scholarly journals Cardiac Cephalgia: Angina in the Head

2021 ◽  
Vol 48 (3) ◽  
pp. 46-49
Author(s):  
Md Mahbubu Rahman ◽  
Md Aminur Razzaque ◽  
Iftikher Alam ◽  
Asif Iqbal ◽  
Golam Rahman Mallick ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Ischaemic Heart Disease ◽  
Tolerance Test ◽  
Early Evaluation ◽  
Presenting Symptoms ◽  
Artery Disease ◽  
Cardiac Cephalgia ◽  
Headache Symptom

Cardiac cephalgia is a migraine like headache that occurs during episodes of myocardial ischaemia. Although most of the patients presenting with ischaemic heart disease have chest pain, there are other rare presenting symptoms like cardiac cephalgia. Headache can be the only presentation of coronary artery disease. We report a case of a 57 years-old man, Presenting with only headache during brisk walking, Exercise Tolerance Test (ETT) was positive for Electrocardiograph (ECG) evidence of provocable myocardial ischemia, who latter was diagnosed as double vessel coronary artery diseaseon Coronary Angiogram (CAG). As the patient preferred remaining without revascularization, he was put onto optimum medical management for ischaemic heart disease. A follow up visit after one month revealed, marked improvement of the headache with anti anginal medications. Early evaluation and diagnosis of the headache symptom should be done because treatment with anti-migraine drugs may deteriorate headache and undermine the diagnosis of coronary artery disease. Bangladesh Med J. 2019 Sep; 48 (3): 46-49

Ischaemic heart disease in women

ESC CardioMed ◽  
2018 ◽  
pp. 2836-2840
Author(s):  
Martha Gulati
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Ischaemic Heart Disease ◽  
Obstructive Coronary Artery Disease ◽  
Diagnostic Testing ◽  
Atypical Presentation ◽  
Artery Disease

The more atypical presentation of women makes the diagnostic evaluation of symptomatic women challenging and results in more frequent referral for diagnostic testing to improve the precision of the ischaemic heart disease likelihood estimate. The classification of ischaemic heart disease and myocardial infarction has moved beyond the diagnosis of obstructive coronary artery disease and encompasses ischaemia that can occur in the presence and absence of obstructive coronary artery disease. Consideration of the different pathophysiology of ischaemia that may occur in women needs to be considered in the evaluation and treatment of ischaemic heart disease in women.

scholarly journals Coronary Angiographic Severity in Patients With Raised Plasma Homocysteine Level

1970 ◽  
Vol 1 (2) ◽  
pp. 169-173 ◽  
Author(s):  
MS Kabir ◽  
AAs Majumder ◽  
MS Bari ◽  
AW Chowdhury ◽  
AM Islam
Keyword(s):  
Coronary Artery Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Ischaemic Heart Disease ◽  
Homocysteine Level ◽  
Plasma Homocysteine ◽  
Plasma Homocysteine Level ◽  
Vessel Disease ◽  
Artery Disease ◽  
Single Vessel Disease

Background: Besides conventional classic risk factors of ischaemic heart disease other variables that have come under scrutiny for their potential contribution include estrogen deficiency, lipoprotein (a), plasma fibrinogen, plasminogen-activator inhibitor type I, endogenous tissue plasminogen activator (tPA), C-reactive protein and homocysteine. A number of studies have been undertaken worldwide shows strong correlation of raised fasting plasma homocysteine level with the development of atherosclerotic vascular diseases, myocardial infarction or increasing severity of coronary artery diseases. Objective: To find out the correlation of fasting plama homocysteine level with the severity of coronary artery disease in our population. Method: We undertook a study involving 100 patients of ischaemic heart disease (determined clinically & by non-invasive tests) in National Institute of Cardiovascular Diseases, Dhaka, Bangladesh, over the period of one year from January 2003 to December 2003. Out of 100 patients, 50 patients having normal homocysteine level were considered as control and another 50 patients having raised plasma homocysteine level were taken as cases. Result: Out of 50 patients, 20% had single vessel disease, 48% had double vessel disease and 32% had 3 vessel diseases. On the other hand in control group 10% patients had normal coronary artery disease, 40% had single vessel disease, 32% had double vessel disease and 18% had triple vessel disease. Conclusion: The study showed significant increase in number of coronary artery involvement by atherosclerotic lesions with increasing levels of plasma homocysteine level. Key words: Homocysteine; Coronary artery disease; Coronary angiogram. DOI: http://dx.doi.org/10.3329/cardio.v1i2.8124 Cardiovasc. j. 2009; 1(2) : 169-173

