1/657. The aetiology of non-exertional angina pectoris.The occurrence of angina pectoris while at rest, although long recognized, has not been satisfactorily explained. In the non-exertional attacks studied there was an increase in heart load, as estimated by the product of heart rate and systolic pressure. Angina occurred when the load exceeded a critical level. Recumbency was associated with 94% of non-exertional attacks; 58% followed a meal; in 54% both factors were present. It is suggested that recumbency causes an increase in heart load because of expansion of blood volume by transfer of fluid from interstitial spaces, and that a meal does so because of digestive activity.- - - - - - - - - - ranking = 1keywords = angina (Clic here for more details about this article) |
2/657. Bilateral subclavian steal syndrome through different paths and from different sites--a case report.Cases of cerebro-subclavian steal syndrome have been reported in the medical literature since 1960. This most often occurs on the left side because of the higher rate of involvement of the left subclavian artery in comparison to the other brachiocephalic branches of the aortic arch. With the use of the internal mammory artery as a conduit for coronary artery bypass, in the past three decades increasing numbers of coronary-subclavian steal in addition to the cerebro-subclavian steal have been observed. The authors report a case of bilateral subclavian steal syndrome through both vertebral arteries, the right common carotid artery, and the left internal mammory artery, without significant signs and symptoms of cerebral ischemia or anginal pain.- - - - - - - - - - ranking = 0.2keywords = angina (Clic here for more details about this article) |
3/657. Long-term successful coronary artery angioplasty in polycythemia vera.In a 65-year-old man with polycythemia vera, invalidating angina pectoris was associated with severe narrowing of the right coronary artery. After percutaneous coronary angioplasty (PTCA) the patient became symptom free and remained so for 12 months, while receiving an antiplatelet agent, a calcium antagonist and nitrate. coronary angiography repeated after a year, because of reappearance of angina, documented good patency of the treated artery and some progression of a narrowing involving another coronary vessel. This is the first reported case of long-term success of PTCA in polycythemia vera, a disease exposed to a high risk of thrombosis and, possibly, of restenosis. It is undefined whether medical treatment contributed to the anatomical and clinical results. As far as a single case can say, polycythemia vera might not represent a prohibitive background for coronary PTCA.- - - - - - - - - - ranking = 0.4keywords = angina (Clic here for more details about this article) |
4/657. Bifurcating aneurysm of the left main coronary artery involving left anterior descending and left circumflex arteries--a case report.Coronary artery aneurysm is a rare coronary abnormality, usually diagnosed incidentally by coronary angiography. Major causes of coronary aneurysms include coronary ectasia, Kawasaki disease, and atherosclerosis. Most of the discrete coronary aneurysms are of atherosclerotic origin. The incidence of atherosclerotic coronary aneurysms is about 0.2%, and the left main coronary artery is the least frequently involved artery. Only a few cases of left main coronary artery aneurysm have been reported in the literature, and a left main coronary artery aneurysm involving the proximal segments of the left anterior descending and the left circumflex arteries has not been reported previously. The authors describe this finding in a man who presented with worsening exertional angina pectoris. coronary angiography demonstrated an aneurysm of the distal left main coronary artery extending into the proximal segments of the left anterior descending and the left circumflex arteries. In addition, a significant flow-limiting atherosclerotic lesion was present in the proximal portion of the left anterior descending artery distal to the aneurysm.- - - - - - - - - - ranking = 0.2keywords = angina (Clic here for more details about this article) |
5/657. coronary vasospasm as a cause of angina following interventional recanalization.Angina following a coronary intervention may be due to vasospasm rather than restenosis. Two cases of angina following a previously successful recanalization are described. In both cases vasospasm was documented as the cause of angina, determined in one case by using an ergonovine provocative test and in the other by using lesion response to nitroglycerine. Rather than another intervention, vasodilator treatment was instituted, with effective symptom amelioration.- - - - - - - - - - ranking = 1.2keywords = angina (Clic here for more details about this article) |
6/657. Multiple spontaneously occurring coronary artery-left ventricular communications: a case report.A search of the literature revealed that spontaneous coronary artery-left ventricular communications have only rarely been reported. These fistulae are frequently associated with angina pectoris which has been attributed to a ventricular steal phenomenon. The patient described herein presented with angina pectoris and was found to have multiple coronary arterioventricular communications without significant coronary atherosclerosis.- - - - - - - - - - ranking = 0.4keywords = angina (Clic here for more details about this article) |
7/657. Long non-iatrogenic right coronary artery dissection in stable angina pectoris treated with stenting.An extensive spontaneous right coronary artery dissection was the only abnormal angiographic finding detected in a 67-year-old man with chronic exercise-induced angina pectoris. The lesion was treated with multiple stenting with good angiographic results. The clinical implications of this finding and the details of the intervention performed are discussed in light of published data concerning this increasingly recognized angiographic entity.- - - - - - - - - - ranking = 1.0937011143744keywords = angina, stable angina, stable (Clic here for more details about this article) |
8/657. The nondiagnostic ECG in the chest pain patient: normal and nonspecific initial ECG presentations of acute MI.The 12-lead electrocardiogram (ECG) is a powerful clinical tool used in the evaluation of chest pain patients, assisting in the selection of the proper therapy. Unfortunately, the ECG is diagnostic of acute myocardial infarction (AMI) in only one-half of such patients at initial hospital evaluation. In the remaining group of patients with the nondiagnostic 12-lead electrocardiogram, the ECG may be entirely normal, show nonspecific sinus tachycardia (ST) segment-T wave abnormalities, or obvious ischemic changes. In adult chest pain patients treated in the emergency department (ED), 1% to 4% of such patients with an absolutely normal ECG had a final hospital diagnosis of AMI; furthermore, patients with nonspecific electrocardiographic abnormalities experienced AMI in 4% of cases. These findings reinforce the teaching point that the history is the most important tool used in the evaluation of chest pain patients. Furthermore, overreliance on a normal or nonspecifically abnormal ECG in a patient with a classic description of anginal chest pain is dangerous.- - - - - - - - - - ranking = 0.2keywords = angina (Clic here for more details about this article) |
9/657. Anomalous origin of the right coronary artery from the left anterior descending coronary artery: a case report.We report on a 59-year-old man with effort angina of recent onset and a very uncommon right coronary artery originating from the middle portion of the left anterior descending; a tight stenosis of the left anterior descending coronary artery was also detected which involved the origin of the aberrant vessel.- - - - - - - - - - ranking = 0.2keywords = angina (Clic here for more details about this article) |
10/657. Axillary lymph node uptake of Tc-99m MIBI resulting from extravasation should not be misinterpreted as metastasis.Ipsilateral axillary lymph node visualization due to extravasation of Tc-99m MDP intravenous injection has been well documented. A patient with suspected angina underwent Tc-99m MIBI myocardial SPECT who had extravasation of Tc-99m MIBI in the antecubital region resulting in ipsilateral axillary lymph node uptake. This finding should not be misinterpreted as lymphatic nodal metastasis in a patient with breast cancer or lung cancer.- - - - - - - - - - ranking = 0.2keywords = angina (Clic here for more details about this article) |
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