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At least 19 recordsLinked to original sources
PubMed1979

[Prodromal symptoms of acute myocardial infarction (author's transl)].

75 out of 100 patients who had survived myocardial infarction, had had prodromal symptoms. 62 patients reported specific prodromi such as first manifestations of angina pectoris or increase in duration and intensity of angina pectoris which had existed for some time previously, and in some cases had been accompanied by general complaints. A further 13 patients had only general symptoms such as onset of dyspnoea, palpitations, or a drop in performance during the 3 months prior to the infarct. The primary manifestation of symptoms consisted of exercise-induced angina pectoris at the beginning of the defined prodromal period in most cases, whereas later in the course manifestations occurred in the form of exercise-independent and spontaneous angina pectoris. In 9 patients symptomatology changed and exercise-induced angina transformed either into spontaneous angina pectoris or permanent pectanginous pain. In 8 of these 9 patients infarction occurred within less than a week after the change of symptoms. Prodromi occurred with approximately the same frequency in anterior and posterior wall infarction. The same applied to the distribution between transmural and non-transmural infarction.

Aged↗
PubMed1978

Sudden death in Auckland.

A representative sample of all sudden cardiac deaths occurring in Auckland in one year is reported. Data describing demographic variables, personal characteristics and habits, previous symptoms, prodromal symptoms, the acute phase and post mortem results, is presented. Incidence values are very close to those of other similar communities. The syndrome of "sudden death" probably defines a heterogenous group of cases. Deaths were significantly more common in the cooler months, and in the lowest social class. Some evidence is presented consistent with the hypothesis that a high alcohol intake is associated with sudden death. No differences were found between cases dying within five minutes and those dying later but within 24 hours, considering several variables. Myocardial fibrosis at post mortem was a common finding. The role of the coronary ambulance is briefly discussed.

Adult↗
PubMed1979

Predictors of reinfarction and sudden death in a high-risk group of acute myocardial infarction survivors.

75 patients aged under 70 years who had survived acute myocardial infarction complicated by both significant arrhythmias and cardiac failure were followed-up for 1 year in an attempt to identify features which suggest the likelihood of late death or reinfarction. Patients were carefully instructed in the identification and importance of possible prodromal symptoms and the availability of a mobile intensivecare ambulance service and a 24 h hospital control centre. Horizontal ST-segment depression or anginal pain on an exercise test done within 6 weeks of infarction was a useful predictor of late death. Routine twice weekly E.C.G. recordings taken by telephone transmitter at rest and after mild exertion resulted in the identification of significant arrhythmias in only 7 patients. 13 patients (17%) died, 5 of them instantaneously. 4 of the 13 patients and 22 of the 62 survivors reported "prodromal symptoms". Unreported prodromal symptoms were elicited retrospectively in 14 of the 62 survivors and from the relatives of 4 of the 13 patients who died. Thus, 35% of prodromal symptoms were not reported despite intensive patient education and counselling. The incidence of "prodromal symptoms" was no higher in patients who died than in those who did not die.

Acute Disease↗
PubMed1979

Meningococcal infections during infancy: confidential inquiries into 10 deaths.

The first 10 deaths from meningococcal infections in children aged under 2 years that were reported to a DHSS multicentre study were reviewed. Confidential inquiries were made of the parents, family doctors, health visitors, and hospital staff concerned with each case, and management was discussed with a paediatrician and pathologist. Diagnosis and treatment were often delayed because doctors did not realise the importance of the purpuric rash. One child died at home, and by the time they were admitted to hospital all the remaining nine were shocked and needed resuscitation. Prodromal symptoms, mainly changes in behaviour, preceded the rash in all cases. These prodromal symptoms should arouse the suspicion of septicaemia and prompt a search for petechiae so that early effective treatment may be started.

Behavior↗
PubMed1976

[The prodromal phase of myocardial infarction (author's transl)].

The prodromal phase was studied retrospectively in 101 patients who had sustained acute myocardial infarctions. Only in a few did the infarction occur suddenly. Prodromal symptoms occurred in 80%: angina pectoris of various forms, especially change in type of complaint, signs of heart failure and non-specific general symptoms. With approaching infarction, approximately from the third week onwards, there was a crescendo course of anginal symptoms and of heart failure. Especially typical was change in the form of the angina, with occurrence of spontaneous or resting angina or recumbent angina. Such anginal symptoms, without previous angina on effort, only occurred during the last seven days before the infarction. Angina with manifest or latent signs of heart failure in the course of increasing symptoms (crescendo course) was typical for the last three to four days before infarction. There was an increased incidence of prodromal signs in anterior-wall infarction. A crescendo course implied a worse prognosis. Prodromal symptoms are frequent and prognostically less favourable also in women.

Adult↗
PubMed1979

Death during jogging or running. A study of 18 cases.

We investigated the circumstances of death and the medical and activity histories of 18 individuals who died during or immediately after jogging. Thirteen men died of coronary heart disease (CHD) and four men and one woman died of other causes. Six CHD subjects had medical histories relevant to the cardiovascular system, but only one had diagnosed CHD. Six CHD subjects experienced prodromal symptoms but continued vigorous exercise programs. Two subjects had exercised less than a month, but most had trained regularly for years. The CHD risk factors for the CHD cases did not differ significantly from those for other age-matched, physically active men. Superior physical fitness does not guarantee protection against exercise deaths. Physicians and exercising adults should be aware of this fact and give appropriate attention to possible prodromal symptoms.

