• Title/Summary/Keyword: Angina pectoris. Chest pain

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A Case Study of one Patient who has a ischemic heart disease(IHD) (허혈성 심질환(Ischemic heart disease) 환자(患者)의 사상(四象) 처방(處方) 투여 1례(例)에 대한 임상보고(臨床報告))

  • Kim, Hye-Won;Song, Jeong-Mo;Kim, Jeong-Ho
    • Journal of Sasang Constitutional Medicine
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    • v.14 no.2
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    • pp.125-131
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    • 2002
  • An ischemic heart disease(IHD) is a anemic state of heart caused by disproportion between heart's demand and supply of oxygen. A patient who has this IHD feels serious chest pain called angina pectoris. In a keen condition it leads to a necrosis of heart muscles, known as myocardial infarction. In an ischemic heart disease the ECG waves gives us useful information of patients' heart. And CK(creatine kinase) in serum and Troponin T are the principal factors in diagnosis of IHD. In this study, the IHD patient classified by Sasang Constitutional Medicine had a notable medical effects. The symptoms of patient are disappeared and waves of ECG is closed to normal. The result of CK in serum is also recovered. So we report the healing process and results of this patient in this study.

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Symptom Experience and Related Factors in Patients with Angina Pectoris (협심증 환자의 증상경험과 관련요인에 관한 연구)

  • Woo, Soo-Hee;Eom, Ae-Yong;Oh, Eui-Geum
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.13 no.3
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    • pp.447-456
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    • 2006
  • Purpose: This study was done to examine symptom experiences and related factors in angina patients. Method: The participants were 92 patients admitted to C university hospital between October and December 2004. The tools used were a questionnaire on symptom experience related to angina developed by Gensini(Coronary Angiographic Gensini Score). Global Assessment of Recent Stress Scale and a tool measuring performance of health behavior. Results: The mean score for symptom experience was relatively low (M=27.65, SD=18.44) as was the score for coronary severity (Gensini score) was 16.30 point (SD=18.04). The mean score for perceived stress was moderate (M=30.16, SD=12.26). Compliance was relatively good in these patients with angina (M=61.55, SD=7.60). Analysis of the correlation of symptom experience showed a statistically significant positive relationship with perceived stress (r=.410, p=.000). There was significant negative relationship (r=-.251, p=.016) between symptom experience and compliance. In the regression analysis, symptom experience was found to be significantly influenced by stress ($R^2$=.168, p=.000), age ($R^2$=.057, p=.002), and economic status ($R^2$=.061, p=.007). These variables explained 26.2% of the variance in symptom experience. Conclusion: The results of this study provide evidence that symptoms of angina can present not only as chest pain itself but also with fatigue, shortness of breath, and sleep disturbance as the most common symptoms.

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A case report of Cardiac chest pain with dizziness and headache treated by Oriental Medicine (현훈(眩暈), 두통(頭痛)을 동반한 심장성(心臟性) 흉통(胸痛) 환자 1례의 한방치료에 의한 증례보고)

  • Koh, Young-Tak;Yoo, Yeoung-Eun;Shim, Sang-Min;Chung, Young-Hoon;Lee, Ki-Ha;Kim, Ki-Joo;Han, Eul-Joo
    • Journal of Oriental Neuropsychiatry
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    • v.18 no.3
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    • pp.309-319
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    • 2007
  • Chest pain is classified into two major categories of cardiac chest pain and non-cardiac chest pain. Cardiac chest pain is caused by cardiovascular disease, for example, myocardial infarction, angina pectoris, valvular heart disease, cardiac enlargement or hypertrophy, dissecting aortic aneurysm, pericarditis, myocarditis, etc. When the chest pain is not attributed to heart disease, it is termed non-cardiac chest pain. Non-cardiac chest pain is caused by pulmonary, gastrointestinal, musculoskeletal disease, psychiatric factor, etc. In tills case, we treated a 54-year old female patient who was diagnosed with dilated cardiomyopathy and suspicious sick sinus syndrome. She complained of chest pain, exertional dyspnea, dizziness and headache. For treatment, we made use of Yugultangami(六鬱湯加味) and Daejobwan(大造丸). Before and after treatment, we measured Heart rate variability(HRV). In result, the clinical symptoms were improved and there was a significant increase in assessmeut by Heart rate variability(HRV). Tills result suggests that Yugultaugami aud Daejowhan have a good effect on cardiac chest pain.

