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)

The association of idiopathic hypertrophic subaortic stenosis (IHSS) with significant coronary atherosclerosis is little known, only 43 cases being available in the literature, 2 of which are personal ones. But the incidence of this association has certainly been underestimated. It is especially found from the sixth decade onwards, and at least 20% of patients with IHSS in and above the age group have stenosing lesions of the coronary artery. It is almost impossible to establish the presence of associated coronary abnormalities from the clinical features of from electrocardiogram. It does however seem worthwhile looking for this condition in IHSS when there is refractory chest pain, especially to beta-blockers, particularly if the patient is aged over 50 and has risk factors for ischaemic heart disease. It is also good to find IHSS associated with known coronary artery disease by using simple non-invasive techniques such as phonomechanocardiography and especially echo-cardiography; it is important not to miss the myocardial lesion and to treat concurrently if there is likely to be an indication for dealing with the coronary arteries surgically. The beta-blockers are the treatment of choice for both conditions, together with anticoagulents. If they fail, myectomy or myotomy together with aorto-coronary bypass graft should be considered.
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PMID:[Obstructive cardiomyopathy and associated coronary atherosclerosis. Review of the literature and report of 2 personal cases]. 10 92

The recent introduction of newer scintillation cameras, convenient radiopharmaceuticals and innovative data-processing systems has hastened the use of radionuclide methods in the evaluation of cardiac function. This review familiarizes the primary internist with physics and instrumentation required in understanding cardiovascular nuclear images. Basic principles underlying the gated cardiac blood-pool scan and the first-pass study are described. Authoritative references are given to readers seeking more complete information. The major emphasis of the review, however, is on the clinical applications of these techniques. The role of these noninvasive methods in myocardial infarction, diagnosis and prognosis of ischemic heart disease, assessment of cardiomyopathies, study of idiopathic hypertrophic subaortic stenosis and left atrial myxoma is discussed. Finally, mention is made of newer applications: evaluation of nitroglycerin action on viable but ischemic myocardium and determination of the hemodynamic effects of propranolol in patients with coronary-artery disease.
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PMID:Radionuclide methods in the assessment of left ventricular function. 11 Jan 47

Ultrasoundcardiograms (UCG) and radiocardiograms (RCG) were obtained from 50 patients with essential hypertension. They were classified into four groups according to the severity index of Veterans Administration Hospital. These echocardiograms were compared with those obtained from 20 normal individuals. Of the 50 patients with hypertension, ten had abnormal patterns of mitral valve echogram: two had shoulder formation of the A wave (A-A'), three had increased amplitude of the A wave (A greater than E), and five had systolic anterior movement (SAM) of the anterior mitral leaflet toward the ventricular septum. The former two groups were considered to have impairment of left ventricular (LV) function proven by UCG and RCG, however, the SAM group was considered to have hyperfunction with concentric hypertrophy of the left ventricle with thickened ventricular septum simulating that of idiopathic hypertrophic subaortic stenosis (IHSS). This was supported by the fact that SAM increased after inhalation of amyl nitrite and decreased after injection of propranolol. The descent rate of the anterior mitral valve decreased and the thickness of the ventricular septum increased with the severity of hypertension, indicating the LV compliance decreases as the severity of hypertension advances. A significant positive correlation was noted between stroke index (SI) obtained by UCG and RCG. There were no significant differences of LV dimensions and function indices measured by UCG and RCG among the groups classified according to the severity index of hypertension. This suggests that such factors as myocardial ischemia might play an important role in LV function as well as the grade of afterload due to hypertension.
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PMID:Echocardiographic observations in hypertension. 12 50

A patient with idiopathic hypertrophic subaortic stenosis and normal coronary arteries, with dynamic electrocardiographic changes resembling acute myocardial ischemia, is presented. A definite association between the electrocardiographic changes and the idiopathic hypertrophic subaortic stenosis cannot be absolutely confirmed; however, the findings demonstrate the broad spectrum of electrocardiographic presentation in this disease.
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PMID:Unusual electrocardiographic presentation of idiopathic hypertrophic subaortic stenosis. 57 57

