The symptom of paroxysmal pain consequent to MYOCARDIAL ISCHEMIA usually of distinctive character, location and radiation. It is thought to be provoked by a transient stressful situation during which the oxygen requirements of the MYOCARDIUM exceed that supplied by the CORONARY CIRCULATION.
Precordial pain at rest, which may precede a MYOCARDIAL INFARCTION.
A clinical syndrome characterized by the development of CHEST PAIN at rest with concomitant transient ST segment elevation in the ELECTROCARDIOGRAM, but with preserved exercise capacity.
Persistent and reproducible chest discomfort usually precipitated by a physical exertion that dissipates upon cessation of such an activity. The symptoms are manifestations of MYOCARDIAL ISCHEMIA.
A volatile vasodilator which relieves ANGINA PECTORIS by stimulating GUANYLATE CYCLASE and lowering cytosolic calcium. It is also sometimes used for TOCOLYSIS and explosives.
A technique for assisting the circulation by decreasing the afterload of the left ventricle and augmenting the diastolic pressure. It may be achieved by intra-aortic balloon, or by implanting a special pumping device in the chest, or externally by applying a negative pressure to the lower extremities during cardiac systole.
Radiography of the vascular system of the heart muscle after injection of a contrast medium.
ANGINA PECTORIS or angina-like chest pain with a normal coronary arteriogram and positive EXERCISE TEST. The cause of the syndrome is unknown. While its recognition is of clinical importance, its prognosis is excellent. (Braunwald, Heart Disease, 4th ed, p1346; Jablonski Dictionary of Syndromes & Eponymic Diseases, 2d ed). It is different from METABOLIC SYNDROME X, a syndrome characterized by INSULIN RESISTANCE and HYPERINSULINEMIA, that has increased risk for cardiovascular disease.
NECROSIS of the MYOCARDIUM caused by an obstruction of the blood supply to the heart (CORONARY CIRCULATION).
Controlled physical activity which is performed in order to allow assessment of physiological functions, particularly cardiovascular and pulmonary, but also aerobic capacity. Maximal (most intense) exercise is usually required but submaximal exercise is also used.
An imbalance between myocardial functional requirements and the capacity of the CORONARY VESSELS to supply sufficient blood flow. It is a form of MYOCARDIAL ISCHEMIA (insufficient blood supply to the heart muscle) caused by a decreased capacity of the coronary vessels.
Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY.
A drug used in the treatment of angina pectoris, heart failure, conduction defects, and myocardial infarction. It is a partial agonist at beta adrenergic receptors and acts as a coronary vasodilator and cardiotonic agent.
Spasm of the large- or medium-sized coronary arteries.
Pathological processes of CORONARY ARTERIES that may derive from a congenital abnormality, atherosclerotic, or non-atherosclerotic cause.
A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (CORONARY ARTERY DISEASE), to obstruction by a thrombus (CORONARY THROMBOSIS), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (MYOCARDIAL INFARCTION).
A vasodilator used in the treatment of ANGINA PECTORIS. Its actions are similar to NITROGLYCERIN but with a slower onset of action.
An ergot alkaloid (ERGOT ALKALOIDS) with uterine and VASCULAR SMOOTH MUSCLE contractile properties.
The veins and arteries of the HEART.
Compounds possessing both a hydroxyl (-OH) and an amino group (-NH2).
Drugs that bind to but do not activate beta-adrenergic receptors thereby blocking the actions of beta-adrenergic agonists. Adrenergic beta-antagonists are used for treatment of hypertension, cardiac arrhythmias, angina pectoris, glaucoma, migraine headaches, and anxiety.
Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.
Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.
Dilation of an occluded coronary artery (or arteries) by means of a balloon catheter to restore myocardial blood supply.
Pressure, burning, or numbness in the chest.
A potent vasodilator agent with calcium antagonistic action. It is a useful anti-anginal agent that also lowers blood pressure.
Expenditure of energy during PHYSICAL ACTIVITY. Intensity of exertion may be measured by rate of OXYGEN CONSUMPTION; HEAT produced, or HEART RATE. Perceived exertion, a psychological measure of exertion, is included.
A selective adrenergic beta-1 blocking agent that is commonly used to treat ANGINA PECTORIS; HYPERTENSION; and CARDIAC ARRHYTHMIAS.
An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.
Percutaneous transluminal procedure for removing atheromatous plaque from the coronary arteries. Both directional (for removing focal atheromas) and rotational (for removing concentric atheromatous plaque) atherectomy devices have been used.
A widely used non-cardioselective beta-adrenergic antagonist. Propranolol has been used for MYOCARDIAL INFARCTION; ARRHYTHMIA; ANGINA PECTORIS; HYPERTENSION; HYPERTHYROIDISM; MIGRAINE; PHEOCHROMOCYTOMA; and ANXIETY but adverse effects instigate replacement by newer drugs.
Compounds based on N-phenylacetamide, that are similar in structure to 2-PHENYLACETAMIDES. They are precursors of many other compounds. They were formerly used as ANALGESICS and ANTIPYRETICS, but often caused lethal METHEMOGLOBINEMIA.
The restoration of blood supply to the myocardium. (From Dorland, 28th ed)
A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment.
Motion pictures of the passage of contrast medium through blood vessels.
A beta-1 adrenergic antagonist that has been used in the emergency treatment of CARDIAC ARRYTHMIAS.
An episode of MYOCARDIAL ISCHEMIA that generally lasts longer than a transient anginal episode that ultimately may lead to MYOCARDIAL INFARCTION.
The number of times the HEART VENTRICLES contract per unit of time, usually per minute.
Radiography of the heart and great vessels after injection of a contrast medium.
A beta-adrenergic antagonist used in the treatment of hypertension, angina pectoris, arrhythmias, and anxiety.
Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion.
Graphic registration of the heart sounds picked up as vibrations and transformed by a piezoelectric crystal microphone into a varying electrical output according to the stresses imposed by the sound waves. The electrical output is amplified by a stethograph amplifier and recorded by a device incorporated into the electrocardiograph or by a multichannel recording machine.
The circulation of blood through the CORONARY VESSELS of the HEART.
Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.
A derivative of the NIACINAMIDE that is structurally combined with an organic nitrate. It is a potassium-channel opener that causes vasodilatation of arterioles and large coronary arteries. Its nitrate-like properties produce venous vasodilation through stimulation of guanylate cyclase.
Method in which prolonged electrocardiographic recordings are made on a portable tape recorder (Holter-type system) or solid-state device ("real-time" system), while the patient undergoes normal daily activities. It is useful in the diagnosis and management of intermittent cardiac arrhythmias and transient myocardial ischemia.
Measurable and quantifiable biological parameters (e.g., specific enzyme concentration, specific hormone concentration, specific gene phenotype distribution in a population, presence of biological substances) which serve as indices for health- and physiology-related assessments, such as disease risk, psychiatric disorders, environmental exposure and its effects, disease diagnosis, metabolic processes, substance abuse, pregnancy, cell line development, epidemiologic studies, etc.
A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations.
Works about pre-planned studies of the safety, efficacy, or optimum dosage schedule (if appropriate) of one or more diagnostic, therapeutic, or prophylactic drugs, devices, or techniques selected according to predetermined criteria of eligibility and observed for predefined evidence of favorable and unfavorable effects. This concept includes clinical trials conducted both in the U.S. and in other countries.
Drugs that inhibit the actions of the sympathetic nervous system by any mechanism. The most common of these are the ADRENERGIC ANTAGONISTS and drugs that deplete norepinephrine or reduce the release of transmitters from adrenergic postganglionic terminals (see ADRENERGIC AGENTS). Drugs that act in the central nervous system to reduce sympathetic activity (e.g., centrally acting alpha-2 adrenergic agonists, see ADRENERGIC ALPHA-AGONISTS) are included here.
Drugs used to cause dilation of the blood vessels.
Lesions formed within the walls of ARTERIES.
Severe cellulitis of the submaxillary space with secondary involvement of the sublingual and submental space. It usually results from infection in the lower molar area or from a penetrating injury to the mouth floor. (From Dorland, 27th ed)
A cardioselective beta-1 adrenergic blocker possessing properties and potency similar to PROPRANOLOL, but without a negative inotropic effect.
A class of drugs that act by selective inhibition of calcium influx through cellular membranes.
A calcium channel blocker that is a class IV anti-arrhythmia agent.
The use of ultrasound to guide minimally invasive surgical procedures such as needle ASPIRATION BIOPSY; DRAINAGE; etc. Its widest application is intravascular ultrasound imaging but it is useful also in urology and intra-abdominal conditions.
Elements of limited time intervals, contributing to particular results or situations.
PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS.
Narrowing or constriction of a coronary artery.
A plasma protein that circulates in increased amounts during inflammation and after tissue damage.
Application of electric current to the spine for treatment of a variety of conditions involving innervation from the spinal cord.
Any dummy medication or treatment. Although placebos originally were medicinal preparations having no specific pharmacological activity against a targeted condition, the concept has been extended to include treatments or procedures, especially those administered to control groups in clinical trials in order to provide baseline measurements for the experimental protocol.
AMINO ALCOHOLS containing the propanolamine (NH2CH2CHOHCH2) group and its derivatives.
Agents that affect the rate or intensity of cardiac contraction, blood vessel diameter, or blood volume.
In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.
The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM.
The use of photothermal effects of LASERS to coagulate, incise, vaporize, resect, dissect, or resurface tissue.
The natural enzymatic dissolution of FIBRIN.
One of the three polypeptide chains that make up the TROPONIN complex. It is a cardiac-specific protein that binds to TROPOMYOSIN. It is released from damaged or injured heart muscle cells (MYOCYTES, CARDIAC). Defects in the gene encoding troponin T result in FAMILIAL HYPERTROPHIC CARDIOMYOPATHY.
The return of a sign, symptom, or disease after a remission.
Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.
Application of electric current in treatment without the generation of perceptible heat. It includes electric stimulation of nerves or muscles, passage of current into the body, or use of interrupted current of low intensity to raise the threshold of the skin to pain.
Procedures in which placement of CARDIAC CATHETERS is performed for therapeutic or diagnostic procedures.
A salicylamide derivative that is a non-cardioselective blocker of BETA-ADRENERGIC RECEPTORS and ALPHA-1 ADRENERGIC RECEPTORS.
Maintenance of blood flow to an organ despite obstruction of a principal vessel. Blood flow is maintained through small vessels.
A pteridine derivative present in body fluids; elevated levels result from immune system activation, malignant disease, allograft rejection, and viral infections. (From Stedman, 26th ed) Neopterin also serves as a precursor in the biosynthesis of biopterin.
The exercise capacity of an individual as measured by endurance (maximal exercise duration and/or maximal attained work load) during an EXERCISE TEST.
Coagulation of blood in any of the CORONARY VESSELS. The presence of a blood clot (THROMBUS) often leads to MYOCARDIAL INFARCTION.
The hollow, muscular organ that maintains the circulation of the blood.
A moderately lipophilic beta blocker (ADRENERGIC BETA-ANTAGONISTS). It is non-cardioselective and has intrinsic sympathomimetic actions, but little membrane-stabilizing activity. (From Martindale, The Extra Pharmocopoeia, 30th ed, p638)
A vasodilator used in angina of effort or ischemic heart disease.
Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care. (Dictionary of Health Services Management, 2d ed)
Therapy with two or more separate preparations given for a combined effect.
A benzothiazepine derivative with vasodilating action due to its antagonism of the actions of CALCIUM ion on membrane functions.
Ocular disorders attendant upon non-ocular disease or injury.
Dosage forms of a drug that act over a period of time by controlled-release processes or technology.
Methods and procedures for the diagnosis of diseases or dysfunction of the cardiovascular system or its organs or demonstration of their physiological processes.
A drug formerly used in the treatment of angina pectoris but superseded by less hazardous drugs. Prenylamine depletes myocardial catecholamine stores and has some calcium channel blocking activity. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1406)
An alpha-1 adrenergic antagonist that is commonly used as an antihypertensive agent.
Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting.
The abrupt cessation of all vital bodily functions, manifested by the permanent loss of total cerebral, respiratory, and cardiovascular functions.
The amount of BLOOD pumped out of the HEART per beat, not to be confused with cardiac output (volume/time). It is calculated as the difference between the end-diastolic volume and the end-systolic volume.
A clinical syndrome with intermittent abdominal pain characterized by sudden onset and cessation that is commonly seen in infants. It is usually associated with obstruction of the INTESTINES; of the CYSTIC DUCT; or of the URINARY TRACT.
Plasma glycoprotein clotted by thrombin, composed of a dimer of three non-identical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products.
A vasodilator with general properties similar to NITROGLYCERIN but with a more prolonged duration of action. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1025)
Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable.
A phosphodiesterase inhibitor that blocks uptake and metabolism of adenosine by erythrocytes and vascular endothelial cells. Dipyridamole also potentiates the antiaggregating action of prostacyclin. (From AMA Drug Evaluations Annual, 1994, p752)
A distribution in which a variable is distributed like the sum of the squares of any given independent random variable, each of which has a normal distribution with mean of zero and variance of one. The chi-square test is a statistical test based on comparison of a test statistic to a chi-square distribution. The oldest of these tests are used to detect whether two or more population distributions differ from one another.
Recording of the moment-to-moment electromotive forces of the heart on a plane of the body surface delineated as a vector function of time.
Drugs or agents which antagonize or impair any mechanism leading to blood platelet aggregation, whether during the phases of activation and shape change or following the dense-granule release reaction and stimulation of the prostaglandin-thromboxane system.
Studies which start with the identification of persons with a disease of interest and a control (comparison, referent) group without the disease. The relationship of an attribute to the disease is examined by comparing diseased and non-diseased persons with regard to the frequency or levels of the attribute in each group.
The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from PREVALENCE, which refers to all cases, new or old, in the population at a given time.
A transferase that catalyzes formation of PHOSPHOCREATINE from ATP + CREATINE. The reaction stores ATP energy as phosphocreatine. Three cytoplasmic ISOENZYMES have been identified in human tissues: the MM type from SKELETAL MUSCLE, the MB type from myocardial tissue and the BB type from nervous tissue as well as a mitochondrial isoenzyme. Macro-creatine kinase refers to creatine kinase complexed with other serum proteins.
Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.
A method of computed tomography that uses radionuclides which emit a single photon of a given energy. The camera is rotated 180 or 360 degrees around the patient to capture images at multiple positions along the arc. The computer is then used to reconstruct the transaxial, sagittal, and coronal images from the 3-dimensional distribution of radionuclides in the organ. The advantages of SPECT are that it can be used to observe biochemical and physiological processes as well as size and volume of the organ. The disadvantage is that, unlike positron-emission tomography where the positron-electron annihilation results in the emission of 2 photons at 180 degrees from each other, SPECT requires physical collimation to line up the photons, which results in the loss of many available photons and hence degrades the image.
A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables.
Inorganic or organic salts and esters of nitric acid. These compounds contain the NO3- radical.
2-(2,2-Dicyclohexylethyl)piperidine. Coronary vasodilator used especially for angina of effort. It may cause neuropathy and hepatitis.
Computed tomography where there is continuous X-ray exposure to the patient while being transported in a spiral or helical pattern through the beam of irradiation. This provides improved three-dimensional contrast and spatial resolution compared to conventional computed tomography, where data is obtained and computed from individual sequential exposures.
The formation of clumps of RED BLOOD CELLS under low or non-flow conditions, resulting from the attraction forces between the red blood cells. The cells adhere to each other in rouleaux aggregates. Slight mechanical force, such as occurs in the circulation, is enough to disperse these aggregates. Stronger or weaker than normal aggregation may result from a variety of effects in the ERYTHROCYTE MEMBRANE or in BLOOD PLASMA. The degree of aggregation is affected by ERYTHROCYTE DEFORMABILITY, erythrocyte membrane sialylation, masking of negative surface charge by plasma proteins, etc. BLOOD VISCOSITY and the ERYTHROCYTE SEDIMENTATION RATE are affected by the amount of erythrocyte aggregation and are parameters used to measure the aggregation.
The lower right and left chambers of the heart. The right ventricle pumps venous BLOOD into the LUNGS and the left ventricle pumps oxygenated blood into the systemic arterial circulation.
Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from DRUG RESISTANCE wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from MAXIMUM TOLERATED DOSE and NO-OBSERVED-ADVERSE-EFFECT LEVEL.
Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic.
The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)
The process which spontaneously arrests the flow of BLOOD from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements (eg. ERYTHROCYTE AGGREGATION), and the process of BLOOD COAGULATION.
The internal resistance of the BLOOD to shear forces. The in vitro measure of whole blood viscosity is of limited clinical utility because it bears little relationship to the actual viscosity within the circulation, but an increase in the viscosity of circulating blood can contribute to morbidity in patients suffering from disorders such as SICKLE CELL ANEMIA and POLYCYTHEMIA.
Abdominal symptoms after removal of the GALLBLADDER. The common postoperative symptoms are often the same as those present before the operation, such as COLIC, bloating, NAUSEA, and VOMITING. There is pain on palpation of the right upper quadrant and sometimes JAUNDICE. The term is often used, inaccurately, to describe such postoperative symptoms not due to gallbladder removal.

