PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Angina Pectoris, Variant”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 199 records · Page 11Linked to original sources
PubMed1996

Significant characteristics of variant angina patients with associated syncope.

To determine whether syncope predisposes to sudden cardiac death, variant angina patients with syncope during cardiac attacks were compared with those without syncope. There were 240 consecutive patients (193 males and 47 females) diagnosed with variant angina pectoris. Thirty patients had a history of syncope during cardiac attacks while the remaining 210 had none. The incidence of cardiac events in the former group was 10.0% (3 of 30) and 10.5% in the latter. There were 3 cases of sudden cardiac death, all in the latter group. Significant clinical variables in the syncope patients included inferior ST-segment elevation and serious arrhythmias. We conclude that there is no relationship between syncope during variant angina and sudden cardiac death.

Adult↗
PubMed1982

Clinical evaluation of stress myocardial scintigraphy with thallium-201 in patients with ischemic heart disease. Semiquantitative analysis of single dose myocardial imaging.

In order to evaluate the usefulness of a stress T1-201 myocardial scintigraphy in semiquantifying the myocardial perfusion, 10 normal subjects and 71 patients with coronary artery diseases were studied with sequential imaging over 3 hours. Myocardial to background ration (M/B) in the exercise phase was significantly higher in the normal subject group than in the coronary artery disease groups. Three hours after exercise (redistribution phase), M/B decreased significantly in the normal subject group but remained unchanged in the coronary artery disease groups. Percent change of M/B with exercise was lower in the effort angina pectoris group (97 +/- 11.2%), and the old myocardial infarction group (101 +/- 14.5%) than in the normal subject group (127 +/- 12%). Sensitivity and specificity of this method were 93% and 47%, respectively. Out of 11 patients with variant angina pectoris, 9 patients showed positive scintigram. Of the 9, however, 6 cases were without organic coronary stenosis in the coronary angiography. There was a significant correlation between M/B on redistribution images (RD.M/B) and ejection fraction determined by left ventriculograms (r = 0.61, p less than 0.001), indicating a close relation between the amount of the residual viable myocardium and the left ventricular function. M/B and its percent change with stress T1-201 myocardial scintigraphy reflect the myocardial perfusion and myocardial perfusion reserve and their semiquantitative analysis provides a useful means for detection of ischemic heart disease.

Adult↗
PubMed1983

Exercise test in variant form of angina pectoris. Comparison of the results with spontaneous attacks.

Exercise tests were performed in 14 patients with untreated variant angina with frequent spontaneous attacks and in 15 patients after treatment abolished the attacks. (1) Anginal attacks associated with ST elevation were induced by exercise in 79% of untreated patients. By contrast, ST elevation was not observed in treated patients and ST depression was induced in 53% of the cases. (2) Exercise-induced ST elevation in untreated patients was shown in the same leads as the spontaneous attacks. (3) Exercise-induced ST elevation appeared initially during the recovery phase after exercise in 36% of untreated patients. Exercise-induced ST depression appeared during or immediately after exercise. (4) The reproducibility of exercise-induced ST elevation was low with repeated tests at different stages, but exercise-induced ST depression was consistently observed. (5) The exercise-induced ST depression and lack of ST changes in treated patients were highly suggestive of the presence and absence of organic coronary artery disease, respectively. However, the exercise-induced ST elevation in untreated patients did not differentiate between the presence or absence of organic stenosis of the coronary arteries. The results of exercise tests vary with the stage of variant angina. It is suggested that a coronary arterial spasm is a trigger mechanism for exercise-induced angina in cases of variant angina with frequent spontaneous attacks.

Adult↗
PubMedDate not supplied

William Heberden and Myron Prinzmetal: angina pectoris.

The most significant accounts of angina pectoris appeared in the medical literature separated by nearly two centuries. They were Heberden's initial description of classic angina and Prinzmetal's report of the variant form. Angina pectoris represents a transient myocardial oxygen deficiency. It is usually related to atherosclerotic coronary artery disease, but there are a number of less common etiologies, most notably aortic stenosis. Stable and unstable forms exist, with stable angina being further subclassified as being of one of four patterns: classic, variant, atypical, and angina equivalent.

Angina Pectoris↗
PubMed1988

Early evolution of symptoms and long-term prognosis in variant angina: importance of the functional component of coronary arterial disease.

