• Title/Summary/Keyword: coronary artery diseases

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Severe chest pain with mid-ventricular obstruction in a patient with hyperthyroidism

  • Nam, Jong-Ho;Son, Jang Won;Hong, Geu-Ru
    • Journal of Yeungnam Medical Science
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    • v.34 no.1
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    • pp.128-131
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    • 2017
  • Mid-ventricular obstruction (MVO) rarely occurs in patients without hypertrophic cardiomyopathy. Increased cardiac contractility may play an important role in causing MVO. We experienced a case of severe chest pain and MVO in a 50-year-old female patient. She had hypertension, diabetes, stroke and peripheral artery disease. Her blood pressure was very high (222/122 mmHg) with severe fluctuation. The transthoracic echocardiography revealed MVO accompanied by hyper-dynamic left ventricular systolic function. We regarded her chest pain and MVO as secondary findings related to other diseases. Coronary angiography and several tests for uncontrolled hypertension were performed, and those evaluations revealed that she had coronary artery disease and hyperthyroidism. We considered that the increase in the myocardial oxygen demand in response to the increase in cardiac contractility and workload associated with hyperthyroidism aggravated her symptoms and MVO. She was treated with methimazole and beta blockers and her symptoms dramatically improved.

Features Related to Smoking and Psychological Characteristics of Coronary Artery Patients Associated with the Stage of Change in Smoking Cessation (금연변화단계에 따른 관상동맥질환자들의 흡연관련 특성과 심리적 특성)

  • Kim, Hwa Soon
    • Korean Journal of Adult Nursing
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    • v.17 no.4
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    • pp.592-601
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    • 2005
  • Purpose: The purpose of this study was to investigate differences in smoking related characteristics and psychological features of coronary artery patients by the stages of change in smoking cessation behaviors. Method: Subjects for this survey were 97 patients who were smoking when doctors diagnosed them to have coronary artery diseases. Result: Subjects were distributed 21.6% in precontemplation stage, 24.7% in contemplation stage, 17.5% in preparation stage, 19.6% in action stage, and 16.5% in maintenance stage respectively. The numbers of previous attempts to quit smoking of subjects in precontemplation stage(mean=3.00, SD=3.71) and contemplation stage(mean=2.63, SD=2.32) were significantly lower than that of subjects in preparation stage(mean=5.82, SD=6.20). Benefit scores of subjects in maintenance stage were significantly greater than those of subjects in precontemplation stage. Self-efficacy, barriers, seriousness, and nicotine dependency were not significantly different by the stages of change. Number of signs and symptoms related to smoking which subjects were experiencing were not significant by the stages of change too. Conclusion: Future intervention programs for smoking cessation should be focused on the strategies to enhance the realization of health benefits that patients might acquire from smoking cessation.

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The Awareness of Cardiovascular Risk Factors and Its Correlates in Patients with Coronary Artery Diseases (관상동맥질환자의 위험요인 인식 및 관련요인)

  • Yang, In-Suk;Choi, Dong-Hoon;Kang, Youn-Hee
    • Korean Journal of Adult Nursing
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    • v.22 no.5
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    • pp.499-508
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    • 2010
  • Purpose: Cardiovascular risk factor modification is important for patients with coronary artery disease to prevent poor progression of the disease. Without an understanding and an awareness of risk factors, patients with coronary artery disease are not able to reduce their risk by the lifestyle modification. The aims of this study were to assess patient's awareness of risk factors and to identify predictors of awareness of risk factors. Methods: A descriptive correlational study using a cross-sectional survey method was performed. The sites of the study were three hospitals in Seoul, Korea. The sample consisted of 214 subjects. The awareness of risk factors and other subjects' characteristics were measured by a questionnaire developed for this study. Results: A range of subjects (gender: 72.0%; hyperlipidemia: 51.9%; hypertension: 40.7%; obese: 37.4%; age: 35.5%; smoking: 22.4%; diabetes: 19.2%; family history: 18.2%) were not able to accurately identify the risk factors. Among predictors, gender (${\beta}$=-.17) and diabetics (${\beta}$=-.25) had statistically significant influences on awareness of risk factors. Conclusion: Our findings highlight the lack of awareness of risk factors for coronary artery disease. The findings have important implications for nursing practice in terms of guiding educational strategies for the modification of risk factors for coronary heart disease.