The effect of race and sex on physicians' recommendations for cardiac catheterization. (1/2517)

BACKGROUND: Epidemiologic studies have reported differences in the use of cardiovascular procedures according to the race and sex of the patient. Whether the differences stem from differences in the recommendations of physicians remains uncertain. METHODS: We developed a computerized survey instrument to assess physicians' recommendations for managing chest pain. Actors portrayed patients with particular characteristics in scripted interviews about their symptoms. A total of 720 physicians at two national meetings of organizations of primary care physicians participated in the survey. Each physician viewed a recorded interview and was given other data about a hypothetical patient. He or she then made recommendations about that patient's care. We used multivariate logistic-regression analysis to assess the effects of the race and sex of the patients on treatment recommendations, while controlling for the physicians' assessment of the probability of coronary artery disease as well as for the age of the patient, the level of coronary risk, the type of chest pain, and the results of an exercise stress test. RESULTS: The physicians' mean (+/-SD) estimates of the probability of coronary artery disease were lower for women (probability, 64.1+/-19.3 percent, vs. 69.2+/-18.2 percent for men; P<0.001), younger patients (63.8+/-19.5 percent for patients who were 55 years old, vs. 69.5+/-17.9 percent for patients who were 70 years old; P<0.001), and patients with nonanginal pain (58.3+/-19.0 percent, vs. 64.4+/-18.3 percent for patients with possible angina and 77.1+/-14.0 percent for those with definite angina; P=0.001). Logistic-regression analysis indicated that women (odds ratio, 0.60; 95 percent confidence interval, 0.4 to 0.9; P=0.02) and blacks (odds ratio, 0.60; 95 percent confidence interval, 0.4 to 0.9; P=0.02) were less likely to be referred for cardiac catheterization than men and whites, respectively. Analysis of race-sex interactions showed that black women were significantly less likely to be referred for catheterization than white men (odds ratio, 0.4; 95 percent confidence interval, 0.2 to 0.7; P=0.004). CONCLUSIONS: Our findings suggest that the race and sex of a patient independently influence how physicians manage chest pain.  (+info)

Fibrinolytic activation markers predict myocardial infarction in the elderly. The Cardiovascular Health Study. (2/2517)

Coagulation factor levels predict arterial thrombosis in epidemiological studies, but studies of older persons are needed. We studied 3 plasma antigenic markers of fibrinolysis, viz, plasminogen activator inhibitor-1 (PAI-1), fibrin fragment D-dimer, and plasmin-antiplasmin complex (PAP) for the prediction of arterial thrombosis in healthy elderly persons over age 65. The study was a nested case-control study in the Cardiovascular Health Study cohort of 5201 men and women >/=65 years of age who were enrolled from 1989 to 1990. Cases were 146 participants without baseline clinical vascular disease who developed myocardial infarction, angina, or coronary death during a follow-up of 2.4 years. Controls remained free of cardiovascular events and were matched 1:1 to cases with respect to sex, duration of follow-up, and baseline subclinical vascular disease status. With increasing quartile of D-dimer and PAP levels but not of PAI-1, there was an independent increased risk of myocardial infarction or coronary death, but not of angina. The relative risk for D-dimer above versus below the median value (>/=120 microg/L) was 2.5 (95% confidence interval, 1.1 to 5.9) and for PAP above the median (>/=5.25 nmol/L), 3.1 (1.3 to 7.7). Risks were independent of C-reactive protein and fibrinogen concentrations. There were no differences in risk by sex or presence of baseline subclinical disease. D-dimer and PAP, but not PAI-1, predicted future myocardial infarction in men and women over age 65. Relationships were independent of other risk factors, including inflammation markers. Results indicate a major role for these markers in identifying a high risk of arterial disease in this age group.  (+info)

Randomised controlled trial of follow up care in general practice of patients with myocardial infarction and angina: final results of the Southampton heart integrated care project (SHIP). The SHIP Collaborative Group. (3/2517)

OBJECTIVE: To assess the effectiveness of a programme to coordinate and support follow up care in general practice after a hospital diagnosis of myocardial infarction or angina. DESIGN: Randomised controlled trial; stratified random allocation of practices to intervention and control groups. SETTING: All 67 practices in Southampton and south west Hampshire, England. SUBJECTS: 597 adult patients (422 with myocardial infarction and 175 with a new diagnosis of angina) who were recruited during hospital admission or attendance at a chest pain clinic between April 1995 and September 1996. INTERVENTION: Programme to coordinate preventive care led by specialist liaison nurses which sought to improve communication between hospital and general practice and to encourage general practice nurses to provide structured follow up. MAIN OUTCOME MEASURES: Serum total cholesterol concentration, blood pressure, distance walked in 6 minutes, confirmed smoking cessation, and body mass index measured at 1 year follow up. RESULTS: Of 559 surviving patients at 1 year, 502 (90%) were followed up. There was no significant difference between the intervention and control groups in smoking (cotinine validated quit rate 19% v 20%), lipid concentrations (serum total cholesterol 5.80 v 5.93 mmol/l), blood pressure (diastolic pressure 84 v 85 mm Hg), or fitness (distance walked in 6 minutes 443 v 433 m). Body mass index was slightly lower in the intervention group (27.4 v 28.2; P=0.08). CONCLUSIONS: Although the programme was effective in promoting follow up in general practice, it did not improve health outcome. Simply coordinating and supporting existing NHS care is insufficient. Ischaemic heart disease is a chronic condition which requires the same systematic approach to secondary prevention applied in other chronic conditions such as diabetes mellitus.  (+info)

The transmyocardial laser revascularization international registry report. (4/2517)

