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Biomedical subjects

C C Welch

Publications and source records attributed to C C Welch.

25 records · Page 2Linked to original sources
PubMed1977

Alcoholic heart disease.

Alcohol has been suspected for many years of being a cause of heart disease. For a while its role was obscured by its association with beriberi heart disease and, more recently, by the toxic effect of cobalt in beer. Experimental studies, however, have provided convincing evidence of the primary role of alcohol itself. The mode of action is still in dispute. In the absence of specific findings, the diagnosis is made chiefly by exclusion of other known causes of heart disease and by a history of excessive alcohol intake over a number of years. The usual methods of treatment for the manifestations of heart failure, arrhythmias, and thromboembolic phenomena are important, but total abstinence from alcohol is the single essential factor. The sooner this is instituted, the better is the chance of interrupting the otherwise inexorable course to death.

Alcoholism↗
PubMed1975

Coronary arteriographic findings in 1,000 women under age 50.

In a consecutive series of 1,000 women under age 50 examined by coronary cinearteriography principally for evaluation of chest pain, 236 had at least 50 percent narrowing of one or more coronary arteries. The youngest, and the only patient who died, was 26 years old. The anterior descending coronary artery was the vessel most frequently involved; the right coronary artery was most often totally occluded. The amount of arterial involvement seemed to be related to the duration of symptoms. Only 10 percent of women with serum cholesterol levels under 200 mg/100 ml had significant coronary artery disease, whereas 44 percent of those with levels over 275 mg/100 ml had significant disease. Electrocardiographic evidence of myocardial infarction was uncommon in women with single vessel disease, but left ventriculograms disclosed that additional patients had areas of decreased contractility. Eleven of 46 women with electrocardiographically diagnosed myocardial infarction had no significant coronary artery disease. The cause of the electrocardiographic finding remained obscure in some. Although there was an excellent correlation of clinical diagnoses with arteriographic findings in women thought not to have angina pectoris, only half of those thought to have angina pectoris had significant coronary artery disease. This finding may be a major reason for recommending coronary arteriography for the evaluation of angina-like pain in women under age 50.

Adult↗
PubMed1975

Coronary artery disease in young women.

Although unusual, coronary artery disease does occur in young women. It may be present to a severe degree between ages 20 and 30, but a typical history of angina pectoris by no means assures the presence of significant coronary artery disease. Proof that oral contraceptives predispose to coronary artery disease is lacking. It seems wise not to recommend them to young women with other known risk factors. Significant risk factors in a group of 1000 women under age 50 studied by cinecoronary arteriography for the evaluation of chest pain included cigarette smoking, hypertension, hypercholesteremia, and glucose intolerance. Combinations of factors increased the risk. Electrocardiographic abnormalities in themselves did not seem to increase the risk of coronary artery disease, but did seem to enhance it in combination with other factors. Electrocardiographic evidence of transmural myocardial infarction without significant coronary artery disease was more common in young women than in young men. Cinecoronary arteriography may possibly be performed after resolution of more severe lesions related to lysis of emboli or thrombi. Special conditions may temporarily increase myocardial oxygen requirements. Angia-like chest pain has been described in patients without significant coronary artery disease. Many have normal electrocardiograms and no known risk factors. Spasm has been mentioned among many possible causes, but is very difficult to tell whether or not underlying atherosclerotic lesions may be present. Whatever the cause, the prognosis for patients with angina-like chest pain and normal coronary arteriography seems excellent; early death is a rarity and improvement is common.

Age Factors↗
PubMed1970

Cinecoronary arteriography in young men.

Of a group of 723 men less than 40 years old who underwent cinecoronary arteriography primarily for evaluation of chest pain, 357 (49%) were found to have at least 50% narrowing of one or more coronary arteries. The youngest person was 17 years old. The distribution of lesions in the young men was similar to that found earlier in a study of persons not selected by age. The anterior descending coronary artery was most frequently affected; the right coronary artery was most often totally occluded. No total occlusions of the left main coronary artery were seen. Electrocardiographic evidence of myocardial infarction, found in 109 patients, was less common with disease of the circumflex or right coronary arteries than with disease of the anterior descending coronary artery. This observation was confirmed by examination of left ventriculograms for areas of decreased contractility. Six patients had no significant arterial narrowing. The extent of arterial involvement seemed to be related to the duration of symptoms in patients who had angina pectoris or myocardial infarctions. Clinical diagnoses correlated well with the angiographic findings, particularly in those men considered to be normal and those with typical angina pectoris. Addition of atypical features or prolonged pain decreased the degree of correlation. Only 20% of those with cholesterol levels less than 200 mg/100 ml had significant lesions, whereas 81% with levels more than 275 mg/100 ml had such findings.

Adolescent↗