Phonocardiography provides one of a growing list of valuable intermediary studies between physical examination and cardiac catheterization. It not only provides a medium for instruction in physical examination, but also allows one to make certain diagnoses and assess severity of numerous cardiovascular lesions. It is especially valuable in the evaluation of all valvular stenoses, especially aortic stenosis. One can also use phonocardiography for screening and diagnosis of idiopathic hypertrophic subaortic stenosis. It is a helpful adjunct in the study of several congenital abnormalities as well as in the assessment of myocardial function in cardiomyopathies and ischemic heart disease, and may often be decisive in confirming the diagnosis of pericardial constriction.
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PMID:Usefulness and limitations of precordial phonocardiography and external pulse recordings. 110 Feb 47

Diastolic dysfunction is being recognized increasingly as a primary cause of congestive heart failure. It may result from physiological abnormalities of myocardial relaxation, or anatomical abnormalities which increase resistance to ventricular inflow. With regard to physiological abnormalities, there is substantial evidence to indicate that myocardial ischaemia and hypertrophy are two conditions characterized by impaired inactivation and relaxation of myocardial cells. These conditions often co-exist in patients with idiopathic hypertrophic subaortic stenosis or calcific valvular aortic stenosis. Recent evidence also suggests a role for calcium overload in the diastolic dysfunction seen in some patients with advanced congestive heart failure. Diastolic dysfunction may be of fundamental importance in the pathophysiology of flash pulmonary oedema in patients with advanced ischaemic heart disease, since myocardial ischaemia in such patients may lead to a decline in relaxation rate, increased resistance to early diastolic filling and further impairment in diastolic coronary blood flow due to intramyocardial compression of capillaries and venules. During the transient ischaemia of angina pectoris, patients with multivessel coronary artery disease often show a striking upward shift in the left ventricular diastolic pressure-volume relationship, signifying a marked decrease in distensibility of the left ventricular chamber. With regard to anatomical abnormalities, diastolic dysfunction in heart failure may result from structural changes within the ventricular wall. Diastolic dysfunction of the left ventricle may result from extrinsic compression by pericardial effusion (tamponade), pericardial constriction, and right ventricular overload. Thus, a variety of physiological and anatomical abnormalities may lead to increased resistance to diastolic filling of one or both ventricles, resulting in diastolic heart failure.
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PMID:Diastolic function and heart failure: an overview. 218 38

Calcium-entry blockers prevent ventricular fibrillation during acute myocardial ischemia in laboratory animals. They may be useful as an adjunct to cold cardioplegia by preserving the myocardium during cardiopulmonary bypass. Their use may limit myocardial infarct size. However, the clinical application of calcium-entry blockers for ventricular dysrhythmias associated with myocardial ischemia has been little explored, as yet. We describe four patients, all of whom had significant cardiac hypertrophy (two had idiopathic hypertrophic subaortic stenosis; one had transposition of great vessels; and one had aortic stenosis) and in whom ventricular fibrillation developed after rewarming or shortly after the termination of bypass. The dysrhythmias were refractory to multiple attempts at defibrillation and conventional pharmacologic interventions. However, in each case, defibrillation was successful after administration of verapamil.
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PMID:Verapamil for refractory ventricular fibrillation during cardiac operations in patients with cardiac hypertrophy. 622 84

The judgment of the function of the left ventricle is computer-tomographically possible using the ECG-regulated cardio-computer-tomography in a temporary resolution of about 0.1 sec. The qualitative and quantitative evaluation of the systolic and diastolic changes of the ventricle in patients with normal CT-findings, with idiopathic hypertrophic subaortic stenosis and with disturbances of motility in chronic ischaemic heart disease confirms the possible functional evidence known from literature. The quantitative parameters, in particular the systolic abbreviation of the axis, allow an estimation of the motility. The measurement of the thickness at the interventricular septum and at the lateral wall of the myocardium as well as the systolic abbreviation of the axis and the left-ventricular ejection fraction are essentially higher in the idiopathic hypertrophic subaortic stenosis than in the normal group. The values of the patients with disturbances of motility in the ischaemic heart disease were clearly below. The diagnosis of the idiopathic hypertrophic subaortic stenosis with response of the size of obstruction by the telesystolic and telediastolic pictures is possible in a high percentage. Sequelae of the chronic ischaemic heart disease, e.g. scars, become visible by a narrowing or an absence of the normal edge of the myocardium. Global and localized disturbances of motility are diagnosable by phase-referred systolic and diastolic ECG-regulated pictures.
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PMID:[Computer tomographic evaluation of left ventricular kinetics]. 653 35