AIMS: This report aimed to provide an analysis of the data submitted from Europe and Asia on transmyocardial laser revascularization. METHODS AND RESULTS: Prospective data was recorded on 967 patients with intractable angina not amenable to conventional revascularization in 21 European and Asian centres performing transmyocardial laser revascularization using the PLC Medical Systems CO2 laser. Patient characteristics, operative details and early complications following transmyocardial laser revascularization were recorded. The in-hospital death rate was 9.7% (95% confidence interval 7.8% to 11.6%). Other early complications were consistent with similar cardiothoracic surgical procedures. There was a decrease of two or more Canadian Cardiovascular Score angina classes in 47.3%, 45.4% and 34.0% of survivors at 3, 6 and 12 months follow-up, respectively (P=0.001 for each). Treadmill exercise time increased by 42 s at 3 months (P=0.008), 1 min 43 s at 6 months (P<0.001) and 1 min 50 s at 12 months (P<0.001) against pre-operative times of 6 min. CONCLUSION: Uncontrolled registry data suggest that transmyocardial laser revascularization may lead to a decrease in angina and improved exercise tolerance. It does, however, have a risk of peri-operative morbidity and mortality. Definitive results from randomized controlled trials are awaited.  (+info)

Heart rate variability and ischaemia in patients with coronary heart disease and stable angina pectoris; influence of drug therapy and prognostic value. TIBBS Investigators Group. Total Ischemic Burden Bisoprolol Study. (5/2517)

AIMS: Determination of the influence of therapy with bisoprolol and nifedipine on the heart rate variability of patients from the Total Ischemic Burden Bisoprolol Study and examination of the prognostic value. METHODS AND RESULTS: Four hundred and twenty-two patients with stable angina were included. The heart rate variability was determined over a period of 24 h. Parameters determined: standard deviation of the mean of all corrected RR intervals, standard deviation of all 5 min mean cycle lengths, square root of the mean of the squared differences of successive corrected RR intervals. Nifedipine reduced the mean values of all heart rate variability parameters tested. Square root of the mean of the square differences of successive corrected RR intervals increased under bisoprolol. Standard deviation of the mean of all corrected RR intervals and standard deviation of all 5 min mean cycle lengths increased from low baseline values and declined from higher baseline values. The increase in heart rate variability under therapy was accompanied by a tendency towards a better prognosis. Patients with an increase in heart rate variability and simultaneous complete suppression of ischaemia under therapy displayed no serious events in the course of one year. CONCLUSIONS: The increase in the heart rate variability, which can be regarded as prognostically favourable, was predominantly observed under bisoprolol. The parameter constellation of an increase in heart rate variability and complete ischaemia suppression on the 48-h Holter ECG was associated with the greatest benefit.  (+info)

Evaluation of technician supervised treadmill exercise testing in a cardiac chest pain clinic. (6/2517)

OBJECTIVE: To determine the efficacy and safety of trained cardiac technicians independently performing treadmill exercise stress tests as part of the assessment of patients with suspected angina pectoris. DESIGN: Retrospective comparison of 250 exercise tests performed by cardiac technicians and 225 tests performed by experienced cardiology clinical assistants (general practitioners who perform regular NHS cardiology duties), and consultant cardiologists over the same time period. SETTING: Regional cardiac centre with a dedicated cardiac chest pain clinic. PATIENTS: All patients were referred by their general practitioners with a history of recent onset of chest pain, which was suspected to be angina pectoris. OUTCOME MEASURES: Peak workload achieved, symptoms, indications for termination, complications. RESULTS: The diagnostic yield of technician supervised tests (percentage positive or negative) was similar to that of medically supervised tests (76% v 69%, NS). The average peak workload achieved by patients was less by 1.2 mets (p < 0.005). This was probably due to more tests being terminated earlier due to chest pain and ST segment depression in the technician group compared with doctors (10% and 16% v 5% and 11% respectively, p = 0.06 and 0.07). One patient in the technician supervised group developed a supraventricular tachycardia during the recovery phase of the exercise test. CONCLUSIONS: Technician supervised stress testing is associated with a high diagnostic rate and low complication rate in patients with suspected ischaemic heart disease. Its efficacy is comparable to tests supervised by experienced doctors and its use should be encouraged.  (+info)

Follow-up care in general practice of patients with myocardial infarction or angina pectoris: initial results of the SHIP trial. Southampton Heart Integrated Care Project. (7/2517)

OBJECTIVE: We aimed to assess the effectiveness of a nurse-led programme to ensure that follow-up care is provided in general practice after hospital diagnosis of myocardial infarction (MI) or angina pectoris. METHODS: We conducted a randomized controlled trial with stratified random allocation of practices to intervention and control groups within all 67 practices in Southampton and South-West Hampshire, England. The subjects were 422 adult patients with a MI and 175 patients with a new diagnosis of angina recruited during hospital admission or chest pain clinic attendance between April 1995 and September 1996. Intervention involved a programme of secondary preventive care led by specialist liaison nurses in which we sought to improve communication between hospital and general practice and to encourage general practice nurses to provide structured follow-up. The main outcome measures were: extent of general practice follow-up; attendance for cardiac rehabilitation; medication prescribed at hospital discharge; self-reported smoking, diet and exercise; and symptoms of chest pain and shortness of breath. Follow-ups of 90.1 % of subjects at 1 month and 80.6% at 4 months were carried out. RESULTS: Median attendance for nurse follow-up in the 4 months following diagnosis was 3 (IQR 2-5) in intervention practices and 0 (IQR 0-1) in control practices; the median number of visits to a doctor was the same in both groups. At hospital discharge, levels of prescribing of preventive medication were low in both intervention and control groups: aspirin 77 versus 74% (P = 0.32), cholesterol lowering agents 9 versus 10% (P = 0.8). Conversely, 1 month after diagnosis, the vast majority of patients in both groups reported healthy lifestyles: 90 versus 84% reported eating healthy food (P = 0.53); 73 versus 67% taking regular exercise (P = 0.13); 89 versus 92% not smoking (P = 0.77). Take up of cardiac rehabilitation was 37% in the intervention group and 22% in the control group (P = 0.001); the median number of sessions attended was also higher (5 versus 3 out of 6). CONCLUSIONS: The intervention of a liaison nurse is effective in ensuring that general practice nurses follow-up patients after hospital discharge. It does not alter the number of follow-up visits made by the patient to the doctor. Levels of prescribing and reported changes in behaviour at hospital discharge indicate that the main tasks facing practice nurses during follow-up are to help patients to sustain changes in behaviour, to encourage doctors to prescribe appropriate medication and to encourage patients to adhere to medication while returning to an active life. These are very different tasks to those traditionally undertaken by practice nurses in relation to primary prevention, where the emphasis has been on identifying risk and motivating change. Assessment of the effectiveness of practice nurses in undertaking these new tasks requires a longer follow-up.  (+info)

The economic consequences of available diagnostic and prognostic strategies for the evaluation of stable angina patients: an observational assessment of the value of precatheterization ischemia. Economics of Noninvasive Diagnosis (END) Multicenter Study Group. (8/2517)

OBJECTIVES: The study aim was to determine observational differences in costs of care by the coronary disease diagnostic test modality. BACKGROUND: A number of diagnostic strategies are available with few data to compare the cost implications of the initial test choice. METHODS: We prospectively enrolled 11,372 consecutive stable angina patients who were referred for stress myocardial perfusion tomography or cardiac catheterization. Stress imaging patients were matched by their pretest clinical risk of coronary disease to a series of patients referred to cardiac catheterization. Composite 3-year costs of care were compared for two patients management strategies: 1) direct cardiac catheterization (aggressive) and 2) initial stress myocardial perfusion tomography and selective catheterization of high risk patients (conservative). Analysis of variance techniques were used to compare costs, adjusting for treatment propensity and pretest risk. RESULTS: Observational comparisons of aggressive as compared with conservative testing strategies reveal that costs of care were higher for direct cardiac catheterization in all clinical risk subsets (range: $2,878 to $4,579), as compared with stress myocardial perfusion imaging plus selective catheterization (range: $2,387 to $3,010, p < 0.0001). Coronary revascularization rates were higher for low, intermediate and high risk direct catheterization patients as compared with the initial stress perfusion imaging cohort (13% to 50%, p < 0.0001); cardiac death or myocardial infarction rates were similar (p > 0.20). CONCLUSIONS: Observational assessments reveal that stable chest pain patients who undergo a more aggressive diagnostic strategy have higher diagnostic costs and greater rates of intervention and follow-up costs. Cost differences may reflect a diminished necessity for resource consumption for patients with normal test results.  (+info)

Angina pectoris is a medical condition that is characterized by recurring chest pain or discomfort due to reduced blood flow and oxygen supply to the heart muscle, specifically the myocardium. It is also known as stable angina or effort angina. The symptoms of angina pectoris typically occur during physical activity or emotional stress and are relieved by rest.

The term "angina" comes from the Latin word for "strangulation," which refers to the feeling of tightness or constriction in the chest that is associated with the condition. Angina pectoris can be caused by atherosclerosis, or the buildup of plaque in the coronary arteries, which supply blood to the heart muscle. This buildup can lead to the formation of atherosclerotic plaques that can narrow the coronary arteries and reduce blood flow to the heart muscle, causing chest pain.

There are several types of angina pectoris, including:

1. Stable angina: This is the most common type of angina and is characterized by predictable and reproducible symptoms that occur during specific situations or activities, such as exercise or emotional stress.
2. Unstable angina: This type of angina is characterized by unpredictable and changing symptoms that can occur at rest or with minimal exertion. It is often a sign of a more severe underlying condition, such as a heart attack.
3. Variant angina: This type of angina occurs during physical activity, but the symptoms are not relieved by rest.
4. Prinzmetal's angina: This is a rare type of angina that occurs at rest and is characterized by a feeling of tightness or constriction in the chest.

The diagnosis of angina pectoris is typically made based on a combination of physical examination, medical history, and diagnostic tests such as electrocardiogram (ECG), stress test, and imaging studies. Treatment for angina pectoris usually involves lifestyle modifications, such as regular exercise, a healthy diet, and stress management, as well as medications to relieve symptoms and reduce the risk of complications. In some cases, surgery or other procedures may be necessary to treat the underlying condition causing the angina.

Word origin: Greek "anginos" meaning "pain in the neck".

The causes of angina pectoris, variant are not well understood, but it is believed to be related to a decrease in blood flow to the heart muscle, particularly during times of rest or low exertion. This can lead to a lack of oxygen and nutrients to the heart muscle, which can cause pain.

The diagnosis of angina pectoris, variant is based on a combination of clinical symptoms, physical examination findings, and results of diagnostic tests such as electrocardiography (ECG), stress test, and echocardiography. Treatment for this condition typically involves medications such as nitrates, calcium channel blockers, and beta-blockers to relieve pain and improve blood flow to the heart muscle. In some cases, surgery may be necessary to improve blood flow or to treat underlying conditions that are contributing to the angina.

Prevention of angina pectoris, variant includes lifestyle modifications such as regular exercise, stress reduction techniques, and avoiding smoking and alcohol consumption. It is important for individuals with this condition to work closely with their healthcare provider to manage their symptoms and prevent complications.

It is important to note that stable angina is different from unstable angina, which is a more severe and potentially life-threatening condition that can occur when there is a sudden blockage in one of the coronary arteries. Unlike stable angina, unstable angina can cause severe chest pain or discomfort that can radiate to other parts of the body and can be accompanied by other symptoms such as shortness of breath, nausea, and vomiting.

