 50 (58.8%) patients. In 16 patients all episodes were asymptomatic, in 9 all episodes were symptomatic, and in 25 patients some episodes were symptomatic and some asymptomatic. During a 24-hour electrocardiogram in 25 patients with both types of ischemia, 175 transient episodes of myocardial ischemia were recorded. Most of them (125, i.e. 71.4%) were asymptomatic. The heart rate in symptomatic and asymptomatic episodes was similar. The magnitude of ST-segment depression in symptomatic episodes was higher than in asymptomatic episodes (P less than 0.01). There was not significant difference in the duration of the two types of myocardial ischemia. This study suggests: 1. During daily activities, in patients with the positive exercise test, asymptomatic episodes of myocardial ischemia are more frequent than symptomatic episodes. 2. The magnitude of ST-segment depression is the main factor in the determination of the presence of anginal pain.
 ...
PMID:Heart rate, magnitude and duration of ST-segment depression in symptomatic and asymptomatic episodes of myocardial ischemia in patients with coronary artery disease recorded by Holter. 274 22

The relation of breathlessness to angina was examined in 7,735 middle-aged British men. Among men who did not report breathlessness, the age-standardized prevalence rate of angina was 4%. In men with mild, moderate or severe breathlessness, the prevalence rates of angina were 16, 29 and 41%, respectively. The association between breathlessness and angina was independent of age or cigarette smoking, with similar relations observed in men who had never smoked. The prevalence of electrocardiograms revealing ischemia increased with the severity of breathlessness, even in men without angina or other evidence of coronary artery disease (CAD) at screening. In men with a low forced expiratory volume in 1 second, the prevalence of angina was also increased, but the association was much weaker than that observed between angina and breathlessness. After a 5-year follow-up, 25% of men severely breathless at screening but without any initial evidence of CAD had developed angina, 5% had had a heart attack (half of these were fatal) and 7% were dead from causes other than CAD. The corresponding rates for men not breathless at screening and without evidence of CAD were: 4% angina, 2.5% heart attack and 2% dead from causes other than CAD. Breathlessness appears to be an early indicator of CAD in the absence of either angina or electrocardiographic evidence of ischemia.
 ...
PMID:Breathlessness, angina pectoris and coronary artery disease. 280 46

Hypertrophic cardiomyopathy (HCM) is a primary myocardial disease of unknown cause that is characterized by a hypertrophied, nondilated, hypercontractile left ventricle. Its etiology and pathogenesis remain undefined but the three principal factors implicated are a genetic predisposition, a hypersensitivity to catecholamines, and an abnormal calcium metabolism. The hypertrophy typically involves the intraventricular septum to varying degrees, but may also involve the apex or free wall and even be concentric. The disease occurs in either an obstructive or a nonobstructive form depending on whether an intraventricular pressure gradient can be demonstrated at rest or on provocation. The gradient and obstruction to outflow is usually seen in patients with asymmetric septal hypertrophy (ASH) and anterior motion of the mitral valve during systole (SAM). Abnormal left ventricular diastolic function characterized by inadequate filling and impaired relaxation has been shown to be very important in both the obstructive and nonobstructive forms of the disease. In addition, inadequate coronary vasodilator reserve as a result of small vessel disease, microvascular spasm, and/or low capillary density per unit myocardial mass has been implicated as an important cause of ischemia in patients without coronary artery disease. HCM is a disease of young adulthood with relatively slow progression; young patients are often asymptomatic, whereas older patients are more limited by dyspnea, angina, dizziness, or syncope. Supraventricular tachyarrhythmias occur in 30% of patients, and high-grade ventricular arrhythmias occur in over 75%. The annual mortality is 3-5%. The common mode of demise is sudden cardiac death. Therefore, the primary objectives of treatment are the amelioration of symptoms, the control of arrhythmias, and the prevention of sudden death. Beta-adrenoreceptor blocking agents decrease myocardial contractility and oxygen demands and increase ventricular volume; therefore, they are most useful in patients with the obstructive form of HCM. Calcium channel antagonists enhance left ventricular relaxation, relieve microvascular spasm, and improve coronary filling and therefore are the agents of choice in patients with diastolic dysfunction. The ability of the calcium channel antagonists to decrease contractility makes them valuable in patients with obstructive HCM. Arterial vasodilators, diuretics, nitrates, and inotropic agents should be avoided because they can increase the intraventricular gradient. Myomyectomy is reserved for those patients with the obstructive form of HCM whose symptoms are refractory to medical therapy.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:Hypertrophic cardiomyopathy: current views on etiology, pathophysiology, and management. 331 Jun 37

