摘要:

ABSTRACT.The bicycle exercise tolerance was studied in ten patients with angina pectoris after one week's treatment with an a‐β‐blocker (labetalol 300 mg b.d.), a‐β‐blocker (propranolol 80 mg b.d.) and placebo. The ST‐segment of the ECG was continously evaluated by on‐line computerized averaging of complexes which greatly reduces noise and eliminates artefacts caused by varying baseline. Blood pressure was lowest with labetalol and heart rate lowest with propranolol. The rate of rise of heart rate during exercise was equally well depressed by both drugs. They also attenuated ST‐depression at a given load but enhanced ST‐depression for a given heart rate. At heart rate 100/min ST‐depression was significantly greater with propranolol than with labetalol. It is concluded that provided ST‐depression during treatment with β‐blockers is correlated to myocardial ischemia in the same way as without such treatments used, other factors, e.g. an increase in cardiac size, will contribute more to the ischemia. Labetalol may cause less increase in cardi

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1981.tb03114.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT.A series of 12 consecutive patients with Prinzmetal's variant angina is presented. There was a preponderance of males (eight/12) and individuals less than 60 years of age (nine/12). Delay in diagnosis was frequent, primarily due to difficulty in achieving a proper 12 lead ECG recording of the attack which often occurred late at night or in the early morning, subsiding within minutes. In some cases, moreover, ST‐depression was observed in the ECG monitoring lead as a reciprocal manifestation of subepicardial ischaemia or due to incorrect polarity in the monitoring lead. The incidence of serious arrhythmias, AV‐block and ventricular tachycardia was high (eight/12); two patients had to be DC‐converted. Coronary arteriography revealed a spectrum from normal or nearly normal coronary arteries to single vessel disease. Nitroglycerin was well suited for treatment of acute attacks. Long‐term treatment with calcium antagonists was effective and without serious side‐effects. The follow‐up time was from 8 months to 5 years (mean 2 years). It is concluded that Prinzmetal's variant angina as such is a rare disease, but that coronary artery spasm is most likely an important contributory factor in the clinical manifestations of coronary artery disease: arrhythmias, sudden death and myocardial

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1981.tb03115.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT.The study reports on the outcome of hyperventilation tests in a 57‐year‐old male with Prinzmetal's variant angina, formerly often complicated by ventricular fibrillation. It was found that hyperventilation for a period of 6 min after a delay of 4 to 6 min was followed by the development of ST‐elevation and pain, but only when the test was performed in the morning, whereas the outcome of tests performed later in the day were negative. Pretreatment with calcium blockers, nifedipine or verapamil proved effective in preventing the anginal response to the test, also when it was performed in the morning. It is concluded that hyperventilation performed in the early morning, but not later in the day, may prove to be an effective and safe procedure for provoking Prinzmetal's variant angina, and that hyperventilation may be useful in the evaluation of the efficacy of drug th

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1981.tb03116.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT.The perception of pain in three groups of patients with angina pectoris has been studied. All patients went through a bicycle ergometer test with an increase of 10 watt each minute. Heart rates and ratings of pain were collected towards the end of each work load. Reliable results of diagnostic interest were obtained. The rating procedure is discussed and a new category rating scale with ratio properties is also presented.

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1981.tb03117.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT.This paper will discuss some of the effects that psychological factors have on chest pain during and following myocardial infarction: 1. Psychological factors and the development of a myocardial infarction; a) the relationships of personality and other high risk factors, b) the onset situation of hopelessness and helplessness, c) immediate psychological precipitants (fact and fantasy), d) denial and delay. 2. Psychological factors during recovery; a) problems associated with the Type A personality, b) critical periods, c) absence of angina and denial, d) the effect of post M.I. angina, e) co‐existence of angina and psychogenic pain. 3. How reaction of the marital partner can affect the patient and his experience of pain. 4. Factors which tend to minimize psychogenic invalidis

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1981.tb03118.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT.Esophageal pain was investigated in 200 consecutive patients prior to surgical correction of reflux. The pain has been analyzed to determine its characteristic and its atypical features. Arm distribution of pain and exercise induced pain were the most atypical features and led to diagnostic difficulty. Although acid perfusion studies reproduced some component of the pain in 94% of patients, reproduction of arm pain was possible in only 37.2% of those with this symptom. The importance of cardiologic evaluation in patients with atypical esophageal pain is emphasized.

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1981.tb03119.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT.Esophageal motor function tests were performed in 160 patients presenting with central chest pain clinically resembling myocardial ischemia. Motor abnormalities consisting of high amplitude, long duration peristaltic waves, diffuse spasm, or simultaneous contractions were found in 63 of those patients Direct correlation of the motor patterns with chest pain was possible in fourteen patients; another fourteen patients had reproduction of their pain with intraluminal acid. Clinical criteria could not differentiate those with esophageal pain from others. Esophageal function test can help in the diagnosis of central chest pain, but they have low sensitivity.

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1981.tb03120.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT.Effort‐related chest pain and chest pain fulfilling the criteria of the Rose questionnaire for angina pectoris are often used as evidence for coronary heart disease. In patients with different kinds of oesophageal dysfunction (OD) the frequency of chest pain of angina‐like type was studied and compared to that in the general population. Eighty per cent of patients with hiatal hernia at oesophageal manometry had chest pain, 63% of which was effort‐related. In 217 patients with a positive acid perfusion test, i.e. the provoked heart burn or pain is the same as that experienced in daily life, 82% had a history of chest pain. The chest pain was effort‐related in 70% and in almost half of the cases their chest pain was classified as angina pectoris according to the Rose questionnaire. Since angina‐like chest pain is a predominant symptom in patients with OD and OD is far more common than angina pectoris due to myocardial ischemia in the general population, it is reasonable to assume that the oesophagus and not the heart is the most common source of angina‐like

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1981.tb03121.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT.A short review of the literature of the acid perfusion test is first given. Data from 67 patients with chest pain investigated with an acid perfusion test during ECG‐surveillance in close connection to an exercise test are then presented. Arrhythmias or ST‐T changes on ECG were not induced by the acid infusion. Six patients had a »positive related« acid perfusion test which in this context means that they recognized the chest discomfort elicited by the acid infusion as that which had brought them to the exercise test. The acid perfusion test in close connection to an exercise test is in selected patients a safe and useful technique for establishing whether or not the symptoms have an oesophageal comp

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1981.tb03122.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT.Gastrointestinal disease imitates angina quite commonly and the oesophagus is usually responsible, both in patients presenting as emergencies and also in those who have been extensively investigated for apparent angina. A questionnaire study of 22 patients with oesophageal spasm and 15 patients with coronary artery disease failed to show any feature that discriminates reliably between these groups.

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1981.tb03123.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY