• Title/Summary/Keyword: Coronary artery diseases

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Quality of Chest Pain According to Causal Diseases and Description of Chest Pain in Patients with Coronary Artery Diseases in Emergency Departments (응급실을 내원한 흉통 환자의 원인질환에 따른 흉통의 질 및 관상동맥질환자의 흉통 표현)

  • Cheon, Sun Hee;Choe, Myoung Ae
    • Journal of Korean Clinical Nursing Research
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    • v.14 no.3
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    • pp.61-72
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    • 2008
  • Purpose: The purpose was to identify quality of chest pain according to causal diseases and pain expression of patients with coronary artery diseases. Method: Participants were 1,964 patients with pain who visited the emergency department of A hospital from January to December 2006. Data were collected from nurses' and doctors' records as to causal disease, and quality and expression of chest pain. Results: Causal diseases were coronary artery diseases, non-specific chest pain, respiratory diseases, non-coronary artery heart diseases and digestive diseases in that order of frequency. Every disease except respiratory disease caused mostly dull and tract pain, but 63.7% of patients with coronary artery diseases complained of typical angina pain and 24.9% complained of atypical angina pain. Patients with coronary artery diseases mostly used word 'heaviness' in describing their dull pain, and 'squeezing' for tract pain. Both male and female patients who were diagnosed with coronary artery disease complained mostly frequently of dull pain and tract pain. Conclusion: The most common causal disease for patients with chest pain was coronary artery disease. Patients with other diseases also frequently complained of dull and tract pain, the same as patients with coronary artery diseases. A considerable number of patients complained various types of atypical angina pain in coronary artery diseases.

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The Relationhip between Stress and Coronary Artery Stenosis in Patients with Coronary Artery Diseases (관상동맥질환 환자들에서 스트레스와 관상동맥 협착 간의 관계)

  • Roh, Kyu-Sik;Koh, Kyung-Bong
    • Korean Journal of Psychosomatic Medicine
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    • v.6 no.2
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    • pp.126-135
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    • 1998
  • The object of this study was to investigate the relationship between stress and the extent of coronary artery stenosis in 101 patients with coronary artery diseases. Global assessment of recent stress(GARS) scale and perceived stress response inventory were used to measure perception for stressors and stress responses. Biological variables such as the extent of coronary artery stenosis, the number of the affected lesions on coronary angiography, serum Low Density Lipoprotein(LDL)-cholesterol, High Density Lipoprotein(HDL)-cholesterol, and total cholesterol were measured in all the subjects. Scores of perceived stress related to changes in relationship and overall global scores on GARS scale had significantly positive correlation with the extent of coronary artery stenosis. On the other hand, scores of percieved stress related to changes in relationship and changes or no changes in routine had significantly positive correlation with the number of the lesions. Scores of perceived stress related to change or no change in routine also positively correlated with serum level of LDL-cholesterol and total cholesterol. In contrast, general somatic symptoms negatively correlated with the extent of coronary artery stenosis. Impulsive-aggressive behavior negatively correlated with the number of the lesions. However, impulsive-aggressive thinking positively correlated with LDL-cholesterol. The above results suggest that perception for stressors may negatively affect the extent of coronary artery stenosis, the number of the lesions, serum LDL-cholesterol and total cholesterol. However, some stress responses showed inconsistent effect on the above biological variables. Thus, strategies designed to modify perception for stressors and some stress responses are likely to help the patients minimize the extent of coronary artery stenosis and prevent the diseases.

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Coronary Artery Bypass Grafting in Patients Over 70 years of Age -A report of two cases- (70세 이상 고령 환자에서 관상동맥 우회술 -2례 보고-)

  • Kim, Ju-Hong;O, Bong-Seok;Lee, Dong-Jun
    • Journal of Chest Surgery
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    • v.28 no.4
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    • pp.401-403
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    • 1995
  • Recently we experienced coronary artery bypass graft in two patients over 70years of age. Among them, one case was 74 old year male and the other case was 73 old year male. The coronary artery diseases of them were angiographically diagnosed to triple vessel diseases. We only used great saphenous vein as graft vessel in two patients. The postoperative courses were good except mediastinal bleeding in 1 case. They were discharged with good results. They were still healthy 40 months in one and 30 months in the other after coronary artery bypass grafting.