Adult↗
PubMed1977

[Catamnestic studies on the prodomal phase of myocardial infarct].

In a retrospective study by means of a half-standardized method of interview in 154 patients with acute myocardial infarction and in a control group of the same age (n = 100) anamnestic data were established, particularly taking into consideration the preinfarction phase. 27% of the patients were surprised by an acute myocardial infarction without prodromal symptoms, in 32% the first occurrence of complaints of angina pectoris was during the last two months before the infarction. 41% had a preexisting angina pectoris which usually showed a crescendo-course with increasing approximation to the infarction. More than half of the patients reported on physical activity or/and emotional stress as causal factors of the preinfarction complaints. The correlation with the localisation of the infarction showed above all an occurrence of the prodromal symptoms in infarctions of the anterior wall and in lesions of the myocardium which in most cases could be ascertained only enzymatically. A greater accumulation of the prodromi was furthermore found in younger patients, in hypertension and preexisting restriction of the heart function. 70% of the patients with warning symptoms consulted a physician because of their heart complaints. In the control group 22% of the persons reported on heart complaints.

Acute Disease↗
PubMed1976

Methyldopa Hepatitis. A report of six cases and review of the literature.

Six cases of methyldopa hepatitis, including two in which the patients died are reported; and 77 cases from the literature are reviewed. Patients in whom severe hepatotoxic reactions to methyldopa develop usually complain of prodromal symptoms typical of hepatitis, often with fever, one to four weeks after therapy is initiated. Jaundice, when it occurs, is usually manifest within three months. Asymptomatic, transient elevations of serum transaminase levels may occur in patients receiving methyldopa. However, since the clinical and histologic features of hepatic injury from methyldopa are indistinguishable from viral hepatitis, it is suggested that the incidence of this iatrogenic disease is higher than generally appreciated. Serum transaminase levels should be determined at the initiation of therapy with methyldopa and four weeks later. Moreover, any patient who has unexplained fever or the prodromal symptoms of hepatitis should undergo liver chemistry studies immediately.

Adrenal Cortex Hormones↗
PubMed1975

Stevens-Johnson syndrome: Twenty-three cases and their otolaryngologic significance.

Stevens-Johnson syndrome is a symptom complex characterized by mucosal, ocular, and cutaneous lesions. Prodromal symptoms of upper respiratory infection or pharyngitis are most common. These are followed by target lesions of skin, sloughing of musous membranes, and ocular inflammation. Twenty-three cases are presented. Most patients (61 percent) were between 10 and 39 years of age. Relapses occurred in three patients. Five patients developed pneumonia, and there were two fatalities. Over one-half of the patients had serious ocular complications. The etiology of this syndrome is uncertain. Multiple allergic factors, drugs (especially long-acting sulfonamides), and infectious agents (most recently mycoplasma pneumoniae) have been implicated. This study does not support any single cause. The use of systemic steroids is generally accepted by most authors. The death rate in this study (10 percent) is essentially unchanged from early reports on patients without steroid therapy. The complications rate directly attributable to steroids is significant in this study group. The major complications of this syndrome are ocular. Aggressive topical management of ocular inflammation is required; however, the morbidity rate remains high despite these measures. The otolaryngologist should be aware of this syndrome as the early symptoms, and the acute complications may require his awareness of the natural and treated courses of this disease.

Adolescent↗
PubMed1975

Prodromata of myocardial infarction and sudden death.

A sample of 160 hospitalized, acute myocardial infarction patients and 138 individuals who died prior to hospitalization from acute coronary heart disease were studied to determine the incidence and duration of prodromal symptoms and action taken to cope with the symptoms. Seventy percent of the in-hospital subsample (IHS) and 64% of the out-hospital subsample (OHS) reported prodromata. The OHS reported a significantly longer median duration of symptoms than the IHS (29 versus 10.5 days). Sixty-seven percent of the IHS reported new or accelerated anginal symptoms as the most frequently occurring symptom, in contrast to 35% for the OHS. Twenty-seven percent of the IHS and 36% of the OHS consulted a physician about symptoms. Individuals in both subgroups, especially chronically diseased patients, considered their symptoms manageable. Likewise, when contacted, their physicians may have viewed these symptoms as manageable. Patients with a high risk of myocardial infarction and sudden death were significantly more likely to have consulted physicians during the prodromal phase than low-risk patients. A clearly delineated prodromal syndrome is needed so that both lay and medical communities can effectively respond to and intervene during the prodromal phase of acute myocardial infarction and sudden cardiac death.

Acute Disease↗
PubMed1978

[Retrospective evaluation of the pre-infarct period].

It is shown on the basis of retrospective appraisal of the course of ischemic heart disease in 235 patients hospitalized for acute macrofocal myocardial infarction that 78% of them had a prodromal period. The prodromal symptoms corresponded to those registered by WHO as preinfarction state. It was also shown that stable ischemic changes in the ECG during dynamic examination are of vital importance in the diagnosis of a preinfarction state. Problems of the medical tactics employed in the prodromal period of acute myocardial infarction are discussed.

Acute Disease↗