Stable angina is often described as a squeezing, pressing, or aching sensation in the chest that can be triggered by physical activity or emotional stress. The pain typically subsides within a few minutes after resting or taking medication. People with stable angina may also experience pain in their arms, shoulders, neck, jaw, or back.

Stable angina is usually diagnosed through a combination of physical examination, medical history, and diagnostic tests such as electrocardiogram (ECG), stress test, and blood tests. Treatment for stable angina typically involves medications to reduce the workload on the heart, improve blood flow, and manage pain. Lifestyle changes such as regular exercise, a healthy diet, and stress management techniques can also help manage the condition. In some cases, surgery may be necessary to open or bypass blocked coronary arteries.

In summary, stable angina is a predictable and manageable type of chest pain that occurs when the heart muscle is not receiving enough oxygen-rich blood due to blockages in the coronary arteries. It can be treated with medication, lifestyle changes, and in some cases, surgery. It is important to seek medical attention if symptoms persist or worsen over time, as this could indicate a more severe condition such as unstable angina or a heart attack.

The symptoms of microvascular angina are similar to those of stable angina, including chest pain or discomfort, shortness of breath, and fatigue. However, microvascular angina episodes can be more frequent and unpredictable than stable angina, and may occur at rest or with minimal exertion.

The diagnosis of microvascular angina is based on a combination of clinical symptoms, physical examination findings, and diagnostic tests such as electrocardiography (ECG), echocardiography, and coronary angiography. Treatment for microvascular angina typically involves medications to relax the blood vessels and improve blood flow to the heart, as well as lifestyle changes such as regular exercise and a healthy diet. In severe cases, surgical intervention may be necessary.

Microvascular angina is considered a syndrome rather than a disease, and it is believed to be caused by a combination of genetic and environmental factors, including smoking, high blood pressure, and high cholesterol levels. It is more common in people who are middle-aged or older, and affects men and women equally.

Overall, microvascular angina is a serious condition that can have a significant impact on quality of life, and it is important for individuals who experience symptoms to seek medical attention to receive an accurate diagnosis and appropriate treatment. With proper management, many people with microvascular angina are able to lead active and fulfilling lives.

There are different types of myocardial infarctions, including:

1. ST-segment elevation myocardial infarction (STEMI): This is the most severe type of heart attack, where a large area of the heart muscle is damaged. It is characterized by a specific pattern on an electrocardiogram (ECG) called the ST segment.
2. Non-ST-segment elevation myocardial infarction (NSTEMI): This type of heart attack is less severe than STEMI, and the damage to the heart muscle may not be as extensive. It is characterized by a smaller area of damage or a different pattern on an ECG.
3. Incomplete myocardial infarction: This type of heart attack is when there is some damage to the heart muscle but not a complete blockage of blood flow.
4. Collateral circulation myocardial infarction: This type of heart attack occurs when there are existing collateral vessels that bypass the blocked coronary artery, which reduces the amount of damage to the heart muscle.

Symptoms of a myocardial infarction can include chest pain or discomfort, shortness of breath, lightheadedness, and fatigue. These symptoms may be accompanied by anxiety, fear, and a sense of impending doom. In some cases, there may be no noticeable symptoms at all.

Diagnosis of myocardial infarction is typically made based on a combination of physical examination findings, medical history, and diagnostic tests such as an electrocardiogram (ECG), cardiac enzyme tests, and imaging studies like echocardiography or cardiac magnetic resonance imaging.

Treatment of myocardial infarction usually involves medications to relieve pain, reduce the amount of work the heart has to do, and prevent further damage to the heart muscle. These may include aspirin, beta blockers, ACE inhibitors or angiotensin receptor blockers, and statins. In some cases, a procedure such as angioplasty or coronary artery bypass surgery may be necessary to restore blood flow to the affected area.

Prevention of myocardial infarction involves managing risk factors such as high blood pressure, high cholesterol, smoking, diabetes, and obesity. This can include lifestyle changes such as a healthy diet, regular exercise, and stress reduction, as well as medications to control these conditions. Early detection and treatment of heart disease can help prevent myocardial infarction from occurring in the first place.

Coronary disease is often caused by a combination of genetic and lifestyle factors, such as high blood pressure, high cholesterol levels, smoking, obesity, and a lack of physical activity. It can also be triggered by other medical conditions, such as diabetes and kidney disease.

The symptoms of coronary disease can vary depending on the severity of the condition, but may include:

* Chest pain or discomfort (angina)
* Shortness of breath
* Fatigue
* Swelling of the legs and feet
* Pain in the arms and back

Coronary disease is typically diagnosed through a combination of physical examination, medical history, and diagnostic tests such as electrocardiograms (ECGs), stress tests, and cardiac imaging. Treatment for coronary disease may include lifestyle changes, medications to control symptoms, and surgical procedures such as angioplasty or bypass surgery to improve blood flow to the heart.

Preventative measures for coronary disease include:

* Maintaining a healthy diet and exercise routine
* Quitting smoking and limiting alcohol consumption
* Managing high blood pressure, high cholesterol levels, and other underlying medical conditions
* Reducing stress through relaxation techniques or therapy.

Word Origin: From coronary (pertaining to the crown) + vasospasm (a spasmodic constriction of a blood vessel).

The buildup of plaque in the coronary arteries is often caused by high levels of low-density lipoprotein (LDL) cholesterol, smoking, high blood pressure, diabetes, and a family history of heart disease. The plaque can also rupture, causing a blood clot to form, which can completely block the flow of blood to the heart muscle, leading to a heart attack.

CAD is the most common type of heart disease and is often asymptomatic until a serious event occurs. Risk factors for CAD include:

* Age (men over 45 and women over 55)
* Gender (men are at greater risk than women, but women are more likely to die from CAD)
* Family history of heart disease
* High blood pressure
* High cholesterol
* Diabetes
* Smoking
* Obesity
* Lack of exercise

Diagnosis of CAD typically involves a physical exam, medical history, and results of diagnostic tests such as:

* Electrocardiogram (ECG or EKG)
* Stress test
* Echocardiogram
* Coronary angiography

Treatment for CAD may include lifestyle changes such as a healthy diet, regular exercise, stress management, and quitting smoking. Medications such as beta blockers, ACE inhibitors, and statins may also be prescribed to manage symptoms and slow the progression of the disease. In severe cases, surgical intervention such as coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) may be necessary.

Prevention of CAD includes managing risk factors such as high blood pressure, high cholesterol, and diabetes, quitting smoking, maintaining a healthy weight, and getting regular exercise. Early detection and treatment of CAD can help to reduce the risk of complications and improve quality of life for those affected by the disease.

Myocardial ischemia can be caused by a variety of factors, including coronary artery disease, high blood pressure, diabetes, and smoking. It can also be triggered by physical exertion or stress.

There are several types of myocardial ischemia, including:

1. Stable angina: This is the most common type of myocardial ischemia, and it is characterized by a predictable pattern of chest pain that occurs during physical activity or emotional stress.
2. Unstable angina: This is a more severe type of myocardial ischemia that can occur without any identifiable trigger, and can be accompanied by other symptoms such as shortness of breath or vomiting.
3. Acute coronary syndrome (ACS): This is a condition that includes both stable angina and unstable angina, and it is characterized by a sudden reduction in blood flow to the heart muscle.
4. Heart attack (myocardial infarction): This is a type of myocardial ischemia that occurs when the blood flow to the heart muscle is completely blocked, resulting in damage or death of the cardiac tissue.

Myocardial ischemia can be diagnosed through a variety of tests, including electrocardiograms (ECGs), stress tests, and imaging studies such as echocardiography or cardiac magnetic resonance imaging (MRI). Treatment options for myocardial ischemia include medications such as nitrates, beta blockers, and calcium channel blockers, as well as lifestyle changes such as quitting smoking, losing weight, and exercising regularly. In severe cases, surgical procedures such as coronary artery bypass grafting or angioplasty may be necessary.

There are several possible causes of chest pain, including:

1. Coronary artery disease: The most common cause of chest pain is coronary artery disease, which occurs when the coronary arteries that supply blood to the heart become narrowed or blocked. This can lead to a heart attack if the blood flow to the heart muscle is severely reduced.
2. Heart attack: A heart attack occurs when the heart muscle becomes damaged or dies due to a lack of oxygen and nutrients. This can cause severe chest pain, as well as other symptoms such as shortness of breath, lightheadedness, and fatigue.
3. Acute coronary syndrome: This is a group of conditions that occur when the blood flow to the heart muscle is suddenly blocked or reduced, leading to chest pain or discomfort. In addition to heart attack, acute coronary syndrome can include unstable angina and non-ST-segment elevation myocardial infarction (NSTEMI).
4. Pulmonary embolism: A pulmonary embolism occurs when a blood clot forms in the lungs and blocks the flow of blood to the heart, causing chest pain and shortness of breath.
5. Pneumonia: An infection of the lungs can cause chest pain, fever, and difficulty breathing.
6. Costochondritis: This is an inflammation of the cartilage that connects the ribs to the breastbone (sternum), which can cause chest pain and tenderness.
7. Tietze's syndrome: This is a condition that occurs when the cartilage and muscles in the chest are injured, leading to chest pain and swelling.
8. Heart failure: When the heart is unable to pump enough blood to meet the body's needs, it can cause chest pain, shortness of breath, and fatigue.
9. Pericarditis: An inflammation of the membrane that surrounds the heart (pericardium) can cause chest pain, fever, and difficulty breathing.
10. Precordial catch syndrome: This is a condition that occurs when the muscles and tendons between the ribs become inflamed, causing chest pain and tenderness.

These are just a few of the many possible causes of chest pain. If you are experiencing chest pain, it is important to seek medical attention right away to determine the cause and receive proper treatment.

The underlying cause of ACS is typically a blockage in one of the coronary arteries, which supply blood to the heart muscle. This blockage can be caused by atherosclerosis, a condition in which plaque builds up in the arteries and narrows them, or by a blood clot that forms in the artery and blocks the flow of blood.

The diagnosis of ACS is typically made based on a combination of symptoms, physical examination findings, and results of diagnostic tests such as electrocardiograms (ECGs) and blood tests. Treatment for ACS usually involves medications to dissolve blood clots and reduce the amount of work the heart has to do, as well as procedures such as angioplasty or coronary artery bypass surgery to restore blood flow to the heart.

Preventive measures for ACS include managing risk factors such as high blood pressure, high cholesterol, smoking, and diabetes, as well as increasing physical activity and eating a healthy diet. Early diagnosis and treatment of ACS can help reduce the risk of complications and improve outcomes for patients.

Early detection and management of atherosclerosis through regular health check-ups, healthy lifestyle choices, and medications can help prevent or delay the progression of the disease and reduce the risk of complications.

Signs and Symptoms:

* Swelling of the floor of the mouth and beneath the tongue
* Difficulty breathing and swallowing
* Pain when swallowing
* Fever and chills
* Swollen lymph nodes in the neck
* Redness and purulent drainage on the skin

Diagnosis:

A diagnosis of Ludwig's angina is based on a combination of physical examination findings, medical history, and diagnostic tests such as blood cultures or imaging studies.

Treatment:

Antibiotics are the primary treatment for Ludwig's angina. Surgical debridement may be necessary to remove infected tissue and promote healing. In severe cases, hospitalization and intensive care may be required to manage respiratory and cardiovascular complications.