Comparison of Polar Maps of Dipyridamole Stress/Rest MIBI Myocardial SPECT and Coronary Angiography in Coronary Artery Disease (관동맥질환에서 디피리다몰부하 $^{99m}Tc$-MIBI 심근 SPECT 극성지도와 관동맥 조영소견의 비교)

  • Lee, Myung-Chul;Lee, Dong-Soo;Lee, Myung-Yong;Choi, Chang-Woon;Sohn, Dae-Won;Chung, June-Key;Lee, Myong-Mook;Park, Young-Bae;Seo, Jung-Don;Lee, Young-Woo;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.1
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    • pp.51-58
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    • 1993
  • We have anlayzed the polar maps of dipyridamole stress/rest $^{99m}Tc$-MIBI SPECT and compared the quantitated perfusion defects of dipyridamole stress polar map and the findings of coronary angiography in 56 pateints with coronary artery diseases. We performed the same day dipyridamole stress-rest myocardial SPECT, reconstructed the polar maps according to Cedars-Sinai method and quantitated perfusion detects of total myocardium and the territory of each artery, comparing the polar maps of patients with normal files. Stenosis more than 50 percent was considered significant and myocardial ischemic score was calculated as summed score of percents of main coronary arteries. Positive concordance of myocardial SPECT with coronary angiography were 82.6% with left anterior descending artery (LAD), 85.7% with left circumflex artery (LCx) and 78.6% with right coronary artery (RCA). Perfusion defect of SPECT polar map and the stenosis of coronary artery showed the contingency phi of 0.55 (p<0.0001) with total atreries, 0.38 (p = 0.016) with LAD, 0.50 (p<0.0001) with LCx and 0.40 (p = 0.007) with RCA. Dipyridamole stress percent defect of polar map was correlated with myocardial ischemic score with Spearman's rho of 0.47 (p = 0.001) in total arteries, 0.48 (p=0.001) in LAD, 0.56 (p < 0.001) in LCx and 0.38 (p=0.002) in RCA. These findings revealed that defect of the dipyridamole stress myocardial $^{99m}Tc$-MIBI SPECT and the percent extent of this defect were related with significant artery stenosis of individual arteries and the degree of stenosis. We thought that we could use the defects in the polar map of dipyridamole stress $^{99m}Tc$-MIBI SPECT for the quantification of myocardiasl perfusion decrease.

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Surgical Result of Coronary Artery Bypass Grafting - The Effect of Pre and Intraoperative Procedures (관동맥 우회술의 수술성적-수술전 처치 및 수술수기의 영향에 관한 연구)

  • Kim, Young-Tae;Hong, Jong-Myun;Chae, Hurn
    • Journal of Chest Surgery
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    • v.26 no.2
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    • pp.141-147
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    • 1993
  • A total of 40 patients having a diagnosis of atherosclerotic coronary arterial disease were analysed on the operative outcomes according to variables as follows: 1) preoperative risk factors such as age, sex, CCS (Canadian Cardiovascular Society) functional class, type of angina, number of diseased vessel, presence of left main coronary artery stenosis, previous history of habitual smoking and presence of other medical diseases (diabetes mellitus, essential hypertension), 2) preoperative management such as intravenous infusion of nitroglycerine, preoperative IABP (intra-aortic balloon pump) support and whether the operation was scheduled as emergency or not, 3) intraoperative variables such as infusion method and composition of cardioplegic solutions, number of distal anastomosis, use of internal mammary artery, total cardiopulmonary bypass time and total cross clamp time. Complications included operative death in 12.5%, perioperative myocardial infarction in 25.0% and perioperative arrhythmia in 17.5%. Nineteen perioperative variables were analyzed to identify risk factors for these end points. For operative death, presence of left main coronary artery stenosis (p = 0.056) and cardiopulmonary bypass time (p = 0.029) were significant in the univariate analysis, but presence of left main coronary artery lesion (p = 0.011, $\chi$$^2$= 6.45) and abscence of preoperative of IABP support (p = 0.069, $\chi$$^2$ = 3.30) were independent predictor in multivariate analysis (stepwise linear logistic regression).

