• 성인간호학회지
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• 제21권5호
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• pp.477-488
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• 2009

Purpose: This study was conducted to identify the clinical characteristics and risk factors on the occurrence of variant angina, and to examine the predicting factors on the vascular endothelial dysfunction of the patients with variant angina. Methods: A total of 134 patients diagnosed with variant angina were recruited from 2006 to 2008. The degrees of endothelial dysfunction were measured and recorded by the researcher using the values of flow-mediated vasodilation of their brachial arteries and Nitroglycerine-mediated dilation. Subjects' demographic data and risk factors were gathered after obtaining informed consent, and their electronic medical records were reviewed to collect laboratory data. Results: The mean age was $54.2{\pm}9.6$ years and 52% was male patients. More than 50% of the male patients were cigarette smokers and had hypercholesterolemia. 84% of the male patients and 70% of the female patients had more than one risk factor of cardiovascular disease. A stepwise multiple regression analysis showed that smoking and hypercholesterolemia predicted the decrease of flow-mediated vasodilation (Adjusted $R^2$ = .204, p < .001). Conclusion: Tailored educational interventions for smoking cessation and cholesterol management are needed to prevent recurrence of angina attack for patients with variant angina and to prevent cardiovascular disease for middle-aged workers.

• 대한한방내과학회지
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• 제45권2호
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• pp.234-245
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• 2024

Variant angina causes chest pain due to abnormal coronary vasospasms. A 60-year-old male who was diagnosed with variant angina was admitted to the Oriental Medicine Hospital and treated with herbal medicines, including Pyungjinsujeom-san and Simjeok-hwan. After treatment, the frequency of chest pain and use of nitroglycerin decreased. Subjective symptoms of chest pain measured using a numerical rating scale (NRS) also decreased. These improvements persisted throughout the hospitalization period. In conclusion, Korean medicines, including Pyungjinsujeom-san and Simjeok-hwan, can be effective for patients with chest pain due to variant angina.

• 대한간호학회지
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• 제42권2호
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• pp.190-198
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• 2012

Purpose: The aim of this study was to evaluate the effects of a smoking cessation education on endothelial function and carboxyhemoglobin levels in smokers with variant angina. Methods: A nonequivalent control group pretest-posttest design was used. Participants were 60 male smokers with variant angina admitted to one hospital: the control group (30) between September and December, 2009, and the experimental group (30) between February and May, 2010. Endothelial function, as defined by flow-mediated vasodilation (FMD) of the brachial artery, and serum carboxyhemoglobin (COHb) were determined at baseline and at 3 months after the initiation of education in both groups. Results: Three months after the program, smoking cessation was successful in 22 of the 30 smokers in the experimental group, but only in 4 of 30 smokers in the control group ($p$<.001). After the education, the experimental group showed a significant increase in FMD, and a significant decreased in serum COHb compared with the control group. Conclusion: The findings indicate that this smoking cessation education program is effective for hospitalized smokers with variant angina.

• Journal of Chest Surgery
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• 제13권2호
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• pp.118-124
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• 1980

A double aorto-coronary bypass procedure performed in 2 cases, one with a Prinzmetal`s variant angina and the other with an unstable angina, is presented. The patient with a Prinzmetal`s angina who had a high-grade obstruction of the left anterior descending and the right coronary system showed a marked postoperative improvement with complete disappearance of anginal pain. The other patient with unstable angina had obstruction of the left anterior descending as well as a marginal branch of the left circumflex artery. Following bypass of these vessels, the patient did well during the immediate postoperative period. However, he developed hypotension in the recovery room and died 6 hours postoperatively, in spite of an intensive effort at resuscitation. The most likely cause of death in this patient is a myocardial infarction.