Sixty-five patients with ST elevation were retrospectively studied in order to evaluate the clinical significance and underlying mechanisms of ST-segment elevation during exercise. Of these, 50 patients had previous myocardial infarction (Group I) and 15 patients did not (Group II). Exercise thallium-201 imaging was performed on 30 patients, resting gated blood pool imaging was performed on 33 patients, and 23 underwent cardiac catheterization for clinical indications. When the two groups were compared, patients in Group I had more frequent multivessel disease (9/13 vs. 3/10, p less than 0.05), anterior infarctions (33/50 vs. 4/10, p less than 0.02), while Group II patients had more frequent single-vessel disease (7/10 vs. 4/13, p less than 0.05). For Group I patients, the most common reason for termination of exercise was fatigue and/or dyspnea (35/50 vs. 0/15, p less than 0.05), with an irreversible defect noted in both stress and delayed views on thallium imaging (20/24 vs. 1/6, p less than 0.05). In Group II, the most common reason for termination was angina (15/15 vs. 2/50, p less than 0.001), with reversible thallium defects noted more frequently (4/6 vs. 3/24, p less than 0.01). Thus, we conclude that in patients with Q waves, left ventricular dysfunction rather than ischemia is the mechanism for ST elevation. In these patients angina is rare, but fatigue, dyspnea, multivessel disease, and fixed thallium defects are common. In patients with non-Q-wave exertional ST elevation, ischemia is the rule, manifested by frequent chest pain and reversible thallium defects.
 ...
PMID:The role of ischemia and ventricular asynergy in the genesis of exercise-induced ST elevation. 335 73

An epidemic of nephritis occurred among soldiers in World War I, predominantly those in the trenches. Characterized by the sudden onset of albuminuria, hypertension, edema, and dyspnea, atypical features such as bronchitis, an evanescent course, low early mortality, and frequent relapses distinguished it from poststreptococcal glomerulonephritis. Pathologic features included glomerular ischemia, capillary thrombi, endocapillary proliferation, and frequently epithelial crescents, suggesting an underlying vasculitis. The cause was not established, but a postinfectious, possibly postviral, etiology seems most plausible. Trench nephritis was the major nephrologic problem of World War I, accounting for 5% of medical admissions and more than 10% of military hospital bed occupancy at that time.
 ...
PMID:Trench nephritis: a retrospective perception. 351 20

Treadmill exercise tests were carried out in 397 women, aged 20 to 69, who were selected at random from an unorganized population. Four types of response were identified: ischemia, reduced stress tolerance due to excessively elevated systolic arterial blood pressure or other causes; reduced stress tolerance due to premature muscular fatigue or dyspnea (in less than 9 minutes of exercise) and the adequate type. The parameters of adequate response to physical stress were established. The incidence of ischemic response was relatively small in women, as compared to men. Ischemic response was only seen in women between 50 and 69 years of age, making a 4.5% rate.
 ...
PMID:[Characteristics of the adequate and pathological reactions to the standard treadmill test in a female population 20 to 69 years old]. 376 33

Alterations in ventricular diastolic properties are commonly seen in the diseased heart, and have been extensively studied in coronary artery disease, congestive cardiomyopathy, and left ventricular hypertrophy due to pressure or volume overload. Acute increases in left ventricular (LV) diastolic pressure relative to volume occur regularly during the transient ischemia of angina pectoris and may contribute to the dyspnea and pulmonary congestion that commonly accompany this condition. Although the mechanism of this altered disastolic distensibility is debated, a substantial body of evidence favors a role for residual diastolic interaction between contractile elements in the ischemic heart. Congestive cardiomyopathy also appears to be associated with increased LV diastolic stiffness. While this may in part be related to fibrosis of the LV wall, shifts of the abnormal diastolic pressure-volume relation toward normal have been reported with sodium nitroprusside infusion or the beta-adrenergic agonist salbutamol, suggesting important contribution of physiologic factors to the increased resting LV stiffness in this condition. LV hypertrophy (LVH) is associated with increased effective diastolic chamber stiffness, but normalized LV diastolic stiffness is increased only in LVH due to chronic pressure overload. Possible explanations for these findings are discussed.
 ...
PMID:Diastolic pressure-volume relations in the diseased heart. 644 88

To address the hypothesis that physical conditioning may improve left ventricular function in patients with coronary artery disease, we performed first-pass radionuclide ventriculography in 53 patients at rest and during upright bicycle exercise before and after 6 to 12 months of exercise training. The peak bicycle workload achieved before the onset of fatigue, dyspnea, or angina increased by an average of 22% (p = .0001) after training, and mean heart rate at a workload equal to the pretraining maximum workload was decreased by 10 beats/min after training (p = .0002). Of 21 subjects with angina or exertional ST segment depression before training, 15 (71%) were able to exercise to the same workload without these manifestations of ischemia after training. Whereas neither mean resting left ventricular ejection fraction (LVEF) nor LVEF at peak exertion was significantly altered, mean LVEF at the pretraining maximum workload was increased from 0.50 to 0.54 (p = .002) after training. There was a significant correlation between the magnitude of training bradycardia and the increment in LVEF at the pretraining maximum workload (p = .009). We conclude that the relative bradycardia at comparable exercise workloads produced by exercise conditioning is associated with improvements in left ventricular performance as assessed by the LVEF. This observation is compatible with the hypothesis that training bradycardia in conditioned subjects with ischemic heart disease is associated with lower myocardial oxygen demand and lesser degrees of ischemia at comparable workloads. However, training effects on ventricular afterload or on ischemia contractile performance of the heart cannot be excluded.
 ...
PMID:Effects of physical conditioning on left ventricular ejection fraction in patients with coronary artery disease. 672 12


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>