scholarly journals PMD6 The Clinical Usefulness of CT Coronary Angiography for the Diagnosis of Ischemic Heart Disease in Patients with Chest Pain

2012 ◽  
Vol 15 (4) ◽  
pp. A63
Author(s):  
E.J. Jang ◽  
H.J. Lee ◽  
Y.J. Kim ◽  
S. Park ◽  
H. Song ◽  
...  
Keyword(s):  
Heart Disease ◽  
Chest Pain ◽  
Coronary Angiography ◽  
Ischemic Heart Disease ◽  
Ct Coronary Angiography ◽  
Clinical Usefulness ◽  
Ischemic Heart

Abstract 342: Impact Of System And Physician Factors On The Diagnostic Yield Of Coronary Angiography In Stable Ischemic Heart Disease: A Population Based Study

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Harindra C Wijeysundera ◽  
Feng Qiu ◽  
Maria C Bennell ◽  
Madhu K Natarajan ◽  
Warren J Cantor ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Ischemic Heart Disease ◽  
Diagnostic Yield ◽  
Obstructive Coronary Artery Disease ◽  
Ischemic Heart ◽  
Patient Factors ◽  
Artery Disease

Background: Wide variation exists in the diagnostic yield of coronary angiography in stable ischemic heart disease (IHD). Previous work has primarily focused on patient factors for this variation. We sought to understand if system and physician factors, specifically hospital and physician type, as well as physician self-referral, have incremental impacts on the yield of coronary angiography, above and beyond that of patient factors alone. Methods: All patients who underwent a diagnostic coronary angiogram for possible stable IHD, at the 18 cardiac centers in Ontario, Canada were identified from October 1st, 2008 to September 30th, 2011. Obstructive coronary artery disease was defined as stenosis greater than 70% in the main coronary arteries or greater than 50% in the left main artery. Physicians were classified as either invasive or interventional. Hospitals were categorized into cath only, stand-alone PCI and full service centers. Multi-variable hierarchical logistic models were developed to identify system and physician level predictors of obstructive coronary artery disease, having adjusted for patient factors. Results: Our cohort consisted of 60,986 patients who underwent a diagnostic angiogram for possible stable IHD, of which 33,483 had obstructive coronary artery disease (54.9%), ranging from 41.0% to 70.2% across centers. Self-referral rates varied from 4.8% to 74.6%. Fewer self-referral patients (52.5%) had obstructive coronary artery disease compared to non-self-referral patients (56.5%), with an odds ratio (OR) of 0.89 (95% CI 0.85-0.93;p <0.001), after accounting for patient factors. Angiograms performed by interventional physicians had a higher likelihood of showing obstructive coronary artery disease (60.1% vs. 50.8%; OR 1.22; 95% CI 1.17-1.28; p<0.001). Fewer angiograms at cath only centers showed obstructive disease (45.0%) compared to full service centers (58.1%); this was of borderline significance (OR 0.59; 95% CI 0.34-1.00; p=0.05). Conclusion: Physician and system factors are important predictors of the diagnostic yield of coronary angiography in stable IHD, even after accounting for patient characteristics. Further study into the drivers of how these physician and system factors impact diagnostic yield is an important focus for quality improvement.

A study on the clinical profile and risk factors of ischemic heart disease in women

2021 ◽  
Vol 19 (3) ◽  
pp. 130-132
Author(s):  
Sarath Kumar Reddy B ◽  
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Chest Pain ◽  
Ischemic Heart Disease ◽  
Stable Angina ◽  
Heart Diseases ◽  
Chronic Stable Angina ◽  
Clinical Profile ◽  
Ischemic Heart ◽  
Ischemic Heart Diseases