PURPOSE: Most investigations describing the long-term outcome of large groups of patients with variant angina pectoris have focused on such endpoints as myocardial infarction, coronary artery surgery, and death, and have asked how the risk of these events is related to the severity of existing organic coronary disease. It is also possible to ask what is the relative importance of organic and functional components in causation of symptoms and outcomes, as was done in this study. PATIENTS AND METHODS: The early and long-term clinical course was observed in a group of 80 patients with variant angina and a low prevalence of severe organic coronary disease (diameter stenosis greater than 70 percent of one vessel in 28.3 percent, of two or more vessels in 2.7 percent). Patients were seen at the UCLA Medical Center between July 1963 and June 1985. RESULTS: The following observations were made: Compared with those experiencing a first episode of angina at rest, subjects whose first episode of vasospastic angina occurred during strenuous effort were more likely subsequently to have a positive exercise test result and a more stable but long-term anginal course. A good initial response to vasodilator therapy indicated a likelihood of being alive and symptom-free without an intervening myocardial infarction by five years after diagnosis, which was twice the rate as if initial response to such treatment was poor. The presence or absence of severe coronary artery obstruction as detected by angiography could not be predicted from the nature or severity of angina, the historical presence of effort angina, or the occurrence of a positive result on an exercise test. The existence of severe coronary stenosis in at least one vessel was not associated with an increased incidence of myocardial infarction, cardiac arrest, or death in the first nine years after diagnosis. CONCLUSION: These findings are consistent with the hypothesis that manifestations of ischemic heart disease in these patients were more directly caused by coronary vasospasm than by the degree of organic coronary obstruction seen by coronary arteriography. In addition, the presence of severe organic stenosis in one coronary artery did not appear to be associated with measurably increased adverse effects on clinical course or survival over the first nine years after diagnosis.

Angina Pectoris, Variant↗
PubMed1980

Variant form of angina pectoris: its clinical features and treatment. The 185th Luis Guerrero Memorial Lecture given at the 6th Paul Dudley White Session, University of Santo Tomas, Manila, The Philippines, January 24, 1979.

The variant form of angina pectoris (VA) is a rather common disease in Japan, and the author himself is suffering from it. Among 100 successive cases of various types of angina seen in our Department, excluding myocardial infarction and post-infarctional angina, 23 cases were VA. The brief duration, cyclic occurrence and frequent incidence of the attacks at night are considered to be the clinical characteristics. The pathogenesis of VA is ascribed to coronary spasm on the basis of findings made in cinecoronary arteriography. ST elevation was observed more frequently on exercise test in VA than in ordinary exertional angina pectoris, indicating that patients with VA are in a markedly spasmophilic state. Although the prognosis is not generally so serious, 33 out of 50 cases of VA had arrhythmias during attacks, including such serious ones as advanced AV block and ventricular fibrillation. Nifedipine was dramatically effective in suppressing repeatedly occurring ventricular fibrillation. A survey of the effects of calcium antagonists in 243 cases of VA in 11 cardiology institutes throughout Japan revealed that these drugs were effective in more than 90% of the cases. Of particular note is the fact that the attacks were completely eliminated in more than 80% of the cases.

Angina Pectoris↗
PubMed1988

Ischemic heart disease and magnesium.

Globally, among mortality and morbidity indices for man, ischemic heart disease (IHD) ranks at the top of the list. In the industrialized world, IHD is the leading killer and accounts for approximately 35% of all deaths each year. This most common cause of death results from insufficient coronary blood flow. IHD is a general term used to describe a pathophysiologic state in which cardiac output is inadequate as a consequence of coronary blood flow deficits brought about when the latter cannot deliver enough O2 to meet the needs of the myocardium. This review is concerned with the etiology of IHD, special forms of IHD such as angina pectoris and variant angina, as well as sudden death ischemia heart disease. The diverse conditions that cause IHD are discussed. Important etiologic factors such as the pathogenesis of atherosclerotic obstruction as well as localized coronary vasospasm are reviewed. Implications of dietary and metabolic alterations in electrolytes are a special focus of this view. Evidence implicating Mg2+-K+ and Mg2+-Ca2+ alterations in the pathogenesis of IHD is reviewed. Special attention is devoted to the role of Mg in vascular tone, coronary blood flow and in clinical management of IHD. It is concluded that judicious use of Mg salts in IHD could be expected to reduce myocardial oxygen demand and influence the myocardial oxygen supply/demand ratio in a favorable manner.

Angina Pectoris↗
PubMed1984

Assessing the risk of angina for dental therapy.

The purpose of this article is to review signs and symptoms of three of the most common patterns of angina pectoris and to outline the prognostic implications as an aid to the dentist when dental therapy is contemplated. The three anginal patterns discussed are classic angina, variant angina, and unstable angina.

Angina Pectoris↗
PubMed1976

[Clinical coronarographic characteristics and pathogenetic mechanism of angina pectoris with s-t elevation (author's transl)].