Ischaemic heart disease and diabetes

ESC CardioMed ◽  
2018 ◽  
pp. 1402-1407
Author(s):  
Ruben L. J. Osnabrugge ◽  
A. Pieter Kappetein
Keyword(s):  
Coronary Artery Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Ischaemic Heart Disease ◽  
Internal Thoracic Artery ◽  
Multivessel Coronary Artery Disease ◽  
Bilateral Internal Thoracic Artery ◽  
Artery Disease ◽  
Procedural Success

Approximately 30% of patients requiring revascularization for chronic ischaemic heart disease are diabetic. Compared with the general population, their mortality due to ischaemic heart disease is three to five times higher. This is due to the fact that in diabetics the process of atherosclerosis is accelerated. Diabetes mellitus significantly reduces long-term outcomes after percutaneous coronary intervention (PCI), whereas short-term procedural success is the same as for non-diabetics. Recent evidence shows that everolimus-eluting stents have better results in diabetics than other drug-eluting stents. Diabetes is also a risk factor for coronary artery bypass grafting (CABG) and in those diabetics who also suffer from peripheral vascular disease and/or renal failure, survival is even further reduced. A major ongoing trial is testing whether bilateral internal thoracic artery grafting provides enhanced survival compared with single internal thoracic artery grafting. Fear of higher sternal wound complications after bilateral internal thoracic artery grafting in diabetics is not substantiated by currently available evidence. There is, however, clear evidence that strict perioperative glucose control using intravenous insulin infusion improves outcomes after CABG in diabetics. Trials comparing CABG versus PCI in diabetics with multivessel coronary artery disease show that PCI carries a higher risk of long-term death, myocardial infarction, and repeat revascularization whereas rates of stroke are slightly higher after CABG. Therefore, CABG remains the preferred treatment strategy in diabetic patients with stable multivessel coronary artery disease.

Susceptibility to ischaemic heart disease: Focusing on genetic variants for ATP-sensitive potassium channel beyond traditional risk factors

2020 ◽  
pp. 204748732092678 ◽  
Author(s):  
Paolo Severino ◽  
Andrea D’Amato ◽  
Lucrezia Netti ◽  
Mariateresa Pucci ◽  
Marco V Mariani ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Ischaemic Heart Disease ◽  
Genetic Variants ◽  
Protective Factor ◽  
Microvascular Dysfunction ◽  
Coronary Microvascular Dysfunction ◽  
Artery Disease

Aims Ischaemic heart disease is classically associated with coronary artery disease. Recent evidences showed the correlation between coronary microvascular dysfunction and ischaemic heart disease, even independently of coronary artery disease. Ion channels represent the final effectors of blood flow regulation mechanisms and their genetic variants, in particular of Kir6.2 subunit of the ATP-sensitive potassium channel (KATP), are reported to be involved in ischaemic heart disease susceptibility. The aim of the present study is to evaluate the role of KATP channel and its genetic variants in patients with ischaemic heart disease and evaluate whether differences exist between coronary artery disease and coronary microvascular dysfunction. Methods A total of 603 consecutive patients with indication for coronary angiography due to suspected myocardial ischaemia were enrolled. Patients were divided into three groups: coronary artery disease (G1), coronary microvascular dysfunction (G2) and normal coronary arteries (G3). Analysis of four single nucleotide polymorphisms (rs5215, rs5216, rs5218 and rs5219) of the KCNJ11 gene encoding for Kir6.2 subunit of the KATP channel was performed. Results rs5215 A/A and G/A were significantly more represented in G1, while rs5215 G/G was significantly more represented in G3, rs5216 G/G and C/C were both more represented in G3, rs5218 C/C was more represented in G1 and rs5219 G/A was more represented in G1, while rs5219 G/G was significantly more represented in G2. At multivariate analysis, single nucleotide polymorphism rs5215_G/G seems to represent an ischaemic heart disease independent protective factor. Conclusions These results suggest the potential role of KATP genetic variants in ischaemic heart disease susceptibility, as an independent protective factor. They may lead to a future perspective for gene therapy against ischaemic heart disease.