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Emergency Coronary Artery Bypass Following Unsuccessful Percutaneous Transluminal Coronary Angioplasty -A Case Report- (경피적 관상동맥성형술후 응급 관상동맥 우회로 조성술 경험)

  • 안욱수
    • Journal of Chest Surgery
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    • v.21 no.2
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    • pp.373-378
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    • 1988
  • Since the introduction of percutaneous; transluminal coronary angioplasty[PTCA] by Grunt-zig in 1977, this is widely used in some patients with coronary artery disease and is an effective alternative to surgery for many patients. Indications for emergency coronary artery bypass graft[CABG] after PTCA are prolonged chest pain, worsening of coronary artery obstruction, "current of injury" by electrocardiogram, cardiogenic shock, and in a lesser incidence, ventricular fibrillation, coronary artery dissection[without obstruction], heart block, and intractable cardiac arrest. Recently, we have experienced one case of emergency CABG following unsuccessful PTCA. The patient was 54 year-old male and admitted with complaint of angina pectoris. The routine electrocardiogram revealed within normal limit. The treadmill test revealed severe chest pain after 2 min. exercise. Coronary cineangiogram revealed 95% segmental stenosis of the proximal right coronary artery. Our cardiologist was planned PTCA. During PTCA, severe chest pain and ischemic pattern on electrocardiogram were developed. But they were not relieved even by morphine and nitroglycerin till 90 min. So we performed emergency single coronary artery bypass graft from aorta to proximal right coronary artery with great saphenous vein. The patient had an excellent postoperative recovery and was free from anginal attack. He has shown striking improvement in general status[NYHA functional class 1] during 6 months after operation.operation.

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Case Report of Korean Medical Treatment of Chest Pain After Percutaneous Coronary Intervention (경피적관상동맥중재술을 시행한 후 발생한 흉통(胸痛)에 대한 한방치료 1례)

  • Min, Seon-woo;Kim, Hak-kyeom;Moon, Ji-seong;Kim, Ye-seul;Park, Ji-yoon;Jeong, Ji-cheon
    • The Journal of Internal Korean Medicine
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    • v.42 no.2
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    • pp.184-196
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    • 2021
  • Objectives: This case report presents the effects of Korean medical treatment in a patient with chest pain after percutaneous coronary intervention (PCI). Methods: An 80-year-old woman was treated with Korean herbal medicine, acupuncture, and cupping therapy. Chest pain, sore tongue, and headache were assessed daily using a numeric rating scale (NRS). Results: After 15 days of treatment, chest pain disappeared, as reflected by an NRS change from 9 to 0, and headache was relieved (NRS decreased from 9 to 2). On the eighth day of treatment, the sore tongue was also relieved, as reflected by an NRS change from 9 to 0. Conclusion: These results show that chest pain after PCI can be relieved with Korean medical treatment, and it is expected that major adverse cardiac events (MACEs) may be prevented with Korean medical treatment. However, additional well-designed studies are required to confirm these findings.

Tests for Acute Coronary Syndrome (급성관동맥증후군 관련 검사)

  • Kim, Kyung-Dong
    • Journal of Yeungnam Medical Science
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    • v.18 no.1
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    • pp.13-29
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    • 2001
  • The enzyme activities of creatine kinase (CK), its isoenzyme MB (CK-MB) and of lactate dehydrogenase isoenzyme 1 (LD-1) have been used for years in diagnosing patients with chest pain in order to differentiate patients with acute myocardial infarction (AMI) from non-AMI patients. These methods are easy to perform as automated analyses, but they are not specific for cardiac muscle damage. During the early 90's the situation changed. First, creatine kinase ME mass (CK-MB mass) replaced the measurement of CK-MB activity. Subsequently cardiac-specific proteins, troponin T (cTnT) and troponin I (cTnI) appeared and displacing LD-1 analysis. However, troponin concentrations in blood increase only from four to six hours after onset of chest pain. Therefore a rapid marker such as myoglobin, fatty acid binding protein or glycogen phosphorylase BB could be used in early diagnosis of AMI. On the other hand, CK-MB isoforms alone may also be useful in rapid diagnosis of cardiac muscle damage. Myoglobin, CK-MB mass, cTnT and cTnI are nowadays widely used in diagnosing patients with acute chest pain. Myoglobin is not cardiac-specific and therefore requires supplementation with some other analyses such as troponins to support the myoglobin value. Troponins are very highly cardiac-specific. Only the sera of some patients with severe renal failure, which requires hemodialysis, have elevated cTnT and/or cTnI without there being any evidence of cardiac damage. The latest studies have shown that elevated troponin levels in sera of hemodialysis patients point to an increased risk of future cardiac events in a similar manner to the elevated troponin values in sera of patients with unstable angina pectoris. In addition, the bedside tests for cTnT and cTnI alone- or together with myoglobin and CK-ME mass can be used instead of quantitative analyses in the diagnosis of patients with chest pain. These rapid tests are easy to perform and they do not require expensive instrumentation. For the diagnosis of patient with chest pain, routinely myoglobin and CK-ME mass measurements should be performed whenever they are requested (24 h/day) and cTnT or cTnI on admission to the hospital and then 4-6 and 12 hours later and maintained less than 10% in imprecision.