Background: Ischemic heart disease (IHD) is one of the principle causes of morbidity and of mortality in women1. Ischemic heart disease may manifest clinically as either chronic stable angina or acute coronary syndrome2 (ACS). Traditional risk factors (hypertension, diabetes, etc.) contribute to the development of IHD in both women and men. Some risk factors are unique to women (e.g., pregnancy-related complications, menopause), which cause increased mortality in women Aim: To study the risk factors and clinical profile of ischemic heart disease in women. Materials And Methods: Hospital-based prospective, cross-sectional study done in 50 patients with ischemic heart disease. Patients with a history of Chest pain suggestive of ischemic heart diseases and Electrocardiogram and cardiac biomarkers suggestive of ischemic heart disease were included in the study. Results: Maximum incidence of ischemic heart diseases is seen in the 6th decade. Mean age is 58.92 + 2.8years. 64%of the patients presented with chest pain, and 36% patients presented without any chest pain. After chest pain, the most common symptom was palpitations, seen in 56% patients, followed by sweating (44%). 30% presented to the medical facility within 3hours. 88% were diagnosed with acute coronary syndrome, and 12% were diagnosed with chronic stable angina. Women specific risk factors include the pregnancy-related complications seen in 10% patients, menopause attained in 86% patients, PCOS seen in 08% patients, use of oral contraceptive pills noticed in 08% patients, Other risk factors identified were hypothyroidism in 16% patients, connective tissue disorders like rheumatoid arthritis seen in 12% of the patients. Conclusion: Awareness regarding atypical symptoms as well as other symptoms of IHD should be created among women to avoid delayed complications. Simple lifestyle modifications like physical activity, diet modifications, etc., will reduce the number of women at risk for IHD.

Abstract 525: Cases with Uncommon Anti-phospholipid Antibody Syndrome Developed Multifocal Vascular Disorders Such as Ischemic Enteritis, Portal Vein Thrombosis, Ischemic Heart Disease and Cerebral Infarction

2016 ◽  
Vol 36 (suppl_1) ◽  
Author(s):  
Yasutaka Kawamura ◽  
So Nakaji ◽  
Nobuto Hirata
Keyword(s):  
Heart Disease ◽  
Coronary Angiography ◽  
Portal Vein ◽  
Cerebral Infarction ◽  
Ischemic Heart Disease ◽  
Portal Vein Thrombosis ◽  
Ischemic Heart ◽  
Vascular Disorders ◽  
Vein Thrombosis ◽  
Ischemic Enteritis

Purpose: We report cases with uncommon anti-phosholipid antibody syndrome developed ischemic enteritis, portal vein thrombosis, ischemic heart disease and cerebral infarction. The difficulty in diagnosing and treatment procedures for multifocal vascular disorders is discussed. Patients and Methods: Patient 1, 76-year-old man, with acute abdomen. Patient 2, 54-year-old man, with intractable esophageal varices. Clinical manifestation was superior mesenteric artery (SMA) thrombosis in the patient 1 and portal vein thrombosis in the patient 2. Serial CT scans were examined on 64 or 80 multidetector-row CT (Toshiba), with bolus injection of contrast media for CT angiography (CTA). Abdominal angiography with endovascular intervention and coronary angiography were performed on Allura Xper FD-20 and FD-10 (Philips). Results: Emergency CTA of patient 1 showed decreased contrast enhancement of SMA and SMV but enhancement of intestinal walls were well preserved. Although the patient’s symptom got better, follow-up CT revealed the growth of SMA thrombosis. The aspiration and the dissolution of SMA thrombosis were performed through the SMA catheter for five days resulted in complete recanalization.Then he felt chest oppression and 75% stenosis of RCA segment 4, followed by complete spastic occlusion on Acetylcholine loading on the coronary angiography, which recovered perfectly with intra-coronary nitroglycerin administration. He discharged our hospital with health, while he had cerebellar infarction with right cerebellar artery occlusion. On patient 2, to resolve portal hypertension, balloon-occluded retrograde transvenous obliteration was scheduled, however, due to numerous collaterals prevented the effective venous obliteration and splenic arterial embolization was selected alternatively. Discussion and Conclusions: The progressive SMA thrombosis with coronary disease and subsequent cerebellar occlusion seen in patient 1, and the portal vein thrombosis in patient 2 without chronic hepatitis nor cirrhosis were unusual. To discover underlining uncommon anti-phosholipid antibody syndrome is important to prevent serious vascular diseases in sequence.