scholarly journals Stress echocardiography in coronary artery disease: a practical guideline from the British Society of Echocardiography

2019 ◽  
Vol 6 (2) ◽  
pp. G17-G33 ◽  
Author(s):  
Richard P Steeds ◽  
Richard Wheeler ◽  
Sanjeev Bhattacharyya ◽  
Joseph Reiken ◽  
Petros Nihoyannopoulos ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Heart Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Ischaemic Heart Disease ◽  
Stress Echocardiography ◽  
Cardiac Computed Tomography ◽  
British Society ◽  
The United Kingdom ◽  
Artery Disease

Stress echocardiography is an established technique for assessing coronary artery disease. It has primarily been used for the diagnosis and assessment of patients presenting with chest pain in whom there is an intermediate probability of coronary artery disease. In addition, it is used for risk stratification and to guide revascularisation in patients with known ischaemic heart disease. Although cardiac computed tomography has recently been recommended in the United Kingdom as the first-line investigation in patients presenting for the first time with atypical or typical angina, stress echocardiography continues to have an important role in the assessment of patients with lesions of uncertain functional significance and patients with known ischaemic heart disease who represent with chest pain. In this guideline from the British Society of Echocardiography, the indications and recommended protocols are outlined for the assessment of ischaemic heart disease by stress echocardiography.

Gender Differences in Non-Obstructive Coronary Artery Disease

2020 ◽  
Vol 26 ◽  
Author(s):  
Maria Bergami ◽  
Marialuisa Scarpone ◽  
Edina Cenko ◽  
Elisa Varotti ◽  
Peter Louis Amaduzzi ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Gender Differences ◽  
Heart Disease ◽  
Coronary Artery ◽  
Ischemic Heart Disease ◽  
Coronary Arteries ◽  
Obstructive Coronary Artery Disease ◽  
Ischemic Heart ◽  
Current Evidence ◽  
Artery Disease

: Subjects affected by ischemic heart disease with non-obstructive coronary arteries constitute a population that has received increasing attention over the past two decades. Since the first studies with coronary angiography, female patients have been reported to have non-obstructive coronary artery disease more frequently than their male counterparts, both in stable and acute clinical settings. Although traditionally considered a relatively infrequent and low-risk form of myocardial ischemia, its impact on clinical practice is undeniable, especially when it comes to infarction, where the prognosis is not as benign as previously assumed. Unfortunately, despite increasing awareness, there are still several questions left unanswered regarding diagnosis, risk stratification and treatment. The purpose of this review is to provide a state of the art and an update on current evidence available on gender differences in clinical characteristics, management and prognosis of ischemic heart disease with non-obstructive coronary arteries, both in the acute and stable clinical setting.

Prevalence of Coronary Artery Disease Risk Factors and Metabolic Syndrome in Children with Heart Disease

2017 ◽  
Vol 39 (2) ◽  
pp. 261-267 ◽  
Author(s):  
Adam L. Ware ◽  
Paul C. Young ◽  
Cindy Weng ◽  
Angela P. Presson ◽  
L. LuAnn Minich ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Metabolic Syndrome ◽  
Heart Disease ◽  
Coronary Artery ◽  
Disease Risk ◽  
Coronary Artery Disease Risk ◽  
Artery Disease
Sign in / Sign up

Export Citation Format

Share Document