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 double-blind study including three different cardioselective beta-blockers, practolol, H 87/07 and metoprolol, was performed in 54 patients with acute myocardial infarction and chest pain shortly after onset of symptoms. Transmural infarctions were found in 42 patients while 12 patients had nontransmural infarctions. Chest pain and the product of heart rate and systolic blood pressure were significantly reduced in the beta-blocker groups whereas no changes were seen after saline. All patients with nontransmural infarctions and 14 out of 29 with transmural infarctions got pain relief lasting for at least 30 min. None of the patients developed signs of left ventricular backward failure, shock, or bradycardia. A decrease in ST segment elevation was observed in all the transmural infarctions after beta-blockade. No changes in ST segment elevation were found after analgesics when given after saline, but in some cases an increase was seen in this parameter when analgesics were given due to insufficient pain relief after beta-blockers or due to return of chest pain. It is suggested that pain relief by beta-blockers indicates decrease of myocardial ischemia.
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PMID:Double-blind study of the effect of cardioselective beta-blockade on chest pain in acute myocardial infarction. 0 98

A single blind randomized parallel study designed to assess the anti-anginal efficacy of pindolol and nifedipine was carried out in 42 ambulatory coronary patients with stable angina pectoris. Drug efficacy was assessed in terms of (a) pain, (b) frequency of anginal episodes, (c) nitroglycerin consumption, (d) exercise tolerance and (e) ST-segment changes. The effect of these drugs on asymptomatic resting myocardial ischemia was also assessed by means of 24-h dynamic electrocardiography (DCG). All patients were checked at weekly intervals. At the end of a 4-wk placebo period, the patients were randomly assigned either to the pindolol or nifedipine group. The treatment lasted for 45 days. During the placebo period, ischemic ECG changes and symptoms of coronary insufficiency were detected in all patients. Furthermore, 12 out of 42 patients had asymptomatic myocardial ischemia at rest. One patient from each group was dropped because of tolerance. At the end of the 45-day study, pindolol and nifedipine were equi-effective on spontaneous and effort-related angina. There were, however, some differences: increased tolerance to exercise appeared earlier with pindolol: the pindolol group showed a slightly reduced while the nifedipine group showed a slightly increased heart rate. Furthermore, nifedipine reduced or eliminated asymptomatic myocardial ischemia in 6 out of 7 patients while only 1 out of 5 improved in the pindolol group.
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PMID:Therapeutic effects of pindolol and nifedipine in patients with stable angina pectoris and asymptomatic resting ischemia. 11 40

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.
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PMID:Noninvasive evaluation of cardiac function in patients with ischemic heart disease by the subclavian arterial blood flow response to exercise. 12 5

Technetium-99m-stannous pyrophosphate (99mTc-PYP) accumulates in acutely infarcted myocardium and can be detected by scintiscanning. The clinical value of 99mTc-PYP scintiscanning was studied in 83 patients 6 hours to 21 days after the onset of acute chest pain. In 12 patients with normal electrocardiograms and serum enzyme values no uptake of 99mTc-PYP was detected on the scintigrams. Of 44 patients with electrocardiographic or enzyme evidence, or both, of acute myocardial infarction the scintigrams were positive in 31, "questionable" in 2 and negative in 11; no positive scan was obtained within 12 hours of the onset of pain, and the scans generally remained positive for up to 5 days. In 24 patients with evidence of prolonged myocardial ischemia the scans were positive in 2, questionable in 4 and negative in 18. The scans were negative in each of three patients with acute or constrictive pericarditis. Localization by electrocardiography and scintiscanning correlated nearly perfectly for transmural infarcts but subendocardial infarcts could not always be localized precisely by scintiscanning. The infarct area (total area of 99mTc-PYP uptake) correlated well with the peak serum value of creatine phosphokinase.
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PMID:Technetium pyrophosphate scanning in the detection of acute myocardial infarction: clinical experience. 18 87

Scintigraphy with pyrophosphate 99mTc was performed in 230 patients with various forms of ischemic heart disease and in 15 persons with pain in the region of the heart caused by osteochondrosis of the cervical and thoracic spinal segments or vegetovascular dystonia (control group). It was found that labelled purophosphate accumulated in the myocardium in necrosis of the heart muscle or when coronary insufficiency takes a course in which necrosis of the myocardial cells is quite possible. Positive results of scintigraphy with pyrophosphate 99mTc are not a strict criterion of acute myocardial infarction because they are also encountered in a chronic course of ischemic heart disease and are evidence in this case that "a state of risk" has occurred during the disease.
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PMID:[Importance of pyrophosphate-99mTc scintigraphy in the diagnosis of acute myocardial infarct]. 22