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The Clinical Summary of the Coronary Bypass Surgery (심장 관상동맥 외과)

  • 정황규
    • Journal of Chest Surgery
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    • v.13 no.3
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    • pp.174-185
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    • 1980
  • It was my great nohour that I can be exposed to such plenty materials of the coronary bypass surgery. Here, I am summarizing the xoronary bypass surgery, clinically. The material is serial 101 patients who underwent coronary bypass surgery between July 17, 1979 to November 30, 1979 in Shadyside Hospital, University of Pittsburgh. 1. Incidence of the Atherosclerosis is frequent in white, male, fiftieth who are living in industrialized country. It has been told the etiologic factor of the atherosclerosis is hereditary, hyperlipidemia, hypertension, smoking, drinking, diabetes, obesity, stress, etc. 2. The main and most frequent complication of the coronary atherosclerosis is angina pectoris. Angina pectoris is the chief cause of coronary bypass surgery and the other causes of coronary bypass surgery are obstruction of the left main coronary artery, unstable angina, papillary muscle disruption or malfunction and ventricular aneurysm complicated by coronary artery disease. 3. The preoperative clinical laboratory examination shows abnormal elevation of plasma lipid in 82 patint, plasma glucose in 40 patient, total CPK-MB in 24 patient stotal LDH in 22 patient out of 101 patient. 4. Abnormal ECG findings in preoperative examine were 29.1% myocardial infarction, 25.8% ischemia and injury, 14.6T conduction defect. 5. Also we had done Echocardiography, Tread Mill Test, Myocardial Scanning, Vectorcardiography and Lung function test to get adjunctive benefit in prediction of prognosis and accurate diagnosis. 6. The frequency of coronary atherosclerosis in main coronary arteries were LAD, RCA and Circumflex in that order. 7. The patients' main complaints which were became as etiologic factor undergoing coronary bypass surgery were angina, dyspnea, diaphoresis, dizziness, nausea and etc. 8. For the coronary bypass surgery, we used cardiopulmonary bypass machine, non-blood, diluting prime, cold cardioplegic solution and moderate cooling for the myocardial protection. 9. We got the grafted veins from Saphenous and Cephalic vein. Reversed and anastomosed between aorta and distal coronary A. using 5-0 and 7-0 prolene continuous suture. Occasionally we used internal mammary A. as an arterial blood source and anastomosed to the distal coronary A. and to side fashion. 10. The average cardiopulmonary bypass time for every graft was 43.9 min. and aortic clamp time was 23 minute. We could Rt. coronary A. bypass surgery only by stand by the cardiopulmonary machine and in the state of pumping heart. 11. Rates by the noumbers of graft were as follow : 21.8% single, 33.7% double, 26.7% triple, 13.9% quadruple, 3% quintuple and 1% was sixtuple graft. 12. combined procedures with coronary bypass surgery were 6% aneurysmectomy, 3% AVR, 1% MVR, 13% pacer implantation and 1% intraaortic ballon setting. 13. We could see the complete abolition of anginal pain after operation in 68% of patient, improvement 25.8%, no change in 3.1%, and there was unknown in 3%. 14. There were 4% immediate postoperative deaths, 13.5% some kinds of heart complication, 51.3% lung complications 33.3% pleural complications as prognosis.

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A Case of Coronary-Pulmonary Artery Fistula (관상동맥-폐동맥 누공 1예)

  • Lee, Kyung Hae;Wang, Joon Kwang;Shin, Sung Joon;Kim, Mi Ok;Kim, Tae Hyung;Son, Jang Won;Yun, Ho Ju;Shin, Dong Ho;Park, Sung Soo;Kim, Kyung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.4
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    • pp.420-425
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    • 2004
  • Fistula between coronary artery and pulmonary artery is a type of coronary artery anomalies. It can cause atypical chest pain and fatigue, angina pectoris, endocarditis, finally myocardial steal can result in heart failure and myocardial infarction. But only 0.1-0.2% of coronary angiographic studies reveal the communications between coronary artery and other spaces. (heart chamber, pulmonary artery etc.) It is frequently congenital, but acquired types are increasing because chest and heart manipulations such as opertion of tetralogy of Fallot, endomyocardial biopsy, radiation therapy, or penetrating blunt trauma are increasing. There are reports about repair of fistula using thrombogenic tips, coil embolization and surgical intervention. We report a connection between coronary artery and pulmonary artery in 79 years old female. She was 30 pack-years smoker and suffered from dyspnea several years with chronic obstructive pulmonary disease. She presented with atypical chest pain and palpitation after admission. Electrocardiography showed ST-T wave abnormality. Emergency coronary angiography and chest CT scan revealed coronary-pulmonary artery fistula. Transcatheter embolization was performed and she was relieved from discomforts.