The study of 46 patients with frequent anginal episodes characterized by S-T elevation (so called "variant angina pectoris") demonstrated that this type of electrocardiographic pattern does not characterize a homogeneous group of patients. In fact, while in some patients angina occurred only at rest, in others it occurred also on exercise. Sometimes ecgraphic alterations characterized by S-T depression were observed on the same leads which on other occasions had shown S-T elevation. The angiographic picture revealed: absence of significant coronary alterations in 10% of cases, stenosis greater than 75% in one main branch in 29%, in two branches in 39% and in three branches in 22% of cases. The hemodynamic monitoring carried out on 14 of these patients demonstrated that the ecgraphic modifications occur before the onset of the hemodynamic parameters which control myocardial O2 consumption. This suggests a primitive reduction of regional myocardial blood supply as a cause of the ischaemic episodes. The study of the regional myocardial perfusion with 201Tl technique in 6 patients confirmed this hypothesis. Coronary angiography carried out during an ischemic episode showed that the reduction of myocardial blood supply was caused by a spasm of a large coronary artery involving a long segment of the vessel, reversible by nitroglycerin administration. Aorto-coronary by-pass operation performed on 6 patients was followed by the disappearance of pain in two patients, even though the "by-pass" patency was angiographically proved in two patients.

Adult↗
PubMed1981

[Prinzmetal's variant form of angina pectoris occurring with ventricular tachycardia, ventricular flutter and fibrillation].

After a brief literature survey, the author described a patient of 42, with its first stenocardia paroxysm, accompanied by tachycardia, clonic-tonic convulsion as MAS syndrome, loss of consciousness and spontaneous restoration. After 6 hours a second stenocardia paroxysm followed, when a gigantic ST segment elevation was recorded in precordial leads, appearance of paroxysmal ventricular tachycardia, ventricular fibrillation, loss of consciousness, restored via defibrillation. ST elevation faded by the 25 the minute. The changes are stressed to be most likely due to coronary spasm of r. descendens of the left coronary artery and to changes in the small myocardial vessels. The opinion that Prinzmetal stenocardia is a variant of angina pectoris is confirmed as well as that paroxysm could be with a lethal end due to ventricular fibrillation.

Adult↗
PubMed1987

Calcium antagonists for Prinzmetal's variant angina, unstable angina and silent myocardial ischemia: therapeutic tool and probe for identification of pathophysiologic mechanisms.

The calcium antagonists provide a unique tool to reduce myocardial oxygen demand and prevent increases in coronary vasomotor tone. For patients with Prinzmetal's variant angina, diltiazem, nifedipine and verapamil are extremely effective in preventing episodes of coronary vasospasm and symptoms of ischemia. Unstable angina pectoris is a more complex pathophysiologic syndrome with episodes of ischemia due to increases in coronary vasomotor tone, intermittent platelet aggregation or alterations in the underlying atherosclerotic plaque. Each of the calcium antagonists is effective as monotherapy in decreasing the frequency of angina at rest. Nifedipine is the only calcium antagonist that has been studied in a combination regimen with beta blockers and nitrates for patients with unstable angina, and control of angina is better with the combination regimen than with either form of therapy alone. Although symptoms of myocardial ischemia in unstable angina are reduced by calcium antagonists, these agents do not seem to decrease the incidence of adverse outcomes. Antiplatelet therapy appears to improve morbidity and mortality in patients with unstable angina, suggesting that thrombus formation may play a central role in that disorder. Episodes of silent or asymptomatic myocardial ischemia, identified by ST-segment monitoring, occur in a variety of disorders of coronary disease. Among patients with Prinzmetal's variant angina and unstable angina, episodes of silent ischemia appear to be as frequent as episodes of angina and the calcium antagonists are effective in decreasing episodes of ischemia regardless of the presence or absence of symptoms. Persisting episodes of silent ischemia among patients with unstable angina despite maximal medical therapy identify patients at high risk for an early unfavorable outcome. Among patients with stable exertional angina, episodes of silent ischemia may be up to 5 times as frequent as episodes of angina, and may be due to increases in coronary vasomotor tone, transient platelet aggregation or increases in myocardial oxygen demand. Preliminary experience suggests that calcium antagonists and beta blockers are effective in decreasing episodes of silent ischemia in patients with stable exertional angina and that a combination regimen may be more effective than either form of therapy alone.

Angina Pectoris↗
PubMed1975

Prinzmetal's variant form of angina pectoris. Re-evaluation of mechanisms.

Thirty-five patients with typical Prinzmetal's variant angina were studied by coronary cineangiography. There was no demonstrable stenosis of the major coronary arteries in 19 patients. Nine patients with single coronary stenosis underwent aortocoronary bypass and had recurrence of the symptoms postoperatively. Administration of nifedipine effected complete cessation of the symptoms among patients formerly treated medically. Although surgical treatment did not effect permanent relief of pain, all patients initially treated surgically experienced relief of pain when nifedipine was administered. The pathophysiology of variant angina remains obscure. Our results suggest that neurohumoral factors exert more of an effect on the myocardial cell than on the coronary vessels.

Angina Pectoris↗