Prognosis:

Early diagnosis and aggressive treatment of Ludwig's angina can improve the prognosis. However, if left untreated or if there are severe complications, the condition can be fatal.

Prevention:

Good oral hygiene practices, regular dental check-ups, and avoiding risky behaviors such as sharing dental instruments or engaging in unprotected oral sex can help prevent Ludwig's angina.

The severity of coronary stenosis can range from mild to severe, with blockages ranging from 15% to over 90%. In mild cases, lifestyle changes and medication may be enough to manage symptoms. However, more severe cases typically require interventional procedures such as angioplasty or bypass surgery to improve blood flow to the heart.

Recurrence can also refer to the re-emergence of symptoms in a previously treated condition, such as a chronic pain condition that returns after a period of remission.

In medical research, recurrence is often studied to understand the underlying causes of disease progression and to develop new treatments and interventions to prevent or delay its return.

Coronary Thrombosis can cause a range of symptoms including chest pain, shortness of breath, lightheadedness and fatigue. The severity of the symptoms depends on the location and size of the clot. In some cases, the condition may be asymptomatic and diagnosed incidentally during a medical examination or imaging test.

Diagnosis of Coronary Thrombosis is typically made using electrocardiogram (ECG), blood tests and imaging studies such as angiography or echocardiography. Treatment options include medications to dissolve the clot, surgery to open or bypass the blocked artery or other interventional procedures such as angioplasty or stenting.

Prevention of Coronary Thrombosis includes managing risk factors such as high blood pressure, high cholesterol levels, smoking and diabetes through lifestyle changes and medications. Early detection and treatment can help reduce the risk of complications and improve outcomes for patients with this condition.

The burden of chronic diseases is significant, with over 70% of deaths worldwide attributed to them, according to the World Health Organization (WHO). In addition to the physical and emotional toll they take on individuals and their families, chronic diseases also pose a significant economic burden, accounting for a large proportion of healthcare expenditure.

In this article, we will explore the definition and impact of chronic diseases, as well as strategies for managing and living with them. We will also discuss the importance of early detection and prevention, as well as the role of healthcare providers in addressing the needs of individuals with chronic diseases.

What is a Chronic Disease?

A chronic disease is a condition that lasts for an extended period of time, often affecting daily life and activities. Unlike acute diseases, which have a specific beginning and end, chronic diseases are long-term and persistent. Examples of chronic diseases include:

1. Diabetes
2. Heart disease
3. Arthritis
4. Asthma
5. Cancer
6. Chronic obstructive pulmonary disease (COPD)
7. Chronic kidney disease (CKD)
8. Hypertension
9. Osteoporosis
10. Stroke

Impact of Chronic Diseases

The burden of chronic diseases is significant, with over 70% of deaths worldwide attributed to them, according to the WHO. In addition to the physical and emotional toll they take on individuals and their families, chronic diseases also pose a significant economic burden, accounting for a large proportion of healthcare expenditure.

Chronic diseases can also have a significant impact on an individual's quality of life, limiting their ability to participate in activities they enjoy and affecting their relationships with family and friends. Moreover, the financial burden of chronic diseases can lead to poverty and reduce economic productivity, thus having a broader societal impact.

Addressing Chronic Diseases

Given the significant burden of chronic diseases, it is essential that we address them effectively. This requires a multi-faceted approach that includes:

1. Lifestyle modifications: Encouraging healthy behaviors such as regular physical activity, a balanced diet, and smoking cessation can help prevent and manage chronic diseases.
2. Early detection and diagnosis: Identifying risk factors and detecting diseases early can help prevent or delay their progression.
3. Medication management: Effective medication management is crucial for controlling symptoms and slowing disease progression.
4. Multi-disciplinary care: Collaboration between healthcare providers, patients, and families is essential for managing chronic diseases.
5. Health promotion and disease prevention: Educating individuals about the risks of chronic diseases and promoting healthy behaviors can help prevent their onset.
6. Addressing social determinants of health: Social determinants such as poverty, education, and employment can have a significant impact on health outcomes. Addressing these factors is essential for reducing health disparities and improving overall health.
7. Investing in healthcare infrastructure: Investing in healthcare infrastructure, technology, and research is necessary to improve disease detection, diagnosis, and treatment.
8. Encouraging policy change: Policy changes can help create supportive environments for healthy behaviors and reduce the burden of chronic diseases.
9. Increasing public awareness: Raising public awareness about the risks and consequences of chronic diseases can help individuals make informed decisions about their health.
10. Providing support for caregivers: Chronic diseases can have a significant impact on family members and caregivers, so providing them with support is essential for improving overall health outcomes.

Conclusion

Chronic diseases are a major public health burden that affect millions of people worldwide. Addressing these diseases requires a multi-faceted approach that includes lifestyle changes, addressing social determinants of health, investing in healthcare infrastructure, encouraging policy change, increasing public awareness, and providing support for caregivers. By taking a comprehensive approach to chronic disease prevention and management, we can improve the health and well-being of individuals and communities worldwide.

Some common examples of eye manifestations include:

1. Redness or inflammation of the conjunctiva (the thin membrane that covers the white part of the eye): This can be a sign of an infection, allergy, or other condition.
2. Discharge or crusting around the eyes: This can be a sign of an infection or allergies.
3. Swelling of the eyelids or eye socket: This can be a sign of an infection, injury, or other condition.
4. Bulging of one or both eyes (proptosis): This can be a sign of a tumor or other condition that is putting pressure on the eye socket.
5. Abnormal alignment of the eyes (strabismus): This can be a sign of a neurological disorder or other condition.
6. Blurring or distortion of vision: This can be a sign of a variety of conditions, including refractive errors, cataracts, glaucoma, or retinal detachment.
7. Abnormal pupillary reaction to light (photophobia): This can be a sign of a neurological disorder or other condition.
8. Eye twitching or spasms: This can be a sign of a neurological disorder or other condition.
9. Blind spots in the field of vision: This can be a sign of a retinal detachment or other condition.
10. Abnormal color vision (color blindness): This can be a sign of a genetic disorder or other condition.

Healthcare professionals may use a variety of tests and procedures to evaluate eye manifestations, including visual acuity tests, refraction tests, retinoscopy, and imaging studies such as ultrasound or MRI. Treatment of eye manifestations depends on the underlying cause and can range from glasses or contact lenses for refractive errors to surgery for cataracts or retinal detachment. In some cases, treatment of the underlying condition can help resolve the eye manifestations.

www.medicinenet.com/sudden_death/article.htm
Sudden death is death that occurs unexpectedly and without warning, often due to a cardiac arrest or other underlying medical condition.

In the medical field, sudden death is defined as death that occurs within one hour of the onset of symptoms, with no prior knowledge of any serious medical condition. It is often caused by a cardiac arrhythmia, such as ventricular fibrillation or tachycardia, which can lead to cardiac arrest and sudden death if not treated promptly.

Other possible causes of sudden death include:

1. Heart disease: Coronary artery disease, heart failure, and other heart conditions can increase the risk of sudden death.
2. Stroke: A stroke can cause sudden death by disrupting blood flow to the brain or other vital organs.
3. Pulmonary embolism: A blood clot in the lungs can block blood flow and cause sudden death.
4. Trauma: Sudden death can occur as a result of injuries sustained in an accident or other traumatic event.
5. Drug overdose: Taking too much of certain medications or drugs can cause sudden death due to cardiac arrest or respiratory failure.
6. Infections: Sepsis, meningitis, and other severe infections can lead to sudden death if left untreated.
7. Genetic conditions: Certain inherited disorders, such as Long QT syndrome, can increase the risk of sudden death due to cardiac arrhythmias.

The diagnosis of sudden death often requires an autopsy and a thorough investigation into the individual's medical history and circumstances surrounding their death. Treatment and prevention strategies may include defibrillation, CPR, medications to regulate heart rhythm, and lifestyle modifications to reduce risk factors such as obesity, smoking, and high blood pressure.

Causes of Colic:

1. Gas and bloating: Gas and bloating are common causes of colic. This can occur when gas builds up in the digestive tract or when the body has difficulty processing certain types of food.
2. Constipation: Constipation can cause colic, as hard stool can put pressure on the intestines and lead to pain.
3. Diarrhea: Diarrhea can also cause colic, as loose stool can irritate the intestines and lead to pain.
4. Eating certain foods: Some foods, such as dairy or gluten, can be difficult for the body to digest and may cause colic.
5. Medical conditions: Certain medical conditions, such as IBS, GERD, or IBD, can cause colic.

Symptoms of Colic:

1. Abdominal pain or discomfort: This is the most common symptom of colic and can be described as crampy, gnawing, or sharp.
2. Gas and bloating: Patients with colic may experience gas and bloating, which can lead to discomfort and abdominal distension.
3. Diarrhea or constipation: Depending on the underlying cause of colic, patients may experience diarrhea or constipation.
4. Nausea and vomiting: Some patients with colic may experience nausea and vomiting.
5. Abdominal tenderness: The abdomen may be tender to the touch, especially in the lower right quadrant of the abdomen.

Treatment for Colic:

1. Dietary changes: Patients with colic may benefit from making dietary changes such as avoiding trigger foods, eating smaller meals, and increasing fiber intake.
2. Probiotics: Probiotics can help to regulate the gut microbiome and reduce symptoms of colic.
3. Antispasmodics: Antispasmodics, such as dicyclomine, can help to reduce abdominal pain and cramping associated with colic.
4. Simethicone: Simethicone is an antigas medication that can help to reduce bloating and discomfort associated with colic.
5. Antidepressants: Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), have been shown to be effective in reducing symptoms of colic in some patients.
6. Psychological support: Colic can be stressful and emotionally challenging for both patients and their caregivers. Psychological support and counseling may be beneficial in managing the emotional impact of colic.

It is important to note that while these treatments may help to reduce symptoms of colic, there is no cure for this condition. In most cases, colic will resolve on its own within a few months. However, if you suspect that your baby has colic, it is important to consult with your healthcare provider to rule out any other underlying medical conditions and develop an appropriate treatment plan.

There are several types of PCS, including:

1. Bouveret's syndrome: This is a severe form of PCS that occurs within the first few days after cholecystectomy, characterized by intense abdominal pain, fever, and distension of the small intestine.
2. Mirizzi's syndrome: This type of PCS develops when the cystic duct remnant is obstructed, causing bile to accumulate in the gallbladder bed and leak into surrounding tissues, leading to inflammation and infection.
3. Acute pancreatitis: This condition occurs when the pancreatic duct becomes blocked or obstructed, causing pancreatic enzymes to build up and cause inflammation in the pancreas and surrounding tissues.
4. Chronic pancreatitis: This is a long-term form of PCS that can develop after cholecystectomy, characterized by persistent inflammation and damage to the pancreas, leading to abdominal pain, diarrhea, and weight loss.
5. Biliary-pancreatic dyskinesia: This is a chronic form of PCS that occurs when the sphincter of Oddi, which regulates the flow of bile and pancreatic juice into the small intestine, becomes dysfunctional, leading to abdominal pain, diarrhea, and malabsorption.

The symptoms of PCS can be severe and debilitating, affecting quality of life and requiring ongoing medical management. Treatment options for PCS include medications to manage symptoms, endoscopic therapy to clear obstructions, and in some cases, further surgical intervention.

