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PubMedDate not supplied

Sympathetic hyperfunction syndrome.

Vegetative troubles induced by sympathetic hyperfunction are presented and an attempt is made to systematize them. Functional tachycardia or premature beats in neurocirculatory asthenia, symptoms of sympathetic irritation in cervical radicular syndrome, hyperkinetic syndrome with positive exercise test, long Q--T syndrome, the classic troubles of sympathetic origin in pheochromocytoma and "the vegetative storm" in cerebral damages or excessively stressful situations may be included in the sympathetic hyperfunction syndrome. Of greater clinical interest is the cervical radicular syndrome with sympathetic irritation, which is presented in details, with reappraisal of some morphofunctional data that must be taken into account in clinical reasoning.

Angina Pectoris, Variant↗
PubMed1983

[Induction of Prinzmetal's angina by stopping exercise. Apropos of 3 cases].

Three cases of anginal pain with ST elevation occurring at the end of exercise are reported. In 2 cases, there was a symptom-free interval between exercise, which was well tolerated, and the clinical and electrical changes. The coronary circulation was angiographically normal, although one of the patients had have previous transmural myocardial infarction. Spontaneous coronary spasm was observed during coronary angiography in this patient. The third case was characterised by exclusively spontaneous angina. ST elevation was observed very early in the recovery phase after stress testing. This patient had severe triple vessel disease. Angiospastic manifestations were noted in the immediate postoperative period after myocardial revascularisation surgery. A review of the litterature shows two types of behaviour. In the rare cases of ST elevation after maximal stress testing (7 cases apart from those reported here) the coronary vessels were normal. On the other hand, when ST elevation occurred during exercise and/or followed ST depression, coronary artery disease was demonstrated: significant 52 cases (81%), less than 70%: 12 cases (19%). Overall, these results indicate that when ST elevation is observed in the recovery phase after stress testing, the coronary arteries are angiographically normal (specificity: 0,9).

Adult↗
PubMed1978

[Short-term localized myocardial ischaemia and its consequences in Prinzmetal angina pectoris (author's transl)].

In a 45-year-old female patient with Prinzmetal angina pectoris coronary angiograms and a 201thallium scintigram were performed during an ergotamine-induced episode of angina. The spontaneous and the ergotamine-induced attacks were characterized by transient ST elevation in the posterior wall ECG leads. The coronary angiogram during the attack showed spasm of the circumflex branch of the left coronary artery. In the 201thallium scintigram a large defect in myocardial thallium uptake was noticed in the posterior wall of the left ventricle. Angina and ECG abnormalities disappeared within 4 minutes. However, the scintigraphic defect disappeared only after 6 hours. The slow recovery of myocardial thallium uptake is thought to represent an alteration of the myocardium after a brief 4 minute interruption of regional coronary arterial blood flow. The diagnostic approach in patients with Prinzmetal angina is discussed.

Angina Pectoris↗
PubMed1984

[Physiopathology of angina pectoris].

The concept of blood flow limited fixed coronary artery stenosis holds true for most of the patients with stable, e.g. exercise-dependent angina pectoris. In this condition exists a disproportion between oxygen demand and oxygen consumption. On the other hand the unstable angina pectoris (angina pectoris at rest) is explained by a variable transient reduction of oxygen supply due to vasoconstriction ("dynamic stenosis"). In addition to the fixed stenosis and vasoconstriction the rheological behaviour plays a further role in the pathogenesis.

Angina Pectoris↗
PubMed1983

A case of ST-segment and T-wave alternans.

A 45-year-old man was admitted to the Government General Hospital, Madras, India, for Prinzmetal's angina. His condition was not responding to the combined treatment of isosorbide dinitrate and propranolol hydrochloride he had been taking one week before admission to the hospital. During his stay in the intensive care unit, 23 episodes of ST-segment elevation occurred. Three episodes showed ST-segment and T-wave alternans, a phenomenon, which, to our knowledge, have not been described. The patient was treated with verapamil hydrochloride and phenoxybenzamine hydrochloride, and he responded well. His condition continued to be stable during a two-year follow-up. A review of the literature and a discussion of this ECG phenomenon is presented.

Angina Pectoris, Variant↗