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Biomedical subjects

V Mukerji

Publications and source records attributed to V Mukerji.

At least 55 records · Page 3Linked to original sources
PubMed1989

Panic disorder in patients with chest pain and angiographically normal coronary arteries.

Although patients with angiographically normal or near normal coronary arteries are at low risk for cardiac disease, several follow-up studies have shown that many continue to report recurrent chest pain associated with social and work dysfunction. Three diagnostic entities have been proposed to explain the morbidity of this group: microvascular angina, esophageal motility disorders and panic disorder. The purpose of this study was to test the hypothesis that panic disorder is found frequently in patients with chest pain who have normal epicardial vessels. Ninety-four subjects with angiographically normal coronary arteries were interviewed according to a structured psychiatric protocol within 24 hours of their catheterizations. Thirty-two (34%) fit Diagnostic and Statistical Manual of Mental Disorders (third edition, revised) criteria for current panic disorder. Because panic disorder can be effectively treated, physicians should consider this diagnosis in this group of patients. Current research findings suggest that panic disorder, microvascular angina and esophageal disorders may each form the basis for chest pain in approximately 25% of these patients. Miscellaneous problems account for the other 25%.

Adult↗
PubMed1989

Gastrointestinal hemorrhage as a complication of cardiac catheterization.

This report describes three patients who developed the rate complication of gastrointestinal hemorrhage following cardiac catheterization. These cases illustrate the diverse mechanisms by which bleeding may occur. The important predisposing factors appear to be widespread atherosclerosis, prolonged hypotension, and gastrointestinal disease potentially associated with bleeding.

Aged↗
PubMed1989

Risk factors for coronary atherosclerosis in the elderly.

To determine the importance of traditional risk factors for coronary artery disease (CAD) in the elderly, the authors studied 64 consecutive patients with angiographically normal or near-normal coronary arteries and 64 patients with CAD. All patients were greater than or equal to sixty years old. The risk factors studied were male sex, hypertension, diabetes mellitus, hypercholesterolemia, cigarette smoking, sedentary life-style, and family history. The prevalence of these risk factors in the two groups of patients was compared. The results suggest that in persons greater than or equal to 60 years old, male sex and cigarette smoking continue to remain risk factors for CAD. Since most of the patients with diabetes and hypertension were on medical management for their condition, the authors' findings also suggest that diabetes mellitus, even under treatment, remains an important risk factor for CAD in the elderly but controlled hypertension does not. Other traditional risk factors (hypercholesterolemia, sedentary life-style, and family history) do not discriminate individuals with moderate to severe CAD from those with normal or near-normal coronary arteries in persons greater than or equal to sixty years old.

Aged↗
PubMed1989

Atypical angina in patients with coronary artery disease suggests panic disorder.

The occurrence of psychiatric disorders in patients with "medical" problems is not only possible but may be even facilitated by these problems. This article examines the relationship between the type of chest pain and the diagnosis of panic disorder among coronary artery disease (CAD) patients. Forty-nine such cardiology patients were interviewed using a structured instrument. Forty percent of patients with atypical angina met DSM-III-R criteria for current panic disorder while no panic disorder was identified in the typical angina group. This finding should have great implications for the care of CAD patients. At least many of the atypical angina patients could benefit from standard effective treatment for panic disorder. This would likely improve their functioning and decrease the financial burden on them and the health care system.

Adult↗
PubMed1989

Cardiovascular changes in athletes.

Athletic training commonly increases left ventricular and diastolic volume and left ventricular wall thickness within weeks to months of the beginning of vigorous conditioning. Bradycardia is usual and a third heart sound is frequently audible. A systolic heart murmur is present in 30 to 50 percent of athletes. An increased PR interval, widening of the QRS complex and repolarization alterations are among the most common electrocardiographic abnormalities. Cardiomegaly and a globular heart are characteristically seen on chest radiographs.

Adaptation, Physiological↗
PubMed1989

Can patients with chest pain and normal coronary arteries be discriminated from those with coronary artery disease prior to coronary angiography?

To determine whether the precatheterization clinical data in patients with chest pain could be used to discriminate patients with normal coronary arteries (NCA) from those with coronary artery disease, the authors compared 125 consecutive patients with less than 30% stenosis of all major coronary arteries and 125 patients with greater than 60% stenosis of one or more major coronary arteries. Clinical characteristics that occurred more frequently in patients with NCA were: nonexertional pain, pain to the left of the sternum, sharp pain, associated palpitations, absence of typical relief with sublingual nitroglycerin, pain commencing less than one week or more than ten years prior to coronary angiography, a normal electrocardiogram, and negative results from a treadmill stress test or from thallium scintigraphy. However, none of these clinical features, either singly or in combination, could be used to identify the patients with NCA with certainty.

Adult↗
PubMed1988

Value and limitations of calcium channel blockade in the treatment of pulmonary hypertension associated with CREST--case reports.