It is essential to seek medical attention if you experience persistent or severe abdominal pain, as early diagnosis and treatment can help alleviate symptoms and prevent complications. A healthcare professional will perform a thorough physical examination and order imaging tests such as CT scans or endoscopy to confirm the diagnosis of PCS. Treatment will depend on the underlying cause of the condition, but may include medications to manage pain, inflammation, and infection, as well as lifestyle modifications to ensure proper digestion and nutrition.

The Canadian Cardiovascular Society grading of angina pectoris (sometimes referred to as the CCS Angina Grading Scale or the ... The CCS grading system for angina is a clinical tool used by doctors to assess the degree of severity of a patient's angina. ... Whilst there are no defined therapy guidelines specific for each class, once the severity of the angina has been assessed, ... CCS Functional Classification of Angina) is a classification system used to grade the severity of exertional angina. ...
Angina pectoris". Am. J. Pathol. 97 (3): 530. PMC 2042409. PMID 389065. Prichard, R (December 1979). "Selected items from the ...
By 1907 Mackenzie experienced frequent episodes of angina pectoris which he mentioned to Sir Thomas Lewis and in 1908 he had a ... Mackenzie, James (1923). Angina pectoris. London: Henry Frowde, Hodder & Stoughton. Mackenzie, James (1908). Diseases of the ... His angina continued after 1908 and became progressively worse until in January 1925 he had a prolonged and severe attack of ... angina and died at around 4am on 26 January 1925. Before his death Mackenzie had asked that his friend John Parkinson perform ...
Kounis syndrome (allergic angina and allergic myocardial infarction). Angina Pectoris. Etiology, Pathogenesis and Treatment. ... "Kounis syndrome (allergic angina and allergic myocardial infarction): A natural paradigm?" Kounis NG. International Journal of ... Kounis syndrome (allergic angina and allergic myocardial infarction): A natural paradigm? International Journal of Cardiology ... It was during this period when he treated two patients who developed angina progressing to acute myocardial infarction ...
... (UA), also called crescendo angina, is a type of angina pectoris that is irregular. It is also classified as a ... The pathophysiology of unstable angina is controversial. Until recently, unstable angina was assumed to be angina pectoris ... Variant angina Yeghiazarians Y, Braunstein JB, Askari A, Stone PH (January 2000). "Unstable angina pectoris". N. Engl. J. Med. ... Murrell, William (1879). "Nitroglycerin as a remedy for angina pectoris". The Lancet. 1: 80-81, 113-115, 151-152, 225-227. doi: ...
Frederick Fillmore French, 52, Manhattan builder (Tudor City, Knickerbocker Village); of angina pectoris; in Pawling, N. Y. An ...
This may lead to angina pectoris (chest pain or tightness on exertion) or heart attacks. Less commonly, arteries of the brain ... Müller C (1938). "Xanthoma, hypercholesterolemia, angina pectoris". Acta Medica Scandinavica. 95 Suppl (89): 75-84. doi:10.1111 ...
He died of angina pectoris. He is known today for the "Arndt-Schulz rule", a pharmacologic principle of homeopathy that is ...
A key symptom of coronary ischemia is chest pain or pressure, known as angina pectoris. Angina may present typically with ... Palaniswamy C, Aronow WS (September 2011). "Treatment of stable angina pectoris". American Journal of Therapeutics. 18 (5): ... Angina is typically located below the sternum. Individuals experiencing angina characterize the pain in different ways, but the ... Beta-blockers may also be used to reduce the incidence of chronic angina. Beta-blockers prevent episodes of angina by reducing ...
64-66 Angina Pectoris: An Electrocardiographic Study. Arch Intern Med (Chic). 1921;27(2):192-223. Atypical Pain with Angina ... Life Expectancy in Angina Pectoris. JAMA. 1946;131(2):95-100. Broadbent, W.H., F.A. Willius and T.E. Keys. Adhesive ... Angina Pectoris and Surgical Conditions of the Abdomen. Ann Surg. 1924;79(4) Thyroid Preparations in the Treatment of the ... Pectoris. Med Clin N Amer. 1921;V:371-393. Electrocardiography and Prognosis: I. Significant T-Wave Negativity in Isolated and ...
Hickie JB (1970). "Alprenolol ("aptin") in angina pectoris. A double-blind multicentre trial". Med. J. Aust. 2 (6): 268-72. doi ... used in the treatment of angina pectoris. It is no longer marketed by AstraZeneca, but may still be available from other ...
with Paul D. White: Spillane, J. D.; White, P. D. (October 1939). "Herpes zoster and angina pectoris". Br Heart J. 1 (4): 291- ... with Paul White: Spillane, J. D.; White, P. (April 1940). "Atypical pain in angina pectoris and myocardial infarction". Br ...
Operativ behandling av angina pectoris; kirurgiska synpunkter. (Chirurgische Behandlung der Angina pectoris; chirurgische ...
Unstable angina pectoris benefits from counterpulsation. Post cardiothoracic surgery-most common and useful is counterpulsation ... Preoperative use is suggested for high-risk patients such as those with unstable angina with stenosis greater than 70% of main ...
A variant form of angina pectoris. Preliminary report. Am Heart J 1959; 27:375. For example Henry Dudeney noted in his 1917 ... Prinzmetal angina: also known as variant angina, referring to angina (chest pain) caused by vasospasm of the coronary arteries ... Electrocardiographic study during a paroxysm of angina pectoris. Am Heart J 1933; 9:259. Prinzmetal, M, Kennamer, R, Merliss, R ... Electrocardiographic changes during brief attacks of angina pectoris. Lancet 1931; 1:15. Brow, GR, Holman, DV. ...
"Sir William Osler, Baronet". Osler, William (9 April 1910). "The Lumleian Lectures ON ANGINA PECTORIS". The Lancet. 175 (4519 ... Angina Pectoris 1911 John Mitchell Bruce, Cardio-Vascular Degeneration 1912 Percy Kidd, Some Moot Points in the Pathology and ...
Sandler, G. (1961). "Clinical Evaluation of Propatylnitrate in Angina Pectoris". British Medical Journal. 2 (5269): 1741-1744. ...
Thomas Jones died in 1803; the cause of death was angina pectoris. He was buried at the family chapel at Caebach, Llandrindod ...
It was also used in the treatment of angina pectoris and schizophrenia. Pheniprazine has been largely discontinued due to ... Sandler G (March 1961). "Clinical evaluation of pheniprazine in angina pectoris". British Medical Journal. 1 (5228): 792-4. doi ...
In medicine, nitroglycerin is probably most commonly prescribed for angina pectoris, a painful symptom of ischemic heart ... Murrell, William (1879). "Nitroglycerin as a remedy for angina pectoris". The Lancet. 1 (2890): 80-81, 113-115, 151-152, 225- ... such as angina pectoris and chronic heart failure. Though it was previously known that these beneficial effects are due to ... the physician William Murrell experimented with the use of nitroglycerin to alleviate angina pectoris and to reduce the blood ...
... has been used to relieve the pain associated with angina pectoris by acting as a selective coronary vasodilator. This ... Osher, Harold; Katz, Kermit; Wagner, Donald (1951). "Khellin in the treatment of angina pectoris". The New England Journal of ... Conn, James J. (1952). "The treatment of angina pectoris with khellin". Annals of Internal Medicine. 36 (5): 1173-1178. doi: ... and Iproniazid in Angina of Effort". Heart. 21 (3): 315-322. doi:10.1136/hrt.21.3.315. ISSN 1355-6037. PMC 1017586. PMID ...
He died of angina pectoris in 1885. "Death of Ex-Mayor Socrates Tuttle". Paterson Daily Press. February 13, 1885. Retrieved ...
This (and other) pharmacological effect makes these drugs useful in the treatment of angina pectoris. Conversely, they can lead ... "AccessMedicine - Harrison's Internal Medicine: Stable Angina Pectoris". 27 September 2007. Archived from the original on 27 ...
Angina Pectoris-Myocardial Infarction Investigations in Japan". Journal of the American College of Cardiology. 38 (1): 11-8. ...
... additional ECP devices have been cleared by the FDA for use in treating stable or unstable angina pectoris, acute myocardial ... "Enhanced external counterpulsation for chronic angina pectoris". The Cochrane Database of Systematic Reviews (2): CD007219. doi ... Other reviews found tentative benefit in those with angina that does not improve with medications. For stroke due to lack of ... External counterpulsation therapy (ECP) is a procedure that may be performed on individuals with angina, heart failure, or ...
"Angina pectoris I. A variant form of angina pectoris". The American Journal of Medicine. 27 (3): 375-88. doi:10.1016/0002-9343( ... Variant angina, also known as Prinzmetal angina, vasospastic angina, angina inversa, coronary vessel spasm, or coronary artery ... "Variant Angina". www.escardio.org. Retrieved 2 April 2018. "Prinzmetal's or Prinzmetal Angina, Variant Angina and Angina ... Treatment of the Kounis syndrome very much differs from that for variant angina. Angina pectoris: the most common form of ...
Duff died in May 1922 from angina pectoris. 1882 Michigan Wolverines football team 1884 Michigan Wolverines football team "1882 ...
The official cause of death was Angina pectoris. "J. A Maynard for Surveyor". The Boston Daily Globe. October 19, 1913. " ...
Leighton died the next day of angina pectoris. Leighton remained a bachelor; rumours of him having an illegitimate child with ...
1966). "The prophylactic value of propranolol in angina pectoris". Am J Cardiol. 18 (3): 370-83. doi:10.1016/0002-9149(66)90056 ... beta-blocker propranalol's effectiveness in headache treatment was a chance finding in patients receiving the drug for angina ( ...
Intermediate coronary syndrome 412 Old myocardial infarction 413 Angina pectoris 413.0 Angina decubitus 413.1 Prinzmetal angina ...
Three days before his death he performed a laparotomy, and on May 21, 1890, Byford succumbed to an attack of angina pectoris. ... he returned to the faculty where he remained until his death in 1890 following an attack of angina pectoris. Byford was born on ...
Ischemic heart diseases Angina pectoris Acute coronary syndrome Acute myocardial infarction See also Category:Valvular heart ... Angina Acute coronary syndrome Anomic aphasia Aortic dissection Aortic regurgitation Aortic stenosis Apoplexy Apraxia ...
... propranolol is a non-selective beta-blocker used for the treatment of hypertension and the prophylaxis of angina pectoris. In ...
Clarke subsequently administered chelation therapy to patients with angina pectoris and other occlusive vascular disease and ... treating workers at a battery factory for lead poisoning when he noticed that some of his patients had improved angina pectoris ...
... are a new potent class of drugs used in treatment of stable angina pectoris and an addition in ...
The F15845 drug has been developed as a potential drug for therapy of angina pectoris. Current anti-anginal drugs, aiming to ... F15845 is a cardiac drug proposed to have beneficial effects for the treatment of angina pectoris, arrhythmias and ischemia by ... assessed in the canine experimental model of angina pectoris". Journal of Cardiovascular Pharmacology. 33 (1): 70-7. doi: ... it has also been shown to inhibit ST segment changes in the canine model of angina. Vacher B, Pignier C, Létienne R, Verscheure ...
Canadian Cardiovascular Society grading of angina pectoris European Heart Rhythm Association score of atrial fibrillation " ... used functional classification of cardiovascular disease is the Canadian Cardiovascular Society grading of angina pectoris. ... the limitations/symptoms are in regard to normal breathing and varying degrees in shortness of breath and/or angina. It ...
On December 5, 1921, in St Ives, Cornwall he collapsed and died from angina pectoris. The New York Times, in its obituary ...
... provided a long sought-after explanation for the therapeutic effects of Nitroglycerin used to treat Angina pectoris and was ...
The cause of his death was recorded as angina pectoris. He was accorded a military funeral and interred at Maitland Cemetery in ...