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Surgical Management of Multiple Coronary Artery Aneurysms - A case report - (다발성 관상동맥류의 수술적 치료 - 1예 보고 -)

  • Kim, Chang-Young;Park, Kyung-Taek;Kim, Yeon-Soo;Ryoo, Ji-Yoon;Chang, Woo-Ik
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.106-109
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    • 2008
  • Multiple coronary aneurysms are rare in adults. The cause may be atherosclerosis, congenital malformations, post-traumatic or post-syphilitic vascular lesions, connective tissue diseases like Marfan and Ehler-Danlos syndromes or Kawasaki disease, all of which cause weakening of the media. Surgical intervention is indicated to prevent rupture, embolization or compression symptoms. The successful management of multiple coronary artery. aneurysms, associated with previous rupture and arrhythmia, originating from proximal potions of ramus intermedius and left circumflex artery are reported.

In silico evaluation of the acute occlusion effect of coronary artery on cardiac electrophysiology and the body surface potential map

  • Ryu, Ah-Jin;Lee, Kyung Eun;Kwon, Soon-Sung;Shin, Eun-Seok;Shim, Eun Bo
    • The Korean Journal of Physiology and Pharmacology
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    • v.23 no.1
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    • pp.71-79
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    • 2019
  • Body surface potential map, an electric potential distribution on the body torso surface, enables us to infer the electrical activities of the heart. Therefore, observing electric potential projected to the torso surface can be highly useful for diagnosing heart diseases such as coronary occlusion. The BSPM for the heart of a patient show a higher level of sensitivity than 12-lead ECG. Relevant research has been mostly based on clinical statistics obtained from patients, and, therefore, a simulation for a variety of pathological phenomena of the heart is required. In this study, by using computer simulation, a body surface potential map was implemented according to various occlusion locations (distal, mid, proximal occlusion) in the left anterior descending coronary artery. Electrophysiological characteristics of the body surface during the ST segment period were observed and analyzed based on an ST isointegral map. We developed an integrated system that takes into account the cellular to organ levels, and performed simulation regarding the electrophysiological phenomena of the heart that occur during the first 5 minutes (stage 1) and 10 minutes (stage 2) after commencement of coronary occlusion. Subsequently, we calculated the bipolar angle and amplitude of the ST isointegral map, and observed the correlation between the relevant characteristics and the location of coronary occlusion. In the result, in the ventricle model during the stage 1, a wider area of ischemia led to counterclockwise rotation of the bipolar angle; and, during the stage 2, the amplitude increased when the ischemia area exceeded a certain size.

Depression and Coronary Artery Disease(I) : Pathophysiologic Mechanisms (우울증과 관상동맥 질환(I) : 병태생리적 기전)

  • Bae, Kyung-Yeol;Kim, Jae-Min;Yoon, Jin-Sang
    • Korean Journal of Biological Psychiatry
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    • v.15 no.4
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    • pp.275-287
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    • 2008
  • Depression and coronary artery disease are both highly prevalent diseases. Many previous studies suggest that depression is a common comorbid condition in patients with coronary artery disease and has a significant negative impact on the onset, course, and prognosis of coronary artery disease. However, the exact mechanisms that underlie the association between these two diseases remain unclear. Pathophysiologic mechanisms that may explain the effect of depression on coronary artery disease include hypercoagulability, hypothalamus-pituitary-adrenal axis and autonomic nervous system dysregulation, altered inflammatory response. On the contrary, pathophysiologic mechanisms in coronary artery disease that affect depression are less well known. It is also suggested that both diseases may share a common genetic vulnerability. The authors reviewed the literature on the pathophysiologic relationships of depression and coronary heart disease.

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