Reversible vasospasm has been hypothesized to underlie the development of pulmonary hypertension in patients with CREST. Drugs that prevent arterial spasm have been used to treat pulmonary hypertension with variable results. The disparate pulmonary hemodynamic responses to calcium channel blockade reported herein suggest that CREST patients with mild pulmonary hypertension may have a component of reversible vasospasm responsive to vasodilator therapy, whereas patients with moderate to severe pulmonary hypertension may have fixed vessel lesions precluding a satisfactory response to calcium channel blockade.

Adult↗
PubMed1988

Panic disorder, cardiology patients, and atypical chest pain.

Although patients with angiographically normal coronary arteries have low mortality, several studies have indicated that their social and work morbidity is high. Panic disorder appears to be a major contributor to the continuing chest pain in this population. There are also many chest pain patients appearing in cardiology clinics who also do not have heart disease but who are not given the opportunity to be evaluated for psychiatric disorders. Among those presenting with atypical or nonanginal chest pain, panic disorder represents a likely etiologic consideration. The fact that such patients do exist in cardiology populations is further substantiated by an open-label trial of alprazolam which demonstrated a positive effect in patients selected from those with atypical chest pain and no heart disease found to fit panic disorder criteria. These findings strongly support the increasing affiliation between cardiology and psychiatry and reinforce the belief that many problems of the heart may be problems of the mind/brain.

Angina Pectoris↗
PubMed1987

Comparative survival following permanent ventricular and dual-chamber pacing for patients with chronic symptomatic sinus node dysfunction with and without congestive heart failure.

To determine whether survival following permanent ventricular demand pacing differs from survival following permanent dual-chamber pacing in patients with symptomatic sinus node dysfunction (unexplained sinus bradycardia, subsidiary rhythms, sinus arrest, sinoatrial block, or the bradycardia/tachycardia syndrome), we followed 79 patients who received a VVI pacemaker (group 1) and 49 patients who received a DVI or DDD pacemaker (group 2) for 1 to 5 years. There was no significant difference in sex distribution, mean age, or the incidence of coronary heart disease, hypertension, valvular heart disease, diabetes mellitus, stroke, or renal failure between groups 1 and 2. Overall, the predicted cumulative survival rates at 1, 3, and 5 years were 89%, 82%, and 74%, respectively, for group 1 and 94%, 86%, and 78%, respectively, for group 2. In patients with preexistent congestive heart failure (CHF), predicted cumulative survival rates at 1, 3, and 5 years were 78%, 69%, and 57%, respectively, for group 1 (n = 23) and 90%, 83%, and 75%, respectively, for group 2 (n = 16). Five-year predicted cumulative survival was significantly lower in group 1 patients with CHF than in group 2 patients with CHF (p less than 0.03). There was no significant difference in 5-year cumulative survival rates between groups 1 and 2 in patients without CHF. The results suggest that permanent dual-chamber pacing enhances survival to a greater extent than permanent ventricular demand pacing in patients with chronic symptomatic sinus node dysfunction and CHF.

Aged↗
PubMed1987

Termination and suppression of multifocal atrial tachycardia with verapamil.

Multifocal atrial tachycardia (MAT) is an ectopic atrial tachyarrhythmia most commonly observed in very ill, elderly patients with hypoxia due to chronic pulmonary or cardiac disease. We have described a patient with recurrent MAT whose paroxysms of arrhythmia were promptly terminated with intravenous verapamil and were ultimately prevented by orally administered verapamil.

Administration, Oral↗
PubMed1987

Panic disorder: a frequent occurrence in patients with chest pain and normal coronary arteries.

From 10% to 20% of patients undergoing coronary arteriography for chest pain are subsequently found to have normal coronary arteries. We investigated the prevalence of panic disorder in these patients in a two-stage study. Our results indicate that approximately one third of patients with chest pain and angiographically normal coronary arteries have panic disorder. Proper diagnosis and treatment of these patients with panic disorder may be expected to substantially reduce their psychosocial morbidity.

Adult↗
PubMed1987

Atypical or nonanginal chest pain. Panic disorder or coronary artery disease?

Of 195 patients with atypical or nonanginal chest pain presenting in a cardiology clinic, 104 consented to be evaluated for anxiety disorders using a structured psychiatric interview. Thirty patients had histories of coronary artery disease (CAD). Fifty-nine patients in the sample (16 of those with CAD and 43 of those without CAD) fit diagnostic criteria for panic disorder (PD). Those without CAD and with PD were primarily women (mean age, 43 years) with predominantly nonanginal chest pain. Those patients with both CAD and PD were primarily men (mean age, 54 years) with predominantly atypical angina. Since PD has been shown to be readily responsive to pharmacologic intervention, this diagnosis should be considered in patients with atypical or nonanginal chest pain.

Adolescent↗