Preparations of the fruits have also been used for angina pectoris therapy. Laboratory rat studies show that the extract slows ...
A doctor diagnosed the cause of Power's death as "fulminant angina pectoris." Power died while being transported to the ...
Angina pectoris Heart failure: Exercise intolerance is a primary symptom of chronic diastolic heart failure. Cardiac arrhythmia ... or angina. Chronic pain that makes a person unwilling to undertake a physical activity is not, by itself, a form of exercise ...
He died aged 78 from Angina Pectoris, on 29 June 1902 at John Square House, Oban, Argyll. He is principally known for ...
Frothingham died suddenly of angina pectoris at his home, 62 West 58th Street in Manhattan, on May 17, 1923. He was buried at ...
Unstable angina (UA) (also "crescendo angina"; this is a form of acute coronary syndrome) is defined as angina pectoris that ... In some cases, angina can be quite severe. Worsening angina attacks, sudden-onset angina at rest, and angina lasting more than ... Angina, also known as angina pectoris, is chest pain or pressure, usually caused by insufficient blood flow to the heart muscle ... Angina pectoris can be quite painful, but many patients with angina complain of chest discomfort rather than actual pain: the ...
... suffered from a serious heart ailment ever since symptoms of angina pectoris began to first appear on the campaign trail in ...
He died at Lynn on 13 September 1818 of angina pectoris, and was buried alongside his wife in the General Baptist Burial Ground ...
Ed died in August 1938 due to diabetes and angina pectoris which he came down with in 1936. A pension of about $10.00 a month ... and the second time with angina pectoris. As Margaret became older, she began to realize she was going to have to rely on her ...
"Angina pectoris I. A variant form of angina pectoris". The American Journal of Medicine. 27 (3): 375-388. doi:10.1016/0002-9343 ... A following study further distinguished this angina from classical angina pectoris due to the fact that the results showed that ... A subsequent study distinguished this type of angina from classical angina pectoris further by showing normal coronary arteries ... referring to it as a variant form of classical angina pectoris. Consequently, this angina has come to be reported and referred ...
... by skilled bead crafters Angina pectoris: The condition was named "hritshoola" in ancient India and was described by Sushruta ( ...
Some proposed uses for AH-1058 include the treatment of angina pectoris, stenosis of the outflow tract from obstructive ...
He went abroad in July, and after several attacks of angina pectoris he died at Baden-Baden in Germany on 1 September 1890. ...
... of angina pectoris, and was buried at Dublin on 20 June. In his will, he left 11,000 volumes to the college, which went on to ...
... came down with angina pectoris. In this role, he participated on 27 November 1940 in the Battle of Cape Spartivento. On 9 ...
Atherosclerosis and angina pectoris. Angina pectoris (also referred to as angina) is chest pain or pressure that occurs when ... Angina that occurs with exercise or exertion is called exertional angina. In some patients, especially in people with diabetes ... Angina also can occur at rest. Angina at rest more commonly indicates that a coronary artery has narrowed to such a critical ... Angina at rest infrequently may be due to the spasm of a coronary artery (a condition called Prinzmetals or variant angina). ...
One percent have angina, also called angina pectoris. Three percent have ever had a heart attack, also called myocardial ...
Kronisk stabil angina pectoris forekommer hos 3-5 % af befolkningen og skyldes iskæmisk hjertesygdom med stenoserende ... Kronisk stabil angina pectoris forekommer hos 3-5 % af befolkningen og skyldes iskæmisk hjertesygdom med stenoserende ... Patienter med kronisk stabil angina pectoris er generet af knugende brystsmerter, som provokeres af fysisk anstrengelse eller ... Ved mistanke om ustabil angina pectoris er der behov for akut indlæggelse. ...
Angina Pectoris Treatment clinics in Schwerin at the best price. Find doctors, specialized in Cardiology and compare prices, ... What you need to know about Angina Pectoris Treatment in Schwerin. Angina pectoris or stable angina is temporary chest pain ... Angina Pectoris Treatment in Schwerin. Compare Prices, Costs & Reviews for Angina Pectoris Treatment in Schwerin. No pricing ... What does a Angina Pectoris Treatment Procedure Involve?. One of the first steps to treat angina pectoris is with medication, ...
Treatment of reversible myocardial ischemia-angina pectoris. by Sweden. Socialstyrelsen. Kommitén för läkemedelsinformation. ...
Angina Pectoris and Thrombophlebitis. Bromelain has been effective in the treatment of cardio vascular diseases (Tochi et al. ... Angina pectoris. Bromelain stops aggregation of platelets and causes blood thinning. Taussig and Nieper 1979. ... blood viscosity and thus reduces the harshness of angina pectoris (Metzik et al. 1999;Maurier 2001) and transient ischemic ... 1999; Bhatacharia 2008). It has the ability to reduce angina and also possess antihypertensive action (Maurer 2001). ...
Safety aspects of spinal cord stimulation in severe angina pectoris.. Coronary Artery Dis. 1994; 5: 845-850. View in Article * ... Dorsal column stimulation for pain relief from intractable angina pectoris.. Pain. 1987; 28: 365-368. View in Article *Scopus ( ... Complications in spinal cord stimulation for treatment of angina pectoris.. Acta Cardiologica. 1997; LII: 325-333. View in ... Severe refractory angina pectoris can occur in end-stage coronary artery disease despite maximal medical and revascularization ...
The prevention and treatment of individual attacks of angina pectoris (angina of effort). Quarterly Journal of Medicine 3:105- ... Angina pectoris associated with high blood pressure and its relief by amyl nitrate. Heart 14:305-327.. View. ... Treatment of angina pectoris by testosterone propionate. New York State Journal of Medicine 43:1424-1428.. View. ... The drug treatment of angina pectoris due to coronary artery disease. American Journal of Medical Science 197:774-782.. View. ...
Unstable angina pectoris. *Cerebral infarction within last 14 days. *Deep vein thrombosis (DVT) or other thromboembolic ...
Atherosclerosis of coronary artery bypass graft(s) without angina pectoris I25.811 Atherosclerosis of native coronary artery of ... Atherosclerotic heart disease of native coronary artery with unstable angina pectoris I25.111 Atherosclerotic heart disease of ... Atherosclerosis of bypass graft of coronary artery of transplanted heart with angina pectoris with documented spasm ... Atherosclerosis of bypass graft of coronary artery of transplanted heart with other forms of angina pectoris ...
angina pectoris (pathology). angina pectoris, pain or discomfort in the chest, usually caused by the inability of diseased ...
Angina patients with AS who undergo EECP had clinically important symptomatic and hemodynamic improvements comparable to their ... Angina Pectoris / epidemiology * Angina Pectoris / physiopathology * Angina Pectoris / therapy* * Aortic Valve Stenosis / ... The safety and efficacy of enhanced external counterpulsation as a treatment for angina in patients with aortic stenosis Clin ... Conclusions: Angina patients with AS who undergo EECP had clinically important symptomatic and hemodynamic improvements ...
Angina pectoris † 1 2/153 (1.31%) 2. 0/159 (0.00%) 0. Atrial fibrillation † 1 1/153 (0.65%) 1. 1/159 (0.63%) 1. ...
Such plaques usually lead to the development of stable angina. They are also vulnerable to plaque rupture and thrombosis. ... ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-Elevation myocardial infarction: a report of ... Mehta SR, Yusuf S. The Clopidogrel in Unstable angina to prevent Recurrent Events (CURE) trial programme; rationale, design and ... Platelet glycoprotein IIB/IIIA in Unstable angina: Receptor Suppression Using Integrilin Therapy. J Am Coll Cardiol. 2002 Jun ...
Angina Pectoris. Immediate release: 5-20 mg PO q8-12hr initially; maintenance: 10-40 mg PO q8-12hr ... hypotension induced by isosorbide dinitrate may be accompanied by paradoxical bradycardia and increased angina pectoris ... USES: Isosorbide dinitrate is used to prevent chest pain (angina) in patients with a certain heart condition (coronary artery ... Nitrate therapy may aggravate angina caused by hypertrophic cardiomyopathy. Treat drug-induced headache with aspirin or ...
No unstable angina pectoris. *No cardiac arrhythmia. *Not pregnant or nursing. *Fertile patients must use effective ...
Angina Pectoris Myocardial Infarction Cardiopulmonary Arrest Tachycardia Hypotension Central Nervous System Restlessness ...
Angina pectoris. Axilla, pain in. Chest, pain in. Coryza. Ecthyma. Eczema. Erysipelas. Erythema nodosum. Headache. Herpes. ... Angina pectoris. Breast, tumour of. Bronchitis. Cancer. Catarrh. Consumption. Debility. Dropsy. Epithelioma. Gastritis. Hay- ... Angina faucium. Aphonia. Bladder, affections of. Blepharophthalmia. Catarrh. Cholera. Crusta lactea. Diarrhoea. Dropsy. ...
Symptoms of CO poisoning are nonspecific and can range from dizziness, headache, and angina pectoris to unconsciousness and ...
angina pectoris. fatty degeneration of heart. gouty heart. hypertrophy of heart. palpitations ...
Nitrolingual Pumpspray is indicated for acute relief of an attack or prophylaxis of angina pectoris due to coronary artery ... In a randomized, double-blind single-dose, 5-period cross-over study in 51 patients with exertional angina pectoris significant ... If beta-blockers are used with nitroglycerin in patients with angina pectoris, additional hypotensive effects may occur. ... Hypotension induced by nitroglycerin may be accompanied by paradoxical bradycardia and increased angina pectoris. Symptoms of ...
Angina is due to poor blood flow through the blood vessels in the heart called the coronary arteries. ... Stable angina is chest pain or discomfort that most often occurs with activity or emotional stress. ... Angina - stable; Angina - chronic; Angina pectoris; Chest pain - angina; CAD - angina; Coronary artery disease - angina; Heart ... The most common cause of angina is coronary artery disease. Angina pectoris is the medical term for this type of chest pain. ...
Angina Pectoris Cardiac Infarction Coronary: Embolism Occlusion Rupture, Insufficiency Thrombosis Infarction of heart, ... Angina pectoris , Heart failure , Hypertensive heart , Myocarditis , Myocardial infarction , Pericarditis , Rheumatic fever , ... Angina faucium Anthracosis Atelactasis Bronchiectasis Calcicosis Chronic pneumonia Cirrhosis of lung Cirrohotic pneumonia Coal ...
Understanding Angina Pectoris * Article How Type 2 Diabetes Increases Your Risk for Heart Attack and Stroke ...
Onset of unstable angina pectoris within 6 months of signing ICF;. *Acute myocardial infarction within 6 months of signing ICF; ...
Repetto, S.; Ambrosetti, P. Changes of urinary tryptamine in angina pectoris. Minerva Med. 1980, 71, 1203. [Google Scholar] [ ...
Coronary-artery bypass surgery in stable angina pectoris: Survival at two years. Lancet 1979; i: 889-893. ... For example, in a trial comparing medical and surgical treatment for stable angina pectoris, some patients allocated to ... to treat and other methods to analyse trial of coronary artery bypass surgery and medical treatment for stable angina pectoris ...
  • In women, elderly persons, and diabetic patients, coronary artery disease may manifest with atypical presentations other than angina pectoris, such as silent ischemia or infarction. (medscape.com)
  • Nitric oxide activity is deficient in spasm arteries of patients with coronary spastic angina. (medscape.com)
  • Concentration of circulating plasma endothelin in patients with angina and normal coronary angiograms. (medscape.com)
  • Although the pathogenesis of acute coronary syndromes has not been fully elucidated, plaque disruption and thrombus formation are considered to be crucial events in the development of unstable angina and acute myocardial infarction. (bmj.com)