• 한국응급구조학회지
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• 제25권1호
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• pp.243-249
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• 2021

A decrease in coronary blood flow leads to an imbalance between the supply of oxygen to the myocardium and its demand, and reversible or irreversible damage to the myocardium could occur depending on the severity of the resultant ischemia and the duration of the imbalance. This imbalance results in a cascade of ischemic reactions in the following order: metabolic abnormalities, diastolic dysfunction, systolic dysfunction, and electrocardiogram changes. Variant angina is caused by the closure of the coronary artery due to reversible coronary artery spasm, resulting in myocardial ischemia and subsequent chest pain as a clinical symptom. Variant angina may be observed as ST segment elevation in electrocardiogram measured when present in chest pain. However, 12-lead electrocardiogram performed after the patient's chest pain resolves does not help in the diagnosis. Since the duration of chest pain appears to be <15 minutes, it is important to perform the 12-lead electrocardiogram when clinical symptoms are present. If nitroglycerin is administered without performing 12-lead electrocardiogram by 119 pre-hospital paramedics, the chest pain would be resolved, making it impossible to identify changes in the ST segment. Before administration of nitroglycerin, changes in the ST segment must be recorded by performing 12-lead electrocardiogram.

• 대한한방내과학회지
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• 제43권5호
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• pp.864-873
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• 2022

Objective: The purpose of this case study was to report the symptom improvement effect of integrative Korean medicine treatment based on Pyongsim Solution: Cheonwangbosim-dan in a patient with variant angina and asthma symptoms. Methods: This 68-year-old male patient was treated with Pyongsim Solution, Gamihyangsayukgunja-tang, Gwakhyangjunggi-san, acupuncture, pharmacopuncture, and cupping therapy for 24 days. The European Quality of Life-5 Dimensions-5 Levels profile, Numerical Rating Scale score, and pulse rate per minute were measured on admission, at two weeks of hospitalization, and upon discharge to assess the clinical outcomes. Results: After treatment, the "mobility" dimension profile of the European Quality of Life-5 Dimensions-5 Levels changed from 1 to 1, "self-care" changed from 1 to 1, "usual activity" changed from 3 to 2, "pain/discomfort" changed from 4 to 3, and "anxiety/depression" changed from 3 to 2. The Numerical Rating Scale score for chest pain decreased from 7 to 5, chest tightness decreased from 6 to 4, sleep disturbance decreased from 6 to 3, polydipsia decreased from 5 to 3, and stomach discomfort decreased from 5 to 3. All the profiles of these five dimensions were unchanged for 11 days in the period between the two weeks of hospitalization and discharge. There were also no changes in the profiles of either "mobility" or "self-care" throughout the entire 24-day hospitalization period. Conclusion: This case report shows that integrative Korean medicine treatment based on Pyongsim Solution can improve the symptoms of patients with variant angina and mild intermittent asthma, suggesting that Pyongsim Solution could be an important herbal medication for treatment.

• 한국방사선학회논문지
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• 제17권4호
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• pp.589-595
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• 2023

관상동맥 경련 유발로 혈관 완전 폐색이 발생할 경우 악성 부정맥 출현으로 사망까지 이를 수 있으므로 관상동맥 경축 협심증 조기 검사는 반드시 필요한 검사이다. 검사 방법 중 관상동맥 조영술을 통한 약물 주입 검사가 일반적으로 시행되고 있다. 따라서 관상동맥 조영 검사 중 경축 협심증 검사의 시술 시간과 조영제 사용량, 방사선 피폭 영향과의 연관성 등을 방사선학적 관점으로 이형성 협심증 조영 검사의 이점을 평가하고자 한다. 2021년 09월부터 2023년 02월까지 관상동맥 조영술과 변이형 협심증 검사를 시행한 142명 환자의 후행적 데이터를 이용하였다. 관상동맥 조영술과 변이형 협심증 검사 비교 분석 결과 체질량 지수를 제외하고 조영제 사용량 67.47 ± 21.81 cc, 흡수선량 15.98 ± 13.8 uGy/m², 공기 중 입사선량 236.73 ± 135.91 mGy, 촬영 시리즈 수 13 장, 검사 시간 1573.6 ± 428.77 s로 관상동맥 조영술만 시행했을 때의 조영제 사용량 49.1 ± 7.73 cc, 흡수선량 9.93 ± 7.81 uGy/m², 공기 중 입사선량 140.6 ± 79.76 mGy, 촬영 시리즈 수 6 장, 검사 시간 544.48 ± 185.76 s보다 통계적으로 유의할 만큼 높은 차이를 나타냈다. (p<0.001) 결론적으로 관상동맥 조영술 외 추가적인 변이형 협심증 검사가 방사선학적 관점에서 더 부정적일 수 있어 과도한 변이형 협심증 검사는 지양하는 것이 좋을 것으로 생각된다. 결론적으로 관상동맥 조영술 외 추가적인 변이형 협심증 검사가 방사선학적 관점에서 더 부정적일 수 있어 과도한 변이형 협심증 검사는 지양하는 것이 좋을 것으로 생각된다. 그럼에도 불구하고 변이형 협심증 검사를 진행해야 할 경우 검사 시간이 길어 질수록 투시 시간과 조영제 사용량도 증가하게 되므로 가능한 빠른 검사 또는 단축 검사를 진행해야 환자의 방사선학적 관점의 부정적인 측면도 해소할 수 있을 것으로 사료된다.