Abstract 14953: Temporal Trends in Non-invasive Diagnostic Tests for Ischemic Heart Disease Among Us Adults Age 64 Years or Younger: Results From the Marketscan Survey, 2010-2018

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Soyoun Park ◽  
Yuling Hong ◽  
Cathleen Gillespie ◽  
Robert Merritt ◽  
Laurence Sperling
Keyword(s):  
Heart Disease ◽  
Chest Pain ◽  
Ischemic Heart Disease ◽  
Single Photon ◽  
Adult Population ◽  
Photon Emission ◽  
Temporal Trends ◽  
Ischemic Heart ◽  
Non Invasive ◽  
Exercise Ecg

Introduction: Heart disease is the leading cause of death in the U.S. Ischemic heart disease (IHD) accounts for two thirds of heart disease deaths. Non-invasive cardiovascular tests (NITs) are often the first step to establish an IHD diagnosis. Methods: We analyzed 2010-2018 IBM® MarketScan® Commercial Databases. NITs including exercise ECG, stress echocardiography, CT coronary artery calcification score (CT-CAC), single-photon emission computerized tomography (SPECT), cardiac CT angiography (CTA), nuclear positron emission tomography/myocardial perfusion imaging (PET/MPI), stress MRI, were identified using current procedural terminology (CPT) codes. IHD using ICD 9/10 codes (410-414, 429.2/I20-I25) and chest pain (786.59/R07.89) or unspecified chest pain (786.50/R07.9) were identified. The 2000 Census population was used to calculate the age standardized prevalence. Results: The data included 20,726,587 individuals (48.1% men, mean age (standard deviation) of 49.1 (13.5) years), among which 67,339 had a diagnosis of IHD or chest pain in 2018. The age standardized prevalence of the overall population that had at least one of the 7 tests is 1.60% in 2018, down from 2.47% in 2010. The responding prevalence for those with IHD or chest pain was 54.3% in 2018 and 61.6% in 2010. Exercise ECG was the most utilized test for the overall population: 0.94% in 2018 down from 1.31% in 2010; SPECT was second most often used with 0.75% in 2018 and 1.24% in 2010. However, SPECT was the most often utilized test among those with CHD or chest pain: 38.2% in 2018, down from 45.0% in 2010, and exercise ECG second most often with 32.6% in 2018 and 34.9% in 2010. An increase in use of CT-CAC, PET/MPI, and CTA tests was observed since 2010, but the prevalence of all were low in 2018. 0.02%. 0.01%, and 0.04% for the overall population and 0.20%, 0.95% and 3.20% for those with IHD or chest pain, respectively. Conclusions: Almost 2% of the general younger US adult population and over half of those with IHD or chest pain had undergone at least one of 7 NITs in 2018. While the utilization of overall NITs for both the general population and those with IHD or chest pain has declined since 2010, it has increased for CT-CAC, PET/MPI, and CTA but still less than 1% for CT-CAC and PET/MPI..

scholarly journals Comparative characteristics of coronary artery damage in different degree of ischemic mitral regurgitation

2019 ◽  
Vol 18 (4) ◽  
pp. 45-50
Author(s):  
V. V. Krylov
Keyword(s):  
Heart Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Mitral Regurgitation ◽  
Ischemic Heart Disease ◽  
Myocardial Revascularization ◽  
Ischemic Mitral Regurgitation ◽  
Ischemic Heart ◽  
Military Hospital ◽  
Coronary Artery Lesions

Introduction. Despite an active study of the problem of ischemic mitral regurgitation, studies of its connections with the degree and localization of coronary artery lesions are contradictory.Objective. Study the features of coronary artery lesions according to coronary angiography in patients with ischemic heart disease and ischemic mitral regurgitation and the connections between the severity of coronary artery lesions and the degree of ischemic mitral regurgitation.Material and methods. A retrospective analysis of the results of the examination of 86 patients with various forms of ischemic heart disease in combination with ischemic mitral regurgitation, operated in the department of cardiovascular surgery of the P.V. Mandryka Central Military Hospital. Results. 89,5 % of patients showed multifocal atherosclerotic coronary artery lesions, requiring direct myocardial revascularization; the predominant type of coronary blood supply was right (82,6 %); the average number of affected main coronary arteries was 2,2±1,1, the average total degree of coronary artery lesion was 42,3±25,1 %.Conclusion. 1. The connections between the degree of ischemic mitral regurgitation and the severity and localization of coronary artery lesions was not revealed. 2. The degree of ischemic mitral regurgitation determined primarily by the progression of ischemic remodeling of the left ventricle. 3. Coronary angiography data cannot be a criterion for determining the degree of ischemic mitral regurgitation, however, they are necessary for determining the surgical tactics of direct myocardial revascularization.

scholarly journals PAINLESS MYOCARDIAL INFARCTION;

