Coronary Heart Disease: Angina Pectoris: Myocardial Infarction

1958 ◽  
Vol 1 (7) ◽  
pp. 215-215
1973 ◽  
Vol 4 (1) ◽  
pp. 77-88 ◽  
Author(s):  
Richard H. Rahe ◽  
Charles F. Tuffli ◽  
Raymond J. Suchor ◽  
Ransom J. Arthur

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.


Author(s):  
C Koringer ◽  
R Jäger ◽  
K Huber ◽  
K lechner

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.


2019 ◽  
Vol 10 (2) ◽  
pp. 137-141
Author(s):  
Aleksandra A. Kholkina ◽  
Yuriy R. Kovalev ◽  
Vladimir A. Isakov ◽  
Natal’ya O. Gonchar

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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