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At least 1,297 records · Page 72Linked to original sources
PubMed1981

Pathophysiology of acute myocardial infarction, 1981.

Recent observations and discoveries necessitate reassessing the pathophysiology of acute myocardial infarction. Platelet aggregability has been shown to be increased in patients with an acute myocardial infarction, and coronary arterial spasm has been documented by arteriography done just before and during the onset of infarction. These clinical observations have been complemented by the recent discovery of two potent substances; thromboxane A2 and prostacyclin, which affect platelet aggregability and coronary arterial tone. These recent observations and discoveries are blended with older pathologic information to attain a more comprehensive understanding of the pathophysiology of acute myocardial infarction. A dynamic interaction among damaged intima, platelet aggregates, and spasm is postulated to occur as a prelude to thrombosis in acute transmural myocardial infarction. Spasm appears to initiate the infarction process in some instances, but the exact sequence of events has not been established.

Aged↗
PubMed1981

Use of ergonovine to identify esophageal spasm in patients with chest pain.

We administered intravenous ergonovine maleate to 14 patients with chest pain resembling angina pectoris and to four healthy volunteers. Five of the patients experienced their typical chest pain after ergonovine, and manometric signs of esophageal spasm also developed. The remaining nine patients and the four volunteers did not experience chest pain, but all subjects except one had some symptomatic response to ergonovine, including chest warmth or heaviness, headache, mild choking sensation, facial numbness, flushing, or nausea. Two of the nine patients and one of the four volunteers developed manometric signs of esophageal spasm after ergonovine but experienced no chest pain. Intravenous ergonovine may be useful to identify esophageal spasm in selected patients with chest pain who have normal coronary arteries or in whom coronary artery disease is insufficient to explain symptoms. However, we believe that the potential risks of ergonovine do not justify its routine use as a provocative agent for esophageal spasm.

Adult↗
PubMed1999

[Syncopal vasospastic angina in a patient with familial nonobstructive hypertrophic cardiomyopathy].

We describe an unusual case of a 51-year-old woman affected with familial non-obstructive cardiomyopathy and syncopal vasospastic angina. The use of hyperventilation stress-echo testing, recommended by the authors because of its simplicity and safety, was decisive in showing the causal role of coronary spasm of the left anterior descending artery. The coronarography had not shown obstructive lesions of the coronary arteries, but during the procedure the patient had refused ergonovine or acetylcholine injections.

Angina Pectoris, Variant↗
PubMed1976

[Natural history of unstable angina. Observations on 157 cases (author's transl)].

157 cases affected with "unstable angina" and hospitalized were observed over a period of from 8 to 24 months (average observation time: 16 1/2 months). The patients were treated with: nitroderivates, beta blocking drugs (when not contra-indicated); treatment of side affects (hypertension; arrhythmias, decompensation, associated pathology, correction of risk factors of coronary heart disease). 9 cases were lost and 148 were studied for the course of the illness. 10.6% died from cardiopathy (2.8% through sudden death; 7.4% from myocardial infarction); there was a 12.1% total incidence of myocardial infarction; 50% of the cases were alive but with sumptoms of stabilized angina, whilst 32.4% were completely asymptomatic. Coronographic alterations and myocardial contractility negatively affect the course of the illness. Negative effects (disease or infarction) were not checked in the cases of stenosis of only one coronary branch. In the casuistry, there were no negative effects in patients with stenosis of one coronary branch, and in cases of two or more branches, negative effects were 28%. 41% of patients with alterations of ventrical contractility gave negative results. An asymptomatic course of the illness was checked more frequently in the intermediate stages than in angina cases.

Angina Pectoris↗
PubMed1976

[Coronary artery spasm induced by the somministration of ergonovine maleate in subjects with spontaneous angina (author's transl)].

In 6 patients affected by spontaneous angina with S-T elevation and coronariographic findings of obstruction, intravenous administration of ergonovine maleate determined the same clinical and ECG patterns of spontaneous episodes. The coronary arteriography during pain showed a marked spasm with occlusion of a large coronary vessel in four patients. In 2 patients with atypical chest pain and normal coronariogram, E.M. did not induce pain, ECG abnormality or coronariographic alterations. The role of spasm in spontaneous angina is discussed.

Adult↗
PubMed1978

[Intimal coronary fibrous dysplasia and Prinzmetal's angina].

It is currently considered as exceptional for there to be arterial pathology other than atheroma in Prinzmetal angina. The authors have found five cases of coronary fibrous dysplasia in the literature. They add a case, in a woman, of intimal fibrous dysplasia diffusely involving the three main coronary vessels. Coronary arteriography showed that spasm of the right coronary artery was the cause of attacks with the clinical and electrocardiographic features of Prinzmetal angina. The whole coronary tree was otherwise normal angiographically and also macroscopically at autopsy. The dysplasia was only discovered by histological study of serial sections of the three coronary vessels. Histological examination showed no evidence of an atheromatous lesion. The authors place these coronary artery lesions within the general classification of arterial fibrous dysplasias. It remains hypothetical whether there is a relationship between the occurrence of spasm and this very special histological feature of the coronary artery wall.

Angina Pectoris↗
PubMed1976

[A case of suprasellar tumor associated with so-called atypical angina pectoris].

A case of suprasellar tumor associated with so-called atypical angina pectoris was reported. A 58-year-old man was admitted to our hospital on Feb. 2, 1973, because of headache, disturbance of visual field and the attack of chest pain. He had been suffering from disturbance of visual field for about 3 years and the attack of chest pain for about 4 months prior to admission. Neurological findings on admission were bitemporal hemianopia, decreased visual acuity and atrophy of the optic disc. Bilateral carotid angiography showed upward displacement of A1 portion of the anterior cerebral artery. Pneumoencephalography demonstrated defect of the anterior part of the third ventricle. Laboratory examination showed hypopituitalism. On March 26, 1973, Right frontal craniotomy was performed under the diagnosis of suprasellar tumor. The walnut-sized tumor was detected in the suprasellar region and removed totally. Histological examination showed dermoid cyst. With regard to the attack of chest pain, the selective coronary angiography was performed. But organic change was not detected and Master's two step test did not induce any pathological finding in EEG. So we made a diagnosis of so-called atypical angina pectoris. There are many arguments about pathogenesis of so-called atypical angina pectoris. There is no organic change of the heart of attention now. Recently it is said that so-called atypical angina pectoris is closely connected with paradoxical sleep. We recognized dysunction of the autonomic nervous system through various examinations. The hypothalamus was displaced upward by a suprasellar tumor in this case. After removal of the suprasellar tumor, the frequency of the attack of chest pain was decreased. The atypical angina pectoris in the presented case may be considered to consequence of distrubance of the hypothalamic function.

Angina Pectoris↗
PubMed1999

[Recurrent ventricular fibrillation in a patient with Prinzmetal angina pectoris--case report].

The description of the case of 35 years old patient with paroxysmal ventricular fibrillation in a course of Prinzmetal angina pectoris treated unsuccessfully with antiarrhythmic drugs who required implantation of cardioverter/defibrillator. The via-venous cardioverter/defibrillator was implanted (ICD). During 6 months observation ventricular tachycardia and ventricular fibrillation occurred four times and was effectively interrupted by the cardioverter/defibrillator.

Adult↗