Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0151744 (myocardial ischemia)
 31,282 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A comparative clinical study of the efficacy of Benzoral, Trasicor, Viskene, Aptene, Eraldine and Inderal was conducted in the ischaemic heart disease patients. Their antiarrhythmic and antianginal effect was determined, as well as their optimum therapeutic dosages, the activity of their specific beta-adrenolytic properties, the effect of the drugs on the bronchi and the peripheral venous tone. Apart from the clinical study, electro- and polycardiography, functional pulmonary tests and the Schellong orthostatic test were used. All the drugs in question were found to produce a distinct specific beta-blocking effect. They are effective in cases of atrial and ventricular extrasystole, paroxysmal tachycardia, sinus tachycardia and tachyarrhythmic fibrillation, as well as for the prevention of anginal attacks and arrhythmic fibrillation. All the drugs produce a negative inotropic effect, Inderal--the strongest, Viskene and Benzoral--the weakest. All beta-blockers can impair bronchial patency in patients with bronchial obstruction. This effect is least pronounced with Eraldine that may be used as the drug of choice in such cases. In most cases the beta-blockers do not affect the peripheral venous tone, but in some cases they may reduce it.
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PMID:[Comparative evaluation of the clinical action of a series of beta-adrenergic blockaders]. 1 Apr 63

On a basis of history, clinical examination, and the electrocardiogram it was possible to identify groups of patients with acute myocardial infarction with good and bad prognoses as regards hospital survival. Individual adverse factors were age, prevous history of ischaemic heart disease, anterior infarction, persistent sinus tachycardia, pulmonary crepitations, hypotension, and raised venous pressure. Multivariate analysis showed four factors remaining significant--age, tachycardia, hypotension, and pulmonary crepitations. As a result of treatment of cardiac arrest, hospital mortality, which would otherwise have been 20 percent, was 17 percent. Preceding unstable angina did not worsen the immediate prognosis.
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PMID:Prognosis of patients with acute myocardial infarction admitted to a coronary care unit. I: Survival in hospital. 58 70

ECG changes were followed up in 69 patients under continuous electrocardiographic monitoring before, during and after esophago-gastro-duodenoscopy (EGD). Of these 32 (46.5%) had ischemic heart disease (IHD). One or more varied abnormalities including supraventricular or ventricular ectopic beats, sinus tachycardia or sinus bradycardia, intermittent right or left bundle branch block, S--T segment depression (and increased preexisting S--T segment depression), T wave flattening or inversion appeared during EGD. Only one patient with IHD developed anginal chest pain during endoscopy. Despite the high incidence of recorded rhythm abnormalities, these were transient, and no treatments were needed. However, it seems advisable to have resuscitation equipment and emergency drugs available during EGD, particularly when it is performed in patients with IHD.
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PMID:Continuous electrocardiographic monitoring during upper gastrointestinal endoscopy. 63 3

Heart rate changes during the immediate postoperative period were studied in 190 patients that underwent revascularization surgery. At the same time, other cardiovascular complications in those patients were analyzed. In 89 patients (46.8%), cardiovascular antecedents were found. Ischemic heart disease was found in 84 patients (44.2%). The most common cardiac arrhythmia was found to be sinus tachycardia, which was seen in 87 patients (45.7%). Following in order of frequency were supraventricular extrasystoles together with ventricular extrasystoles in 18 patients (9.4%) and isolated ventricular extrasystoles in 16 (8.4%). The most common cardiovascular and hemodynamic complications, both associated and as predisposing causes, were high blood pressure in isolation or combined with heart failure found in 58 (30.5%) and 8 (4.3%) patients, respectively. Hypokalemia played an important role since it was found in 105 patients (55.3%), 90 of whom had cardiac arrhythmia (85.7%). Seven revascularized patients (3.7%) died due to cardiovascular causes.
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PMID:[Disorders of the heart rhythm in the immediate postoperative period in patients who have undergone vascular surgery]. 184 20

Although the pig has been used as an experimental model for ischemic heart disease and sudden death, relatively little is known about the anatomy of the conduction system (CS) of this animal. We attempted to correlate electrophysiologic and anatomic differences between the pig and human CS. Invasive electrophysiologic studies were performed in five healthy anesthetized pigs. In contrast to the adult human, the pig has sinus tachycardia, shortened PR and H-V intervals, and a relatively short sinoatrial conduction time. Compared with the human CS, serial sections of the CS of pig hearts showed the following differences: (1) the atrioventricular node is located more to the right of the summit of the ventricular septum; (2) the penetrating bundle is very short, and the bifurcation of the bundle into bundle branches occurs more proximally; (3) there is more connective tissue and less elastic tissue; and (4) there is a copious amount of nerve fibers (about 50 percent throughout the CS). The presence of the abundant neural tissue implies that there is an important neurogenic component to conduction in the pig. Because of the above differences from the human, the pig should be used with caution as an experimental model in ischemic heart disease and sudden death where arrhythmias are studied.
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PMID:The conduction system of the swine heart. 206 Mar 44

