Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Spasm of coronary arteries can cause chest pain indistinguishable from classic angina pectoris in patients without atherosclerosis of these vessels or recognizable heart disease. Associated electrocardiographic changes usually correspond to the coronary artery affected and disappear when the attack of pain ends. Sublingual nitrates are excellent agents for the control of the episodic anginal symptoms. There have been scattered reports of myocardial infarction occurring in patients with normal coronary arteries; a role of arterial spasm in these cases in speculative.
 ...
PMID:Myocardial ischemia from coronary arterial spasm. 0 82

Eighty out of eighty-six patients (93%) with mammary artery implants were followed postoperatively for an average of three and a half years. The immediate mortality rate was 7% (6 cases), and the late mortality was 6% (5 cases). All had angina preoperatively. Twenty-four had a history of myocardial infarction and thirty-one were on limited physical activity, because of the pain. After surgery, thirty-three (45%) became asymptomatic. The angina improved significantly in thirty-five (47%) and remained unchanged in six (8%). Improvement in ventricular repolarization on ECG was observed in 69% of the patients. Postoperative cineangiography was performed in twenty-three patients; thirteen with single and ten with double implants. Out of the total of thirty-three implants, four (12%) were obstructed and twenty-seven patent (82%); twenty were in two cases of double implant, only one implant could be satisfactorily studied effectively functioning (61%). No obstructions were seen in the single implants. Non functioning implants were found in five (38%) of the thirteen single implants and in two of the twenty double ones (10%). The highest incidence of obstruction or non-functioning implants occurred in the group that did not show improvement (43%). This rate fell to 40% in the group that had some improvement and to 29% in those that were completely asymptomatic. Twelve of the eighteen patent mammary implants (67%) on the anterior wall of the left ventricle and eight of nine (89%) on the lateroinferior wall, established collateral circulation to the coronaries. Indication for surgery was considered satisfactory for nineteen out of the twenty-three patients and poor in four. There were two cases of obstruction of the implant (7%) in the group where surgery was correctly indicated and three of the twenty-three (11%) patent implants were non-functioning. Clinical improvement of the angina occurred in 84% in the first group and 50% in the other. In conclusion, this technique of indirect revascularization of the myocardium is valid for patients with severe diffuse lesions of the coronaries with a collateral network and preserved myocardial contractility.
 ...
PMID:Long-term results of mammary artery implants. 1 Dec 20

In this report the clinical, laboratory, and histopathologic findings of nine children with polyarteritis are reviewed. All have had evidence of systemic involvement. Eight presented with fever, calf pain, erythematous painful nodules, and elevation of the acute-phase reactants. All were treated with prednisone at a dosage of 2 mg/kg/day. All of the children are alive but have had relapses at least once during the course of tapering the dosage of corticosteroids. Serious complications of disease have included myocardial infarction, hypertension, and impaired renal function.
 ...
PMID:A syndrome of childhood polyarteritis. 1 61

The analgesic effect of self-administered nitrous oxide 50%/oxygen 50% ('Entonox" analgesic apparatus) was compared with air given by the same method in a double-blind trial in 81 patients with myocardial infarction. Self-administered nitrous oxide/oxygen, which was associated with a low frequency of side-effects, proved significantly more effective than air in the early relief of severe cardiac pain, but not in the relief of moderate or slight pain or when administration was continued after ten minutes.
 ...
PMID:A double-blind trial of patient-controlled nitrous-oxide/oxygen analgesia in myocardial infarction. 4 60

The clinical findings in 45 patients with angina and normal coronary arteries are reviewed. The primary site, radiation, and character of the pain were typical of angina but the pain was atypical in its relation to stress, frequency of occurrence, relief with rest, and response to nitroglycerin. 22 had abnormal electrocardiograms with evidence of past myocardial infarction in 3. 5 had abnormal exercise tests. During a two-year follow up period there were no further myocardial infarctions and anginal pain either disappeared or improved in 73%. It is concluded that patients with angina and normal coronary arteries can often be distinguished clinically and that they have a good prognosis.
 ...
PMID:Clinical features and follow-up of patients with angina and normal coronary arteries. 6 May 68

To evaluate cardiac function, the regional blood flow of the subclavian artery as a parameter of cardiac output was measured instead of measuring cardiac output itself in 12 normal subjects and 17 patients with ischemic heart disease. The measurement of the subclavian arterial blood flow was continuously and noninvasively made utilizing the Doppler ultrasonic flowmeter before, during and after exercise. The exercise was performed in the upright position on a bicycle ergometer for 3 minutes at the work load of 230 Kpm/min. Delta F Ratio, that is, the ratio of the increased blood flow during the exercise to the increased blood flow during the first 3 minutes after the termination of the exercise, was calculated in all subjects. Delta F Ratio as well as the response pattern of the blood flow to exercise was investigated. In patients with ischemic heart disease, the increase in the subclavian arterial blood flow during the exercise was slow, and the time required to return to the pre-exercise level was remarkably prolonged in comparison with normal subjects. The mean delta F Ratio of the younger normal group was 7.43, and that of the older normal group was 5.53. While in patients with ischemic heart disease, markedly lower values were observed. The mean delta F Ratio of the following subgroups of patients with ischemic heart disease, the myocardial infarction group, the angina pectoris group, and the group of ischemic heart disease without pain, were 1.25, 1.97, and 2.52 respectively. The difference in the mean delta F Ratio between the older normal group and each subgroup of ischemic heart disease was statistically significant. Low delta F Ratio in patients with ischemic heart disease is supposed to be the manifestation of diminished cardiac reserve due to decreased myocardial contractility. As a simple parameter of cardiac output, the continuous measurement of the subclavian arterial blood flow by the Doppler flowmeter is a useful method for the noninvasive evaluation of cardiac function. Especially, the calculation of delta F Ratio may provide the numerical presentation of cardiac function.
 ...
PMID:Noninvasive evaluation of cardiac function in patients with ischemic heart disease by the subclavian arterial blood flow response to exercise. 12 5