  • 10-13 Some investigators have reported that culprit lesions in patients with unstable angina are predominantly occupied by soft plaques, while hard plaques are more common in patients with chronic stable coronary disease. (bmj.com)
  • Coronary heart diseases include heart attacks , sudden unexpected death, chest pain ( angina ), abnormal heart rhythms , and heart failure due to the weakening of the heart muscle. (medicinenet.com)
  • Exertional angina may be the first warning sign of advanced coronary artery disease . (medicinenet.com)
  • Angina at rest more commonly indicates that a coronary artery has narrowed to such a critical degree that the heart is not receiving enough oxygen even at rest. (medicinenet.com)
  • Angina pectoris definition is described as a chest pain that is caused by a diminished supply of blood to the heart because of a lesion on the walls or valves of the heart, or an obstruction by way of narrowing of the coronary arteries. (magnesiumandhealth.com)
  • Patients with diastolic heart failure (HF), i.e., clinical HF with normal or near normal left ventricular ejection fraction (LVEF), may develop unstable angina pectoris (UAP) due to epicardial atherosclerotic coronary artery disease and/or to subendocardial ischemia, even in the absence of coronary artery disease. (nih.gov)
  • Angina pectoris may be treated with medications, angioplasty, and stenting , or coronary bypass surgery. (mymeditravel.com)
  • Severe refractory angina pectoris can occur in end-stage coronary artery disease despite maximal medical and revascularization therapy. (heartlungcirc.org)
  • The drug treatment of angina pectoris due to coronary artery disease. (jameslindlibrary.org)
  • OBJECTIVE To investigate the use of intravascular ultrasound (IVUS) in detecting the presence of arterial remodelling in patients with unstable angina. (bmj.com)
  • PATIENTS 60 of 95 consecutively admitted patients with unstable angina (41 male, 19 female), mean (SD) age 61.2 (8.1) years. (bmj.com)
  • CONCLUSIONS IVUS is capable of detecting adaptive and constrictive remodelling of target lesions and its relation to plaque morphology in unstable angina. (bmj.com)
  • There are three types of angina - stable, unstable and prinzmetal's. (magnesiumandhealth.com)
  • With unstable angina the symptoms can be more severe and not so predictable. (magnesiumandhealth.com)
  • An unstable attack can be a precursor to a heart attack and thus it is taken more seriously than stable angina. (magnesiumandhealth.com)
  • Medical attention should be sought immediately at the first sign of unstable angina. (magnesiumandhealth.com)
  • Usefulness of positive troponin-T and negative creatine kinase levels in identifying high-risk patients with unstable angina pectoris. (bvsalud.org)
  • In patients with stable angina pectoris, even the most carefully performed history and physical examination have limitations. (medscape.com)
  • Silent ischemia during daily life is an independent predictor of mortality in stable angina. (medscape.com)
  • Nicardipine, 30 and 40 mg thrice daily, was administered to 66 patients with stable angina pectoris in a multicentre, randomised, double-blind, cross-over trial. (nih.gov)
  • Short- and long-term treatment of stable effort angina with nicardipine, a new calcium channel blocker: a double-blind, placebo-controlled, randomised, repeated cross-over study. (nih.gov)
  • Randomized double-blind placebo-controlled comparison of nicardipine and nifedipine in patients with chronic stable angina pectoris. (nih.gov)
  • Comparative efficacy of nicardipine, a new calcium antagonist, versus nifedipine in stable effort angina. (nih.gov)
  • Stable angina is the most common and symptoms usually last for a few minutes before they subside, often with the help of nitroglycerine tablets. (magnesiumandhealth.com)
  • Angina pectoris or stable angina is temporary chest pain that occurs when the heart muscle needs more blood than it is getting as a result of decreased blood flow, which usually develops during physical activity or strong emotions. (mymeditravel.com)
  • A 46-year-old Greek female (weight 60 Kg, height 1.65 cm) with symptomatic stable angina and myocardial ischemia documented at 99mTc-MIBI SPECT scintigraphy admitted to the hospital complaining of retrosternal chest pain appeared at rest one hour before admission. (biomedcentral.com)
  • Do not attempt to self-treat angina, acute respiratory distress syndrome, or acetaminophen poisoning! (empowher.com)
  • Intramyocardial, autologous CD34+ cell therapy for refractory angina. (medscape.com)
  • Enhanced external counterpulsation improves systolic blood pressure in patients with refractory angina. (medscape.com)
  • To illustrate the practical, beneficial and effective use of spinal cord stimulation as a treatment option for refractory angina in a local context. (heartlungcirc.org)
  • A case series clinical audit of 11 patients with refractory angina treated with spinal cord stimulation over a one-year period was carried out. (heartlungcirc.org)
  • Spinal cord stimulation is an effective medium-term treatment option for refractory angina pectoris with significant benefits to functional parameters and patient symptoms. (heartlungcirc.org)
  • Clinical outcome of patients treated with spinal cord stimulation for therapeutically refractory angina pectoris. (heartlungcirc.org)
  • Angina is chest pain, chest pressure, often associated with shortness of breath. (medlineplus.gov)
  • Therefore, Procardia Generic is used in the treatment of angina, a type of heart pain related to poor oxygen supply to the heart muscles. (bioblastpharma.com)
  • Treatment of reversible myocardial ischemia-angina pectoris. (who.int)
  • With MyMediTravel you can browse 1 facilities offering Angina Pectoris Treatment procedures in Schwerin. (mymeditravel.com)
  • The goal of angina pectoris treatment is to reduce the severity and frequency of the symptoms, as well as to lower the risk of heart attack and death. (mymeditravel.com)
  • What does a Angina Pectoris Treatment Procedure Involve? (mymeditravel.com)
  • How Long Should I Stay in Schwerin for a Angina Pectoris Treatment Procedure? (mymeditravel.com)
  • MyMediTravel currently lists 1 facilities in Schwerin offering Angina Pectoris Treatment procedures - see above for the complete list, along with estimated prices. (mymeditravel.com)
  • The price of a Angina Pectoris Treatment can vary according to each individual's case and will be determined based on your medical profile and an in-person assessment with the specialist. (mymeditravel.com)
  • What's the Recovery Time for Angina Pectoris Treatment Procedures in Schwerin? (mymeditravel.com)
  • What sort of Aftercare is Required for Angina Pectoris Treatment Procedures in Schwerin? (mymeditravel.com)
  • Spinal cord stimulation is an under-utilized but well-established modality for the treatment of intractable angina pain. (heartlungcirc.org)
  • The comparative value of drugs used in the continuous treatment of angina pectoris. (jameslindlibrary.org)
  • The prevention and treatment of individual attacks of angina pectoris (angina of effort). (jameslindlibrary.org)
  • Treatment of angina pectoris by testosterone propionate. (jameslindlibrary.org)
  • Angina pectoris (also referred to as angina ) is chest pain or pressure that occurs when the blood and oxygen supply to the heart muscle cannot keep up with the needs of the muscle. (medicinenet.com)
  • Angina is a type of chest discomfort due to poor blood flow through the blood vessels of the heart muscle. (medlineplus.gov)
  • Percutaneous transmyocardial laser revascularisation for severe angina: the PACIFIC randomised trial. (medscape.com)
  • In most clinical settings, however, such as hypertension or angina where there is little correlation between plasma levels and clinical effect, propranolol hydrochloride extended-release capsules have been therapeutically equivalent to the same mg dose of conventional propranolol hydrochloride extended-release capsules as assessed by 24-hour effects on blood pressure and on 24-hour exercise responses of heart rate, systolic pressure, and rate pressure product. (nih.gov)
  • In angina pectoris, propranolol generally reduces the oxygen requirement of the heart at any given level of effort by blocking the catecholamine-induced increases in the heart rate, systolic blood pressure, and the velocity and extent of myocardial contraction. (nih.gov)
  • One of the first steps to treat angina pectoris is with medication, your doctor may give you nitrates, clot-preventing drugs, statins, aspirin, calcium channel blockers, blood pressure-lowering medications, or beta-blockers. (mymeditravel.com)
  • With nicardipine therapy, duration of exercise and cumulative oxygen consumption increased, while times to onset of angina and 1 mm ST segment depression were prolonged. (nih.gov)
  • An insufficient supply of oxygen to the heart muscle causes angina. (medicinenet.com)
  • Both resting and nitroglycerin decrease the heart muscle's demand for oxygen, thus relieving angina. (medicinenet.com)
  • By blocking catecholamine-induced increases in heart rate, in velocity and extent of myocardial contraction, and in blood pressure, metoprolol reduces the oxygen requirements of the heart at any given level of effort, thus making it useful in the long-term management of angina pectoris. (nih.gov)
  • What are the symptoms of angina? (magnesiumandhealth.com)
  • Symptoms of CO poisoning are nonspecific and can range from dizziness, headache, and angina pectoris to unconsciousness and death. (egms.de)
  • Patients taking a beta-blocking drug who begin taking Nifedipine may develop heart failure or increased angina pain. (bioblastpharma.com)
  • Angina pain may also increase when your Nifedipine dosage is first started, when it is increased, or if it is abruptly stopped. (bioblastpharma.com)
  • Nifedipine may interact with beta-blocking drugs to cause heart failure, very low blood pressure, or an increased incidence of angina pain. (bioblastpharma.com)
  • The effects of intravenous aminophylline on the capacity of effort without pain in patients with angina of effort. (jameslindlibrary.org)
  • A method for the evaluation of the effects of drugs on cardiac pain in patients with angina of effort. (jameslindlibrary.org)
  • Exertional angina typically lasts from one to 15 minutes and usually is relieved by rest or by placing a tablet of nitroglycerin under the tongue. (medicinenet.com)
  • If the pain only lasts a few seconds or minutes then it's probably not angina. (magnesiumandhealth.com)
  • A simple, rapid and sensitive RP-HPLC method developed for quantitative determination of an angina pectoris drug i.e. 2,3,4-Trimetazidine Dihydrochloride and its three related substances using C18 150 X 4.6, 5um column and mobile phase consisting of aqueous buffer and Methanol. (rjptonline.org)
  • Hemingway H, Langenberg C, Damant J, Frost C, Pyorala K, Barrett-Connor E. Prevalence of angina in women versus men: a systematic review and meta-analysis of international variations across 31 countries. (medscape.com)
  • Angina pectoris associated with high blood pressure and its relief by amyl nitrate. (jameslindlibrary.org)
  • Changes in your angina may mean your heart disease is getting worse. (medlineplus.gov)
  • Based on the 1989 U.S. National Health Inter- ter 7, adults with diabetes are more likely than those view Survey (NHIS), 3% of men and women without diabetes to have hypert en sion and age 18-44 years who reported having diabetes dyslipidemia (low levels of high-density lipoprotein, also reported having ischemic heart disease. (nih.gov)
  • If the tests do not show any serious problems but angina is present, then your doctor or cardiologist will probably give you advice on changing your lifestyle habits. (magnesiumandhealth.com)
  • People who have angina often receive the medicines below. (medlineplus.gov)