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Coronary artery vasospasm after atrial septal defect surgery

  • Yoon, Jin Won;Lee, Young Soo;Kim, Dong Keun;Choi, Young Hoon;Kim, Dong-Ju;Lee, Jae Jin;Ahn, Hyo Seung;Cho, Wook Hyun
    • Journal of Yeungnam Medical Science
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    • v.31 no.2
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    • pp.122-126
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    • 2014
  • Coronary vasospasm is one of the fatal complications that may occur in patients undergoing open heart surgery. To date, however, there are not many cases in this series and no definite pathophysiology has been documented. We experienced a case of coronary artery vasospasm after atrial septal defect (ASD) surgery and then successfully treated it with both transbrachial intraaortic balloon pump and percutaneous cardiopulmonary support. Only several hours after ASD surgery, the patient exhibited the cardiovascular collapse, the ST-segment elevation, followed by ventricular fibrillation and normal coronary angiography findings. It is important to make a differential diagnosis of coronary artery vasospasm in patients presenting with ST-segment elevation who had no notable coronary artery diseases. This case indicates that clinicians should be aware of the possibility that the coronary artery vasospasm may also occur in patients undergoing ASD surgery.

Hemodynamic Analysis of Coronary Artery Microcirculation Using a Pig's Morphometric Data

  • Shin Sehyun;Park Jungsu
    • Journal of Mechanical Science and Technology
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    • v.19 no.6
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    • pp.1313-1320
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    • 2005
  • Stenosed coronary artery may play an important role in various coronary heart diseases. However, it has not been known how much stenosed coronary artery affects coronary circulation system, quantitatively. The present study developed a mathematical model for microcirculation in the left common coronary artery (LCCA) with adopting a previously measured morphological data and mechanical properties of the coronary vessels. We examine the effect of percent diameter stenosis on blood flow rate and shear stress for two cases. Case I comprised of one-stenosed element at $10^{th}$ order ($\%$ diameter stenosis are 10, 30, and 50, respectively). Case II consisted of completely occluded element at $10^{th}$ order (number of occluded elements are 0, 1, and 2 out of 8, respectively). As the level of stenosis becomes severe, the shear stress increases significantly but the flow rate reduction was relatively small. However, for the occluded case, there was linearly proportional reduction of flow rate according to number of occluded elements. Either such high shear stress associated with coronary artery stenosis or reduced flow rate due to occlusion may cause atherosclerosis and myocardial ischemia.

The Comparison of Anger between Patients with Coronary Artery Disease and Healthy Individuals (관상동맥질환 환자들과 정상인 간 분노의 비교)

  • Koh, Kyung-Bong;Lee, Sang-Hyuk;Kim, Jang-Woo;Roh, Kyu-Sik
    • Korean Journal of Psychosomatic Medicine
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    • v.12 no.1
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    • pp.23-29
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    • 2004
  • The objective of this study was to make a comparison on anger level between patients with coronary artery diseases and healthy individuals. 233 patients with coronary artery diseases and 215 normal controls were enrolled in this study. The Anger Expression Scale, the anger and aggression subscales of the Stress Response Inventory(SRI) and the hostility subscale of the Symptom Checklist-90-revised(SCL-90-R) were used to assess the level of anger. The patients with coronary artery diseases scored significantly higher on the anger-out and anger total subscales of the anger expression scale, the anger and aggression subscales of the SRI than the normal controls. The patients with angina pectoris had significantly higher scores in the anger-out and anger-total subscale than those with myocardial infarction. Male subjects scored significantly higher on the anger-in subscale than females, whereas female subjects scored significantly higher on the anger-out subscale than male subjects. These results suggest that patients with coronary artery diseases are likely to have a higher level of anger or anger expression than normal controls and that there may be difference in anger expression between male and female patients. It is emphasized that anger management is needed to prevent the coronary artery disease patients from aggravating the illness.

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Review of the coronary artery disease in terms of insurance medicine (관상동맥질환의 보험의학적 이해)

  • Lee, Sinhyung
    • The Journal of the Korean life insurance medical association
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    • v.32 no.2
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    • pp.33-38
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    • 2013
  • Coronary artery diseases are very important agenda in the insurance medicine. Insurance medicine is defined as using medical knowledge for insurance administration such as underwriting, claims, and customer satisfaction. This review article contains review of coronary artery disease in terms of insurance medicine. Estimation of extra-risks for acute myocardial infarction are MR of 349% and EDR of 41‰. In medical underwriting, individual life applicants can be assessed by Framingham's CHD risk assessment model. In claims, medical claims review is a useful method of consulting for claims staffs. Several diagnostic criteria of acute myocardial infarction are introduced in time. The universal definition of myocardial infarction by ESC/ACCF/WHF was demonstrated the most valuable predictor of 10-year mortality. Contents for State-Of-The-Art of the coronary artery disease are current antithrombotics. There are many novel anti-thrombotic agents such as ticagrelol, dabigatran, rivaroxaban, and pegnivacogin.

