Group Therapy in the Outpatient Management of Post-Myocardial Infarction Patients

1973 ◽  
Vol 4 (1) ◽  
pp. 77-88 ◽  
Author(s):  
Richard H. Rahe ◽  
Charles F. Tuffli ◽  
Raymond J. Suchor ◽  
Ransom J. Arthur
Keyword(s):  
Myocardial Infarction ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Angina Pectoris ◽  
Group Therapy ◽  
Long Range ◽  
Mortality Rates ◽  
Outpatient Management ◽  
Rehabilitation Process ◽  
Early Results

A controlled experiment of the utility of group therapy as an adjunct to the medical outpatient management of patients following myocardial infarction has been in progress for nearly a year. The long-range purpose of the experiment is to assess the possible benefits of group therapy experience in terms of subjects' job rehabilitation rates, angina pectoris prevalence, nitroglycerin use, rehospitalization for coronary heart disease, as well as reinfarction and mortality rates-compared to those for control subjects. The early results from the group therapy experience, however, have provided important information and are reported here to illustrate the psychological physiology of the rehabilitation process and emphasize patients' special needs, too often ignored during their convalescence.

LEVELS OF PLASMINOGEN ACTIVATOR INHIBITOR IN PATIENTS WITH ANGINA PECTORIS

1987 ◽  
Author(s):  
C Koringer ◽  
R Jäger ◽  
K Huber ◽  
K lechner
Keyword(s):  
Myocardial Infarction ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Angina Pectoris ◽  
Plasminogen Activator ◽  
Normal Population ◽  
Plasminogen Activator Inhibitor ◽  
Titration Assay ◽  
Age Range ◽  
Activator Inhibitor

Several groups have shown that fibrinolytic capacity is impaired in survivors of myocardial infarction, due to increased levels of the fast-acting plasminogen activator inhibitor (PAI). In order to study the behaviour of PAI in patients with coronary heart disease, 180 patients with angina pectoris were investigated. They were 148 males and 32 females, ages ranging from 29 to 70 years (52.8 ± 8.2, mean ± S.D.). A sex- and age- matched normal population served as a control (n=105, age-range 30 to 69 years, 52.4 ± 7.9). PAI was determined by a functional titration assay, and its activity expressed as arbitrary units (AU). PAI levels were significantly (p <0.005) higher in patients with angina (24.3 ± 10.3 AU/ml, range 10.1 to 112.0 AU/ml) than in normals (20.4 ± 4.6 AU/ml, range 10.5 to 31.6 AU/ml). PAI levels were unrelated to sex or age, in both the patient and the control groups. As expected, plasma triglyceride levels were correlated to PAI in patients (r=0.19, p<0.01) and in normals (r=0.20, p<0.05). Patients with a history of previous myocardial infarction (n=114) had similar PAI levels as patients without infarction (24.2 ± 11.1 AU/ml as compared to 24.4 ± 9.6 AU/ml). It is concluded that PAI levels are elevated in patients with coronary heart disease, whether myocardial infarction has taken place or not.

Mortality in serious mental illness

2011 ◽  
Vol 26 (S2) ◽  
pp. 2150-2150
Author(s):  
U. Osby
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Bipolar Disorder ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cerebrovascular Disease ◽  
Causes Of Death ◽  
Mortality Rates ◽  
Rate Ratios ◽  
Bipolar Patients

IntroductionThere is evidence that patients with bipolar disorder have an increased mortality from somatic causes of death, including coronary heart disease and myocardial infarction. However, present mortality ratios and mortality trends over time are not known.AimTo analyze relative mortality and mortality trends for patients with bipolar disorder in relation to the population for cerebrovascular disease, coronary heart disease and myocardial infarction.MethodsAll patients in Sweden with a clinical diagnosis of bipolar disorder from the introduction of ICD-10 (1987–2006) found in the National Swedish Patient Register were followed-up in the Cause of death register. Mortality rate ratios (MRR) for different cardiovascular diseases and different age groups were calculated, as well as numbers of excess deaths, relative to the population. Also, admission rate ratios (ARR) and yearly mortality rates for bipolar patients versus the population were calculated for the same time period.ResultsFrom all causes of death, there were 5,471 deaths for bipolar patients. MRR was 2.58 (95% CI: 2.51–2.65). For cerebrovascular disease MRR was 2.19 (95% CI: 2.01–2.40), and for coronary heart disease MRR was 2.10 (95% CI: 1.98–2.2.24). In the subgroup of acute myocardial infarction MRR was 1.97 (95% CI: 1.81–2.14). In cerebrovascular disease, ARR was increased to 1.47 (95% CI: 1.35–1.59), while in coronary heart disease ARR was 1.06 (95% CI: 0.98–2.24), and in acute myocardial infarction 1.09 (95% CI: 0.0.98–1.22). Yearly mortality rates for these causes of death decreased both among patients and the population, without indication of a decreasing gap.ConclusionsIn patients with bipolar disorder, mortality from cerebrovascular disease and coronary heart disease with its subgroup acute myocardial infarction was doubled during 1987–2006. In contrast, admission rates for coronary heart disease and acute myocardial infarction were not increased. Yearly mortality rates decreased both for the patients and the population, but there were no indications of a decreasing gap.KeywordsBipolar disorder; Register study; Cerebrovascular disease; Coronary heart disease; Acute myocardial infarction; Mortality rate ratios; Admission rate ratios.

scholarly journals Myocardial bridge and coronary artery fistulas in a patient with angina

2019 ◽  
Vol 10 (2) ◽  
pp. 137-141
Author(s):  
Aleksandra A. Kholkina ◽  
Yuriy R. Kovalev ◽  
Vladimir A. Isakov ◽  
Natal’ya O. Gonchar
Keyword(s):  
Myocardial Infarction ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Surgical Treatment ◽  
Angina Pectoris ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Myocardial Bridge

Cardiovascular diseases (CVDs) are the leading cause of mortality among the population. At the core of the progression of the coronary heart disease is the atherosclerosis of the coronary arteries, which is found in majority of patients suffering from angina and in patients with myocardial infarction. However, in some cases, coronary angiography reveals, that patients with the mentioned clinical manifestations have their coronary arteries unchanged. This is treated as syndrome X or microvascular angina. Along with that, development or aggravation of the coronary heart disease may be based on the congenital peculiarities in the coronary arteries location and structure, such as muscular bridges and fistulas of the coronary artery. This is confirmed by a number of studies, which indicate the role of the above mentioned pathologies in the occurrence of angina and myocardial infarction. Nevertheless, there is also the opposite view, which is supported by a number of specialists. According to them, the presence of the mentioned peculiarities in the structure of the coronary channel is deemed as the patient-specific norm. Hence, the issue of the surgical treatment of the patients with the aforementioned coronary arteries anomalies remains controversial. The clinical case report of the patient with the symptoms of angina pectoris, in which the coronary angiography did not reveal the stenosis of the coronaries arteries, but located the myocardial bridge and the coronary fistula. The role of the congenital coronary vessels pathology in the angina pectoris is analyzed. The diagnosis guidelines and the tactics of the conservative and surgical treatment of patients with the above mentioned syndromes are discussed.

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