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)

Coronary revascularization has been suggested as sole therapy for secondary prevention of sudden cardiac arrest associated with ischemia. The use of implantable defibrillators (ICD) in combination with coronary revascularization for this patient population is unclear. Among 412 consecutive patients receiving an ICD, 23 (6%) were identified as sudden cardiac arrest survivors who were noninducible with programmed stimulation and had unstable angina or ischemia on a functional study; they underwent successful coronary revascularization. During a follow-up of 34 +/- 18 months, 10 (43%) of the 23 patients received ICD shocks (8 +/- 8 per patient, range 1 to 22 shocks), and nine of the 10 patients had syncope/presyncope associated with at least one ICD discharge. Patients with ICD discharges were compared with those without ICD discharges, and no clinical characteristics were statistically different between the two groups. In conclusion, revascularization alone may be inadequate therapy for survivors of sudden cardiac arrest associated with ischemia who are noninducible with programmed stimulation, and clinical variables cannot predict which patients are likely to have recurrent malignant ventricular arrhythmias.
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PMID:Incidence of implantable defibrillator discharges after coronary revascularization in survivors of ischemic sudden cardiac death. 763 7

The cervical vertebral arteries were visualized by real-time B-mode ultrasonography with duplex Doppler in 595 consecutive patients. Comparison with angiography in 40 patients showed a sensitivity of 84% and a specificity of 97% in identifying vertebral artery lesions. The incidence of vertebral artery lesions in patients with symptoms of ischemia referable to the vertebrobasilar distribution was 28% (24/84), significantly higher (p = 0.05) than the incidence of 13% (7/54) in patients with carotid artery insufficiency. Patients with completed strokes in the vertebrobasilar territory had an even higher incidence of vertebral lesions (44%,14/ 32) than patients with transient symptoms of vertebrobasilar insufficiency (19%, 10/52) (p < 0.001). The incidence of vertebral lesions in patients with nonlocalizing symptoms of syncope (8%, 5/67), presyncope (10%, 3/31), isolated vertigo (5%,4/77), unsteadiness (4%,2/55), lightheadedness (0/27), and transient global amnesia (0/18) were all significantly lower than the incidence in patients with focal vertebrobasilar symptoms (p < 0.01). Imaging of the cervical vertebral arteries by real-time B-mode ultrasonography may be helpful in determining the etiology of symptoms in patients with a diagnosis of vertebrobasilar insufficiency.
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PMID:Noninvasive imaging of the cervical vertebral artery in the diagnosis of vertebrobasilar insufficiency. 2648 22

The most common cardiomyopathies often present to primary care physicians with similar symptoms, despite the fact that they involve a variety of phenotypes and etiologies (1). Many have signs and symptoms common in heart failure, such as reduced ejection fraction, peripheral edema, fatigue, orthopnea, exertion dyspnea, paroxysmal nocturnal dyspnea, presyncope, syncope and cardiac ischemia (1). In all cardiomyopathies, the cardiac muscle (myocardium) may be structurally and/or functionally impaired. They can be classified as hypertrophic, dilated, left-ventricular non compaction, restrictive and arrhythmogenic right ventricular cardiomyopathies.
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PMID:Cardiomyopathies. 3157 51