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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.

Prediction of Obstructive Coronary Artery Disease by Coronary Artery Calcification Finding on Low-dose CT Image for screening of lung diseases: Compared with Calcium Scoring CT (폐질환 선별검사를 위한 저선량 CT영상의 관상동맥 석회화 소견으로부터 폐쇄성 관상동맥질환 예측: 석회화수치 CT검사와 비교)

  • Lee, Won-Jeong
    • The Journal of the Korea Contents Association
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    • v.11 no.10
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    • pp.333-341
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    • 2011
  • To compare between calcium scoring CT (CSCT) and Low-dose CT (LDCT) image finding for coronary artery calcification (CAC) in screening of lung disease by MDCT. A total of 61 subjects who retired-workers exposed to inorganic dust were performed LDCT and CSCT by using a MDCT scanner on the same day, after be approved by the institutional review board, and obtaining the written informed consent from all subjects. LDCT images were read for detecting lung diseases as well as CAC by a experienced chest radiologist, then the subjects were divided either the positive group with CAC or the negative group without it. The CSCT was used to quantify and detect the presence of calcification in the coronary artery, and score of CAC calculated by using a Rapidia software (ver 2.8). In all coronary arteries, calcium score of positive group was higher better than that in negative group, especially in the total calcium (13.7 vs. 582.9, p=0.008) and the left anterior descending artery (3.2 vs. 249.0, p=0.006). CAC findings between CSCT and LDCT image were showed excellent agreement in cut-off point 100(K-value=0.80, 95% CI=0.69-0.91) from total calcium score. CAC findings on LDCT images showed the higher relation with CSCT. Therefore, the obstructive coronary artery disease could be predicted by CAC on LDCT images for screening of lung diseases.

Surgical Treatment of Left Main Coronary Artery Diseases (좌주관동맥협착의 외과적 치료)

  • 안병희;장원채
    • Journal of Chest Surgery
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    • v.29 no.12
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    • pp.1323-1328
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    • 1996
  • The obstructive diseases involving the left main coronary artery(LMCA) are serious. Surgical treatment is generally regarded as much more effective than medical therapy in terms of long-term survival and relief of symptoms. This study represents an attempt to present an analysis of early surgical results in 21 cases conducted at Chonnam University Hospital between October 1992 And August 1995. The subject. 12 males and 9 female, ranged in age from 25 to 67 years with a mean age of 49.3${\pm}$12.5 years. As for indications for operation, unstable angina was reported on 66.7% of the subjects, while stable angina and acute myocardial infarction in 4 and 3 cases, respectively. There were also 2 cases of Takayasu's aortitis and 1 case of failed percutaneous translumlnal coronary angioplasty(PTCA). Eleven subjects had isolated LMCA diseases compared to 10 subjects with associated LMCA diseases. Of the patients with ass;3ciated LMCA diseases, 4 subjects had single coronary artery disease, 3 had double coronary artery disease, remaining 3 suffered from triple coronary artery disease. As for the group with isolated LMCA disease, ostidl angioplasty llsing autopericardium was conducted with 5 subjects. The remaining subjects with the isolated diseases and all of the patients with associated LMCA disease underwent aortocoronary bypass grafts. The left internal mammary artery was used in all patients and the average number of anastomoses was 3.13 ${\pm}$0.93. One subject died of low cardiac output syndrome at the second postoperative day. There were 5 instances of postoperative complication including reoperation for bleeding in two patients, wound infection in two, and arrhythmia in one. Follow-up coronary angiogram were conducted with eights patients, including five patients who underwent ostial angioplasty. In these cases, the patients showed surf. ficient enlargement of the left coronary ostium and the grafted vessels kept their patency. In our experience, surgical treatment of the LMCA diseases has not shown a higher rAte of operative mortAlity or morbidity than other obstructive coronary artery diseases. To patients with ostial stenosis, which is frequently observed among young female, angioplasly utilizing autopericardium seems to be a desirable choice considering the cosmetic effect, chances of reoperation and hemodynamic characteristics.

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