• Bulletin of the Korean Chemical Society
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• 제32권7호
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• pp.2274-2278
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• 2011

Verapamil is a calcium channel blocker and is classified as a class IV anti-arrhythmic agent. It is used in the control of supra ventricular tachyarrhythmias, and in the management of classical and variant angina pectoris. It is also used in the treatment of hypertension and used as an important therapeutic agent for angina pectoris, ischemic heart disease, hypertension and hypertrophic cardiomyopathy. Verapamil commonly co-administered with NSAIDs (non-steroidal anti-inflammatory drugs) i.e. diclofenac sodium, flurbiprofen, Ibuprofen, mefanamic acid and meloxicam. A simple and rapid RP-HPLC method for simultaneous determination and quantification of verapamil and NSAIDs was developed and validated. The mobile phase constituted of acetonitrile: water (55:45) whose pH was adjusted at 2.7 and pumped at a flow rate of 2.0 mL $min^{-1}$ at 230 nm. The proposed method is simple, precise, accurate, low cost and least time consuming for the simultaneous determination of verapamil and NSAIDs which can be effectively applied for the analysis of human serum.

• Journal of Chest Surgery
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• 제18권2호
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• pp.220-231
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• 1985

In selected patients with occlusive lesions of coronary arteries, aortocoronary bypass grafting has been effective in reducing anginal symptoms and in increasing the patients` longevity. Between May, 1977, and December, 1983, 41 patients with coronary occlusive disease received aortocoronary bypass surgery at Yonsei University Medical Center in Seoul. Thirty-three were male and 8 were female. Their ages ranged from 33 to 70 years [average 531.6 years]. Of the 41 patients, 11 suffered from stable angina, 30 suffered from unstable angina and 4 suffered from a variant type of angina. Eleven patients had 1 diseased vessel, 11 patients had 2 diseased vessels, 19 patients had 3 diseased vessels, and 5 patients had a diseased left main coronary artery. A single graft was placed in 5 patients, a double graft was placed in 17 patients, a triple graft was placed in 11 patients and a quadruple graft was placed in 8 patients. Nineteen patients received a sequential graft [40 sites of 20 vessels]. The average internal diameter of the grafted distal coronary artery was 2.380.15, 1.630.13 mm on the left side and 3.200.20, 1.830.21 mm on the right side. Two operative deaths occurred in the early years of our experience. The mortality rate was 4.87% and there were no late deaths. Of the 39 survivors, 30 [76.9%] were Functional Class I [free of symptoms without medication], 7 [17.9%] were Functional Class II and only 2[5.2%] were Functional Class III during the follow up period [653.75 patient-months]. On the basis of this experience, we conclude that coronary artery occlusive disease is occurring in increasing numbers in Korea. Therefore, a concerted effort is needed to detect this disease and to manage the increasing number of patients suffering from it.

• Journal of Chest Surgery
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• 제54권2호
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• pp.150-153
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• 2021

Moyamoya disease (MMD) is characterized by progressive steno-occlusive lesions of the distal or proximal branch of the internal carotid arteries, and cerebrovascular symptoms are its major complications. Extracranial vascular involvement including the coronary artery has been reported, and some case reports have described variant angina or myocardial infarction. However, no report has yet described a case of myocardial infarction after coronary artery bypass grafting (CABG). Here, we present a patient with MMD who suffered cardiac arrest caused by myocardial infarction due to a coronary spasm after offpump CABG and who was discharged successfully after treatment with a veno-arterial extracorporeal membrane oxygenator and percutaneous coronary intervention.