There were under observation 440 patients with ischemic heart disease due to atherosclerosis of the coronary arteries in the phase of exacerbation of the disease and 52 patients suffering from hypertensive disease with a clinical picture of ischemic heart disease; 192 practically healthy individuals were examined as controls. Significant increase in the levels of cholesterol, triglycerides, and glucose in blood of the patients with ischemic heart disease and of those with hypertensive disease was revealed. In patients with ischemic heart disease marked by pain and disorders of the rhythm as well as in individuals with hypertensive disease hormonal-metabolic shifts, monotypical in character, were noted. It is suggested that hormonal-regulatory disorders are of primary character in atherogenesis.
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PMID:[Hormonal and metabolic disorders in ischemic heart disease]. 36 20

Coronary artery spasm was induced by intravascular administration of ergonovine maleate (Ergotrate) during cardiac catheterization. In 78 patients suspected to have Prinzmetal's angina, no morbidity or death has resulted despite complete occlusive spasm in two and three coronary arteries. Typical EKG changes and akinesia of the myocardium in the distribution of the occluded vessels documented functional myocardial ischemia during spasm. The occlusive spasm is readily reversed by sublingual or intravascular nitroglycerin, and ventricular contractility returns to normal following relief of spasm. Occlusive spasm has been demonstrated in 15 patients with clinical evidence of Prinzmetal's angina. Symptoms have been effectively relieved by coronary vasodilators in 10 patients. Of the 5 patients in whom medical therapy failed, 4 were treated surgically. These 4 patients were in the intensive care unit with protracted, prolonged pain, subendocardial infarctions, and persistent failure of coronary vasodilators. Aorta-coronary bypass grafts have been combined with total cardiac denervation by autotransplantation (one patient) and total cardiac denervation by stripping of the great vessels (3 patients). Two of the patients treated by cardiac denervation died in the early postoperative period. The patient treated by autotransplantation has total relief of symptoms but persistent spasm on angiography. The angiographic demonstration of occlusive coronary spasm remains a valuable diagnostic tool to document definitively the presence of spasm. The surgical results question the value of surgical intervention in this disease.
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PMID:Coronary artery spasm. medical management, surgical denervation, and autotransplantation. 40 7

Oesophageal dysfunction (OD) is a common finding in patients discharged from a coronary care unit without definite diagnosis. Of 55 patients investigated with oesophageal manometry, acid perfusion test and exercise ECG, 32 had signs of OD and 19 signs of ischaemic heart disease (IHD). Symptoms such as heart burn, acid regurgitations, feeling of a lump in the throat, surfeitness after meals, chest pain at night, and relief of chest pain when lying with the head raised were significantly more common in patients with OD than in patients with normal oesophageal function. Chest pain was significantly more often provoked by effort, emotions or cold and more often relieved by nitroglycerine in patients with signs of IHD than in those without. These pain-provoking factors were, however, also common in patients with OD. A careful case history with specific inquiry directed at not only cardiac but also oesophageal symptoms is important in the differential diagnosis of chest pain.
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PMID:Oesophageal dysfunction in non-infarction coronary care unit patients. 43 65

A 60-year-old patient with variant angina was shown to have myocardial ischemia in two different regions supplied by separate major coronary arteries. Neither artery had significant coronary atherosclerotic obstruction. Ventricular fibrillation was noted during ST-segment elevation in anteroseptal leads. The attacks of pain and arrhythmias disappeared during nifedipine therapy.
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PMID:Multivessel coronary artery spasm. 44 62

Bicycle ergometry on the "Elema" electrical bicycle ergometer was conducted on 6, patients of climacteric age (41 to 55 years) with pain in the region of the heart and ECG changes. The method made it possible to confirm the diagnosis of climacteric cardiopathy in 39 and to reveal climacteric cardiopathy and concurrent ischemic heart disease in 23 patients. It was noted that physical load had a favourable effect on processes of repolarization in the myocardium of patients with climacteric cardiopathy.
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PMID:[Use of the bicycle ergometric test in the differential diagnosis of climacteric cardiopathy]. 45 27


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