To determine the sensitivity of myocardial scintigraphy with technetium-99m pyrophosphate during the early phase of acute myocardial infarction, 31 patients admitted to the coronary care unit with prolonged ischemic pain underwent imaging within 4 to 8 hours and again at 24 hours after the onset of symptoms. In 11 of 15 patients with documented acute myocardial infarction, increased focal myocardial uptake was demonstrated on early myocardial scintigraphy. Focal uptake was observed in only 2 of 16 patients with unstable angina pectoris. Three or four patients with normal early scintigrams had massive transmural myocardial infarction. Normal early scintigrams in these three patients may have reflected poor perfusion because the images were abnormal at 24 hours. In four patients the extent of technetium-99m pyrophosphate uptake increased more than 20 percent at 24 hours without other evidence of infarct extension. In the other seven patients, there was no significant change in the area of the abnormal radioactive uptake between early and delayed scintiscans. This study suggests that technetium-99m pyrophosphate scintigraphy can defect acute myocardial infarction as early as 4 hours after the onset of symptoms although the sensitivity rate (73 percent) is less than that at 24 hours.
 ...
PMID:Myocardial scintigraphy with technetrium-99m pyrophosphate during the early phase of acute infarction. 20 76

The clinical behaviour of 90 patients on beta-blocking drugs for established coronary heart disease who were admitted to a coronary care unit with prolonged ischaemic myocardial pain was compared with that of 90 similar patients not on this therapy. Transmural myocardial infarction was confirmed in 30 of the patients on beta-blockers and in 62 controls. A diagnosis of myocardial necrosis without infarction was made in 20 patients on beta-blockers and in 14 controls. Coronary insufficiency was diagnosed in 40 patients on beta-blockers and in 14 controls. The incidence of simus bradycardia, hypotension, syncope, and radiological pulmonary oedema was similar in the two groups. Established beta-blockade, therefore, has not been shown to prejudice the outcome of patients with coronary heart disease admitted to hospital with prolonged ischaemic myocardial pain. On the contrary, it may protect some patients from the development of a myocardial infarction.
 ...
PMID:Long-term beta blockade: possible protection from myocardial infarction. 23 66

The relationships between aortic stenosis, coronary artery disease, angina pectoris, and myocardial infarction were examined in 173 patients with isolated calcific aortic stenosis who had coronary arteriography as well as cardiac catheterization. All were over age 40 and had definite cardiac symptoms; 156 later had aortic valve replacement. Coronary lesions narrowing the lumen by 50% or more were present in 37% of patients aged 40 to 59 and 68% of those aged 60 to 82. Coronary disease was present in 64% of patients with angina pectoris and 33% of those without angina. Angina which occurred only in association with dyspnea on exertion was associated with coronary disease in 45% of instances, whereas angina which also occurred on exertion without any dyspnea or which occurred with emotional stress, after meals, during sleep, or at rest unprovoked was associated with coronary disease in 80% of instances. Patients with coronary disease without any chest pain or with atypical pain considered nonanginal were men, usually over age 60, with congestive heart failure as the predominant symptom. Electrocardiograms showing transmural inferior or anterolateral infarction nearly always indicated coronary disease, while QS patterns in Leads V1-2 occurred frequently with normal coronary arteries. Serum cholesterol was elevated in 23% of those with coronary disease and 8% of those without. A group of patients with moderate aortic stenosis could be identified, with aortic valve areas of 0.55 to 0.80 cm. per square meter, in whom coronary disease was the sole or chief cause of symptoms. The operative mortality rate with aortic valve replacement was 9.6% in those with coronary disease and 1.4% in those without significant coronary disease. Coronary disease is frequently present in patients with calcific aortic stenosis, particularly in those over 60, those with angina, and those with symptoms despite only moderate aortic stenosis. The type of anginal syndrome, the ECG evidence of transmural infarction, and the coronary risk factors provide additional clues for clinical diagnosis.
 ...
PMID:Aortic stenosis, angina pectoris, and coronary artery disease. 30 Feb 16

Intra-aortic balloon pump assistance (IABPA) for cardiogenic shock is well established. The response to balloon pumping and patient survival are better after low output from cardiotomy than after myocardial infarction. Elective use of IABPA preoperatively allows an extra margin of safety for patients with acute coronary insufficiency, significant left main coronary artery stenosis, or depressed left ventricular function. However, advances in monitoring techniques during the induction of anesthesia and weaning from cardiopulmonary bypass support, as well as improved methods for myocardial preservation, have reduced the requirements for elective IABPA. Current indications for preoperative IABPA include: patients with acute coronary insufficiency who are totally unresponsive to full medical management and who continue to have pain and electrocardiographic changes at rest, and patients with serious left main coronary artery stenosis who also have acute coronary insufficiency or depressed left ventricular function. The survival of patients with valvular heart disease and left ventricular dysfunction is not improved with preoperative IABPA, while most patients with depressed left ventricular function from coronary artery disease may now undergo revascularization uneventfully, although inevitably some will still require postoperative IABPA.
 ...
PMID:Changing patterns of intra-aortic balloon pump assistance. 30 76


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