2013 ◽  
Vol 20 (06) ◽  
pp. 882-886
Author(s):  
IJAZ-UL-HAQUE TASEER ◽  
SHAHZAD ALAM KHAN ◽  
MUHAMMAD IMRAN NAZIR ◽  
Sohail Safdar
Keyword(s):  
Heart Disease ◽  
Chest Pain ◽  
Ischemic Heart Disease ◽  
Health Care Professionals ◽  
Research Work ◽  
Sampling Technique ◽  
Ischemic Heart ◽  
Clinical Feature ◽  
Suspected Case ◽  
Coronary Syndrome

Objective: To determine the frequency of painless MI in patients with acute coronary syndrome. Study design: Descriptivecross-sectional study. Setting and duration: This study was conducted at cardiology unit Nishtar Hospital Multan and Chaudhry PervezElahi Institute of Cardiology Multan. The study duration was 1 year starting from July 2011 to June 2012. Materials and Methods: Thisdescriptive study included 331 patients of AMI of either sex and age which were admitted at “Cardiology unit Nishtar Hospital Multan andChaudhry Pervez Elahi Institute of Cardiology Multan” using non-probability convenience sampling technique. Informed verbal consentwas taken from each patient for participation. Results: Out of these 331 patients 308 (93.1%) patients reported chest pain as thepresenting complaint. Remaining 23(6.9%) presented with clinical feature other than chest pain. Of these 23 patients who presentedwithout chest, minimum age was 30 years while maximum was 90 years with mean age 54.82 ± 12.28 years. Patients with painless AMIpresented with variety of symptoms. Most common symptoms seen in patients of AMI without chest pain were generalized weakness andcold sweats. Out of 23 patients with painless AMI, 15(65.22%) patients were male and 08(34.8%) were female. Diabetes mellitus waspresent as co-morbid condition in 16(69.56%) while 7(30.44%) patients were non diabetic. Hypertension was present in 8(34.78%)patients with painless AMI. Conclusions: Painless AMI or atypical presentation of AMI is seen in substantial proportion of ischemic heartdisease patients. Absence of chest pain in AMI patients may misguide the doctors and diverts his attention towards other diagnosis whichcan lead to considerable delay in the essential therapies required in the management of AMI. It definitely affects morbidity and mortality ofemergency department. Health care professionals particularly those working in emergency set up must keep in mind that absence ofchest pain in suspected cases of ischemic heart disease does not necessarily rule out AMI. Features of AMI other than chest pain shouldalso be kept in mind while dealing with a suspected case of ischemic heart disease. Further research work on painless AMI andpresentation of AMI other than chest pain is needed.

scholarly journals The role of platelet indices in ischemic heart disease: a hospital based case control type of study

2019 ◽  
Vol 7 (9) ◽  
pp. 3426
Author(s):  
Priyanka S. Gandhi ◽  
Bhavna N. Gamit
Keyword(s):  
Platelet Count ◽  
Heart Disease ◽  
Chest Pain ◽  
Ischemic Heart Disease ◽  
Heart Diseases ◽  
Inverse Correlation ◽  
Ischemic Heart ◽  
Noncardiac Chest Pain ◽  
Platelet Volume ◽  
Pain Patients

Background: In developing countries, Ischemic heart diseases (IHD) is one of the leading causes of morbidity and mortality. The underlying pathology of CAD is atherosclerosis. When this atherosclerotic plaque ruptures, platelets play a crucial role in the prothrombotic events and forms a thrombus on this plaque and as a result coronary artery gets occluded causing ischemia and infarction. Platelet contains many chemokines, cytokines and growth factors. Release of these factors along with interaction with endothelial cells and leukocytes promotes inflammation and progression of atherosclerosis. We aimed to investigate the association between platelet volume indices in patients with diagnosis of Ischemic heart disease in comparison with control group.Methods: By using automated cell counter platelet count and platelet volume indices - were compared with Normal healthy or non-cardiac chest pain patients with the use of unpaired t test.Results: In the present study, we demonstrated that platelet count is significantly low and MPV and PDW are significantly high in Ischemic heart disease as compared to patients with noncardiac chest pain or healthy subjects. The correlation of MPV with PC revealed an inverse correlation between the patients of IHD and healthy or non-cardiac chest pain patients which is statistically significant.Conclusions: The platelet volume indices are an important, simple, effortless and a cost-effective tool useful in predicting the development of an acute coronary event sometimes in the near future and therapeutic modification for improved patient’s cardiovascular care.

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