1/18. nicorandil can induce severe oral ulceration.OBJECTIVE: To increase physicians' and dentists' awareness that nicorandil is a potential inducer of severe mouth ulceration. STUDY DESIGN: Nine new cases of ulceration from 3 European countries were included in this study. RESULTS: Oral ulceration developed within 9 months of beginning nicorandil therapy, and ulcers resolved within 1 month of withdrawal of the drug. No lesions developed on other epithelia. CONCLUSIONS: A number of drugs used in the care of patients with cardiovascular disease can cause oral adverse effects. nicorandil, a new potassium-channel activator used in some countries to treat angina pectoris, precipitates persistent ulcerative stomatitis in some patients.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
2/18. factor v Leiden and prothrombin G20210A in relation to arterial and/or vein rethrombosis: two cases.The factor v Leiden (FV Leiden) and prothrombin G20210A mutations, are the most common established genetic risk factors for deep vein thrombosis (DVT). However, the relationship between these mutations and arterial thrombotic syndromes (coronary heart disease, myocardial infarction, stroke) has not been established. Some studies have suggested a relationship between them, but other authors have considered it unlikely that these anomalies are a major risk factor for arterial thrombosis. From the clinical point of view, a question arises concerning the risk of repeated thrombosis in patients carrying one of these two mutations. The question is whether the recurrence is attributable to the mutations or to the presence of additional circumstantial risk factors. As the risk of repeated thrombosis varies considerably from one patient to another, decisions about long-term treatment require weighing the persistence of risk factors for vascular disease (venous and arterial), especially in selected cases such as young patients or patients with thrombosis of unusual localization.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
3/18. gadolinium-based coronarography in a patient with renal failure: first clinical report.This article reports the use of gadolinium to perform a coronarography in a patient with renal insufficiency, unstable angina, and peripheral vascular disease. The examination was well tolerated and the images obtained of good quality. Cathet Cardiovasc Intervent 2001;54:68-69.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
4/18. Antiphospholipid antibodies and ischemic neuropathy following cardiac surgery.sciatic nerve palsy is an uncommon complication of cardiac surgery and is thought to be induced by a combination of reduced femoral artery blood flow, small vessel vascular disease or prolonged hypoxia. We here describe a new case which is the first described with transient elevation of antiphospholipid antibodies. Although transient elevation of lupus coagulation inhibitor is known to occur frequently in patients treated in an intensive care unit, there are very few data about the possible role of antiphospholipid antibodies in the generation of ischemic neuropathies. We can not prove that the ischemic neuropathy in our case has been favored by the presence of lupus coagulation inhibitor and antiphospholipid antibodies as the occurrence of the symptoms seemed to precede the transient elevation of lupus coagulation inhibitor. This case suggests that antiphospholipid antibodies and lupus coagulation inhibitor should be included in the work up of patients who present nerve damage after cardiac surgery but further studies are needed to ascertain this association.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
5/18. spinal cord stimulation for refractory angina pectoris and peripheral vascular disease.spinal cord stimulation has been used in clinical practice for more than three decades. The primary use of this therapy has been in spine-related disorders. In recent years, the therapy has been used more extensively in diseases of the vascular system. Increasingly, interest has piqued in using this mode of treatment for refractory angina and ischemic pain secondary to peripheral vascular disease. In this publication, we review the current literature on these two indications and present case examples of both therapies.- - - - - - - - - - ranking = 5keywords = vascular disease (Clic here for more details about this article) |
6/18. Aneurysmal dilatation of the coronary arteries: diagnostic patterns and clinical significance.In order to define the clinical features, clinical patterns and significance of aneurysmal dilatation of the coronary arteries, five cases are presented which were diagnosed by coronary angiography. Three cases presented with left ventricular dysfunction secondary to coronary arterial occlusive disease and the fourth patient presented with thromboembolic cerebrovascular disease. The fifth case presented with manifestations of acute myocardial infarction.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
7/18. A case of trazodone-induced ventricular tachycardia.trazodone was associated with the occurrence of life-threatening premature ventricular contractions and angina in a 45-year-old white man who had no prior cardiovascular disease. Caution in prescribing trazodone and in the cardiac monitoring of patients receiving trazodone is recommended.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
8/18. Clinical indications for calcium channel blockers.Ca2 channel blocking agents have proven to be one of the most exciting groups of drugs for management of many cardiovascular diseases and as potentially first-line agents for treatment of angina pectoris and hypertension. Unlike beta blockers, they can directly relax coronary and peripheral arteries and, therefore, reduce total peripheral resistance and improve tissue perfusion. Ca2 channel blockers are drugs of choice for patients with Prinzmetal's angina and should be first-line drugs for mixed angina, and can be used alone or with beta blockers for classic angina. These drugs as a group have many potential clinical indications, especially in diseases in which vascular or smooth muscle spasm seems to cause the disease. Although all three Ca2 channel blockers have a common mechanism of action, their cardiac and hemodynamic effects are different, nifedipine being the least depressant to cardiac function. In choosing the right agent, careful consideration should be given to the patient's characteristics in order to derive maximum benefit with minimal risks.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
9/18. The coronary-subclavian steal syndrome: report of a case and recommendations for prevention and management.The coronary-subclavian steal syndrome involves the siphoning of blood from the myocardium through an internal mammary artery graft because of a proximal subclavian artery stenosis or occlusion, and results in myocardial ischemia. With the increased use of the internal mammary artery for myocardial revascularization, the potential exists for recurrence of angina pectoris in patients who have or in whom develops high-grade stenosis or occlusion of the subclavian artery, because of the coronary-subclavian steal syndrome. The coronary-subclavian steal syndrome can be prevented by the identification of patients with or at risk to develop subclavian artery occlusive disease. All patients undergoing cardiac catheterization prior to coronary artery bypass grafting in which use of the internal mammary artery is anticipated should be evaluated for the presence of upper extremity and cerebrovascular ischemia, the presence of cervical or supraclavicular bruits, and an upper extremity blood pressure differential of 20 mm Hg or greater. patients with these findings or with evidence of diffuse atherosclerotic vascular disease should have brachiocephalic arteriography at the time of coronary arteriography to identify significant subclavian artery occlusive disease. When this is demonstrated, use of the internal mammary artery as a free graft instead of an in situ graft or use of saphenous vein grafts is indicated. patients in whom recurrent angina develops following coronary artery bypass grafting that included an internal mammary artery graft should have coronary arteriography to evaluate the presence of coronary-subclavian steal syndrome, and brachiocephalic arteriography. Carotid-subclavian bypass grafting, probably best done with a prosthetic conduit, is the procedure of choice for management of the coronary-subclavian steal syndrome.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
10/18. Aortic root dissection complicating coronary bypass surgery.Four cases are presented of aortic root dissection after aortocoronary bypass surgery in which the origin of the intimal tear was at or very near the aortic site of saphenous vein anastomosis. Two cases were documented at autopsy. In one of two cases diagnosed with aortography, the patient underwent surgical correction and survived. All patients had long-standing severe hypertensive cardiovascular disease or severe generalized atherosclerotic disease, or both. Clinical awareness of aortic dissection after coronary bypass surgery in this group of patients should make early diagnosis with successful surgical correction feasible.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
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