The present study was conducted in 30 cases of snake bite to understand fully the intricacies of the cardiac profile and to render help in the management of the problem arising out of them. All were subjected to routine and specific investigations (ECG, X-ray Chest, SGOT). The present study concluded that 57 per cent of patients of snake bite were in 2nd and 3rd decades of life. Viperine snake bite occurred in 93 per cent and elapide snake bite in 7 per cent of cases. Cardiotoxicity was seen in only 25 per cent patients with viperine bite. Seventy-six per cent of the patients presented within 24 hours of the bite. Seventy per cent of patients had haemorrhagic manifestations and 30 per cent had cardiotoxicity. The disturbance in heart rate was seen in 47 per cent, rhythm disturbance in 6.7 per cent, tachycardia in 36.7 per cent and bradycardia in 10 per cent cases. Hypertension was found in 6.7 per cent, hypotension in 16.7 per cent. Thirty per cent of patients had gallop rhythm and it persisted in 16.6 per cent patients till discharge. One patient had evidence of pulmonary edema and one had basal congestion. Cardiomegaly on chest X-ray was found in one patient and elevated SGOT titres were found in ten per cent. Common electrocardiographic changes were sinus tachycardia, sinus arrhythmia (6.6%), sinus bradycardia (10%), tall T-wave in V2 (3.3%), pattern suggestive of acute anterior wall infarction with reciprocal changes (3.3%), myocardial ischemia (10%), non-specific ST-T changes (16.7%) and atrioventricular block (3.3%). The mortality rate was 10 per cent and all these patients had bleeding manifestations and abnormal electrocardiograms.
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PMID:Profile of cardiac complications of snake bite. 225 4

We report our initial experience with three patients who underwent heart transplantations at National Taiwan University Hospital. Two had idiopathic dilated cardiomyopathy. One had ischemic heart disease. Anesthesia was induced with fentanyl, ketamine, etomidate and pancuronium. In addition to regular maintenance with fentanyl, diazepam and pancuronium, low doses of isoflurane were added for skin incision and sternotomy. The anesthetic courses were uneventful. Mild hypotension was noted in the first case after cardiopulmonary bypass, and was immediately corrected by increasing the preload and dosage of inotropes. Sinus tachycardia from the donor SA node was the predominant rhythm after cardiopulmonary bypass. Our experience agrees with other reports that anesthesia for cardiac transplantation is a relatively safe procedure under careful hemodynamic monitoring and pharmacological support. Aseptic techniques, adequate preload and hemostatic agents supply are the major concerns for anesthetists.
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PMID:Cardiac transplantation at National Taiwan University Hospital: a review from the anesthesiologist's standpoint. 265 5

Electrocardiographic (ECG) changes in nine patients under continuous ECG monitoring before, during and after balloon dilatation for achalasia were followed; of these, three had ischaemic heart disease (IHD). One or several abnormalities including sinus tachycardia, supraventricular or ventricular ectopic beats, S-T segment depression and T-wave flattening appeared during the procedure; these were more commonly found in patients with IHD. Despite the high incidence of recorded ECG abnormalities, these were transient, and no treatment was needed. However, it seems advisable to have resuscitation equipment and emergency drugs available during balloon dilatation for achalasia, particularly when this procedure is performed in patients with IHD.
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PMID:Continuous electrocardiographic monitoring during balloon dilatation in achalasia. 281 33

Esmolol is an ultra-short-acting beta-adrenergic blocking agent that possesses minimal partial agonist activity or direct membrane depressant activity. The short duration of action of esmolol is attributable to rapid enzymatic hydrolysis by red blood cell esterases, forming ASL-8123 and methanol. Experiments in the constant-flow-perfused isolated canine hindlimb indicate that therapeutic (beta blocking) doses of esmolol lack direct vascular effects and alpha-adrenergic blocking activity and that therapeutic doses do not interfere with vascoconstrictor effects of peripheral sympathetic nerve stimulation. Esmolol produces cardiac electrophysiologic and hemodynamic effects consistent with those of beta blockade. Specifically, esmolol decreases heart rate, depresses atrioventricular nodal conduction, and decreases determinants of myocardial oxygen demand. The beneficial antiarrhythmic and infarct-size limiting effects of esmolol have been demonstrated in several experimental models. Whereas beta blockers in general are effective in settings of supraventricular arrhythmias, sinus tachycardia, and myocardial ischemia, esmolol provides the added dimension of "titratability." Thus, the short duration of action of esmolol allows for very rapid titration to a preferred steady-state level of beta blockade; rapid adjustment to different steady-state levels of beta blockade, as may be required by changing status of the patient, and rapid disappearance of beta blockade following discontinuation of esmolol infusion, should this be necessary in the event of deleterious cardiac hemodynamic effects. Thus, esmolol is ideally suited for use in the treatment of patients in whom beta blockade is desirable, but in whom level of beta blockade must be very carefully modulated.
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PMID:Pharmacology and pharmacokinetics of esmolol. 287 84

The diagnosis and treatment of cardiac dysrhythmias answers the following four questions: Is the patient stable? Is the rate fast or slow? Are the ventricular complexes wide or narrow? Is the rhythm regular or irregular? The most common narrow complex regular tachycardias are sinus tachycardia, atrial flutter, atrial tachycardia that blocks, and paroxysmal supraventricular tachycardia. Carotid sinus massage is useful in differentiation. Irregular narrow-complex tachycardias are usually atrial fibrillation. An ultra-rapid wide-complex or polymorphous irregular tachycardia is likely to be atrial fibrillation with ventricular preexcitation. Wide-complex regular tachycardias present a special challenge, since wide beats may result from supraventricular or ventricular impulse formation. Ventricular tachycardia is more likely than supraventricular tachycardia in the presence of underlying ischemic heart disease, atrioventricular dissociation, fusion or capture beats, or a very broad (greater than .14 seconds) QRS complex. Still, misdiagnosis is common; the most costly mistake is over-diagnosis of SVT. In emergencies, where vital organ hypoperfusion is present, the origin of the impulse and the name of the dysrhythmia are unimportant. With the exception of sinus tachycardia, all life-threatening, rapid tachycardias should be terminated by electrical cardioversion.
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PMID:A wide, complex look at cardiac dysrhythmias. 332 2


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