Effects of Tong Xin Lou (TXL) on levels of serum lipid in high fat diet-induced dyslipidemia in mice (통심락(通心絡)이 고지방식이로 유도된 이상지질혈증 생쥐의 체내 지질 변화에 미치는 영향)

  • Ha, Tae-Hoon;Kim, Hyun-Young;Kim, Hyung-Woo;Cho, Su-In;Kim, Young-Gyun
    • The Korea Journal of Herbology
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    • v.27 no.3
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    • pp.107-112
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    • 2012
  • Objectives : This study was designed to investigate the effects of Tong Xin Lou (TXL) on lipid accumulation in liver tissue in Hypercholesterolemic mice. TXL is new drug, which is one of Cardiotonic Pills. TXL is used for activating the blood flow in the restoration stage of cerebral infarction, and for alleviation of angina pectoris including the symptoms as chest oppressed and stabbing pain. Methods : Hyperlipidemia was induced by providing high fat diet for 6 weeks. Normal group was provided with normal rodent diet. TXL was administered orally in the concentration of 10 mg/day for 2 weeks (TXL group). D/W was administered orally in CTL group for 2 weeks. We observed histopathological changes in liver and heart tissues, and also investigated the effect on body weights, and levels of total cholesterol, HDL-cholesterol, LDL-cholesterol and triglyceride in serum. Results : In this study, TXL did not affects weight gain in hypercholesterolemic mice. TXL group showed downward tendency of lipid accumulation compared with CTL group. In addition, oral administration of TXL lowered levels of total cholesterol (P < 0.05) and triglyceride (P < 0.05), which were elevated by induction of hypercholesterolemia. Conclusion : These results suggest that TXL can prevent lipid accumulation in liver tissue through regulation of dyslipidemia.

Nutrients and Individual Fatty Acids Intake Patterns in the Coronary Artery Disease Patients with Different Degrees of Stenosis (관상동맥질환자에서 병변의 협착정도에 따른 일반영양소 및 개별지방산의 섭취양상)

  • 김수연
    • Journal of Nutrition and Health
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    • v.30 no.8
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    • pp.976-986
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    • 1997
  • Coronary artery disease (CAD) such as angina pectoris and myocardial infarction(MI) have been considered the major cause of death for decaddes . THeir incidence and prevalence are still increasing . Numerous studies have been done on the risk factor analysis of CAD in Western countries. Since the diet in Western countries is different from that in Korea it is difficult to assume that the Korean diet has the same effects as its western counterpeart on the development of CAD . THus the gudidelines for the Western CAD patients can no totally be applied to Koreans. This study was conducted to investigate the relationship between diet and CAD in Koreans. Subjects were comprised of patients admitted to the hospital for chest pain with poxxilbe CAD (men 129, women 65) . They were divided into the following three groups according to angiographic results ; angiogrphically normal coronary artery group (control), single vessel disease group(SVD) and multiple vessel disease group (MVD) . Intakes of dietary fatty acids and other nutrients were assessed by the semiquantitative food frequency method. Blood was also obtained from subjects for serum lipid analysis. Serum lipid profiles of men were clearly different form those of women. For men, serum choesterol levels (or LDL or LDL/HDL) seemed to be higher in the MVD group compared to the control and SVD groups, while TG level was significantly higher in the MVD group for women. Both men and women showed significantly higher caloric , fiber and vitamins C and A intakes in the MVD group than in the other two groups. Higher caloric intakes was due to higher intakes of carbohydrate and protein rather than fat intake. In terms of fatty acids intake, there were no significant differences among the three groups . Smoking seemed to have great effect on eating patterns in CAD patients. Smokers and ex-smokers showed significantly higher intakes of most nutrients including individual fatty acids that non-smokers. The results of stepwise regression showed that moderate alcohol intake decreases LDL levels and increases HDL levels and smoking seems to lowe HDL levels in CAD patients.

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