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Query: UMLS:C0151744 (myocardial ischemia)
 31,282 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The role of coronary artery spasm in the production of myocardial ischemia has recently become the focus of increased attention. This phenomenon is now well established as a causative mechanism underlying the resting chest pain attacks in Prinzmetal's variant angina. There is also evidence that coronary spasm may play a more significant role in the broad spectrum of ischemic heart disease than can be documented by current techniques. The autonomous nervous system constitutes a major element in the pathophysiology of spasm. Coronary arteriography, in spite of important limitations, remains the only technique for final documentation of this phenomenon, but radionuclide scintigraphy appears to be promising. Nitroglycerin is effective for the relief of the acute attack, while long acting nitrates and the calcium antagonists: nifedipine, perhexiline and verapamil are useful in the prevention of recurrences.
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PMID:Coronary artery spasm: its role in the pathogenesis of myocardial ischemia. 50 1

The successive deterioration of left ventricular pump function during exercise-induced angina pectoris was studied in 20 candidates for aortocoronary bypass surgery. Left ventricular stroke work and power were calculated from continuous left ventricular pressure recordings and repeated measurements of cardiac output every 30 sec using the thermodilution technique. The average left ventricular enddiastolic pressure (LVEDP) increased continuously during exercise whereas stroke work index (SWI) did so only in the beginning of the exercise period up to a maximum value and then fell towards the end of exercise. The onset of angina occurred at an average LVEDP of 34 mm Hg when SWI had already started to fall in most patients. During exercise all patients had markedly lower SWI than normals. Patients with high coronary arteriographic score and patients with a previous myocardial infarction had significantly lower SWI during exercise than those with low score or those without a previous infarct. At rest there were no differences between these groups which emphasises the importance of haemodynamic measurements under stress conditions in patients with ischaemic heart disease.
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PMID:Left ventricular pump function in effort angina. 51 Mar 52

The authors studied the changes in four indices of kalikrein-kinine system. For that purpose 80 patients were examined, subdivided into the following groups; 1) hypertonic disease -- I -- II and II stage -- 20 patients; 2) myocardiosclerosis -- 20 patients; 3) unstable stenocardia -- 20 patients; 4) myocardial infarction -- 20 patients. The results obtained are compared with the results of the control group of 20 healthy subjects. The method of Colman and collaborators, modified by Veremeenko and collaborators was used for the quantitative determination of prekalikrein and kalikrein inhibitors. The data obtained suggest an enhanced kalikrein activity, very likely kinine as well, i.e. -- stimulation of kalikrein kinine system in IHD patients, determined by the increased formation and decreased inactivation of the enzyme (kalikrein).
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PMID:[Changes in the serum level of prekallikrein and kallikrein inhibitor activity in ischemic heart disease]. 51 57

We report a case of a 44-year-old male with variant angina who developed acute anterior myocardial infarction 2 weeks following demonstration of normal left coronary artery. This experience provides inferential evidence that myocardial ischemia resulting from coronary spasm may progress into myocardial infarction.
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PMID:A case of variant angina with normal coronary arteriogram who developed acute myocardial infarction and cerebral embolism. 52 49

A comparison was performed between the echocardiographic (EchoC) indices for the pump and contraction function of left ventricle and the stage of left-ventricle insufficiency, determined according to clinical criteria of 82 patients with ischemic heart disease (IHD)--old myocardial infarction and (or stable angina pectoris without left-ventricle infarction and for stable angina pectoris without left-ventricle aneurysm. With IHD, regardless of the considerable asynergy of left ventricle, some of the functional EchoC-indices were established to preserve their diagnostic values and definitely to differentiate the majority of the cases with, from those without, cardiac insufficiency, objectivizing the determination of initial left-ventricle insufficiency. The most significant diagnostic value of EchoC-assessment of left-ventricle function in IHD has the following complex of EchoC-indices: diastolic extent, left ventricle index resp, expulsion fraction (EF), shortening fraction (FS), average velocity of circumferential fibres (VCF), distance between point E of mitral echogram and interventricular septum (S-E distance), telediastolic interval A-C of mitral echogram and extent, index of left auricle, resp.
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PMID:[Echocardiographic evaluation of left ventricular function in ischemic heart disease (IHD)]. 52 71

The ECG is an indirect and non-specific test of myocardial ischemia, which means that the limits in respect to sensitivity and specificity must be evaluated. The dynamic Holter ECG is a useful method, particularly if pain appears during the recording time. The exercise test as an example of additional stress is of great general interest, especially in man; stress-testing is particularly useful in explaining the origin of atypical anginal pain. Hence the interpretation criteria must be closely followed rather than enlarged as long as the indication for diagnostic coronary-angiography is limited by the result of exercise testing. When other non-invasive methods are not readily available it should be possible to broaden the diagnostic criteria to increase sensitivity; by the same token, the number of false positive tests will be controlled by these complementary non-invasive methods.
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PMID:[Electrocardiographic manifestations of myocardial ischemia]. 53 52

In 305 patients operated upon for symptomatic ischaemic heart disease, a series of resting electrocardiograms, obtained during the first days after operation, was evaluated. A new Q wave was found in 10% of the patients. The genesis of this EGG change had not correlation with the patients' age and sex, presence of hypertension and diabetes mellitus, tobacco smoking, blood cholesterol level, functional calss of angina pectoris, previous myocardial infarction, the number of affected coronary arteries, duration of extracorporeal circulation or anoxic circulatory arrest, and peroperatively measured graft blood flow. A new Q wave after revascularization occurred more frequently in patients with multiple venous aortocoronary bypasses. The new Q wave is an EGG manifestation of myocardial necrosis with subsequent local disturbance of left ventricular function.
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PMID:A new Q wave in the electrocardiogram in patients operated upon for ischaemic heart disease. 53 2

We report a patient with aortic regurgitation and ischemic heart disease in whom normal, effortless micturition repeatly precipitated angina. To our knowledge, only one other case of micturition angina has been reported in English literature since the first such case was recorded in the 17th century. The mechanism of production of this syndrome remains obscure.
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PMID:Micturition angina: a case report. 58 86

The person who has asymptomatic myocardial ischemia is at high risk because he does not have the benefit of the warning signals afforded by the substernal pain that tells most patients with angina to stop what they are doing.
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PMID:Prevention of heart disease in the normal subject with a positive exercise test. 58 14

The response to exercise during increasing workloads (supine bicycling), was studied in 105 men, of whom 70 had ischemic heart disease and 35 did not, clinically classed into 6 groups. Heart rates, blood pressures and systolic time intervals (STI) were measured in relation to exercise tolerance and capacity. The ischemic heart disease (IHD) subjects differed from the nonischemic by an increased PEP/LVET ratio at rest and by a tendency of the diastolic blood pressure to increase upon exercise. Two main types of abnormal reaction of STI to workload were ascertained: (1) prolonged LVETc with respect to controls (prevailing in angina pectoris), and (2) prolonged PEPEc together with shorter LVETc (typical for left ventricular failure). The dominant feature appears to be the depressed contractility in the latter and a decreased compliance (or rate of relaxation) in the former. Estimation of STI may contribute to the evaluation of the exercise tolerance test in long-term examination of ischemic patients.
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PMID:A noninvasive study of the response of ischemic heart to exercise. 59 Feb 97


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