The symptom of paroxysmal pain consequent to MYOCARDIAL ISCHEMIA usually of distinctive character, location and radiation. It is thought to be provoked by a transient stressful situation during which the oxygen requirements of the MYOCARDIUM exceed that supplied by the CORONARY CIRCULATION.
Precordial pain at rest, which may precede a MYOCARDIAL INFARCTION.
A clinical syndrome characterized by the development of CHEST PAIN at rest with concomitant transient ST segment elevation in the ELECTROCARDIOGRAM, but with preserved exercise capacity.
Persistent and reproducible chest discomfort usually precipitated by a physical exertion that dissipates upon cessation of such an activity. The symptoms are manifestations of MYOCARDIAL ISCHEMIA.
A volatile vasodilator which relieves ANGINA PECTORIS by stimulating GUANYLATE CYCLASE and lowering cytosolic calcium. It is also sometimes used for TOCOLYSIS and explosives.
A technique for assisting the circulation by decreasing the afterload of the left ventricle and augmenting the diastolic pressure. It may be achieved by intra-aortic balloon, or by implanting a special pumping device in the chest, or externally by applying a negative pressure to the lower extremities during cardiac systole.
Radiography of the vascular system of the heart muscle after injection of a contrast medium.
ANGINA PECTORIS or angina-like chest pain with a normal coronary arteriogram and positive EXERCISE TEST. The cause of the syndrome is unknown. While its recognition is of clinical importance, its prognosis is excellent. (Braunwald, Heart Disease, 4th ed, p1346; Jablonski Dictionary of Syndromes & Eponymic Diseases, 2d ed). It is different from METABOLIC SYNDROME X, a syndrome characterized by INSULIN RESISTANCE and HYPERINSULINEMIA, that has increased risk for cardiovascular disease.
NECROSIS of the MYOCARDIUM caused by an obstruction of the blood supply to the heart (CORONARY CIRCULATION).
Controlled physical activity which is performed in order to allow assessment of physiological functions, particularly cardiovascular and pulmonary, but also aerobic capacity. Maximal (most intense) exercise is usually required but submaximal exercise is also used.
An imbalance between myocardial functional requirements and the capacity of the CORONARY VESSELS to supply sufficient blood flow. It is a form of MYOCARDIAL ISCHEMIA (insufficient blood supply to the heart muscle) caused by a decreased capacity of the coronary vessels.
Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY.
A drug used in the treatment of angina pectoris, heart failure, conduction defects, and myocardial infarction. It is a partial agonist at beta adrenergic receptors and acts as a coronary vasodilator and cardiotonic agent.
Spasm of the large- or medium-sized coronary arteries.
Pathological processes of CORONARY ARTERIES that may derive from a congenital abnormality, atherosclerotic, or non-atherosclerotic cause.
A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (CORONARY ARTERY DISEASE), to obstruction by a thrombus (CORONARY THROMBOSIS), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (MYOCARDIAL INFARCTION).
A vasodilator used in the treatment of ANGINA PECTORIS. Its actions are similar to NITROGLYCERIN but with a slower onset of action.
An ergot alkaloid (ERGOT ALKALOIDS) with uterine and VASCULAR SMOOTH MUSCLE contractile properties.
The veins and arteries of the HEART.
Compounds possessing both a hydroxyl (-OH) and an amino group (-NH2).
Drugs that bind to but do not activate beta-adrenergic receptors thereby blocking the actions of beta-adrenergic agonists. Adrenergic beta-antagonists are used for treatment of hypertension, cardiac arrhythmias, angina pectoris, glaucoma, migraine headaches, and anxiety.
Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.
Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.
Dilation of an occluded coronary artery (or arteries) by means of a balloon catheter to restore myocardial blood supply.
Pressure, burning, or numbness in the chest.
A potent vasodilator agent with calcium antagonistic action. It is a useful anti-anginal agent that also lowers blood pressure.
Expenditure of energy during PHYSICAL ACTIVITY. Intensity of exertion may be measured by rate of OXYGEN CONSUMPTION; HEAT produced, or HEART RATE. Perceived exertion, a psychological measure of exertion, is included.
A selective adrenergic beta-1 blocking agent that is commonly used to treat ANGINA PECTORIS; HYPERTENSION; and CARDIAC ARRHYTHMIAS.
An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.
Percutaneous transluminal procedure for removing atheromatous plaque from the coronary arteries. Both directional (for removing focal atheromas) and rotational (for removing concentric atheromatous plaque) atherectomy devices have been used.
A widely used non-cardioselective beta-adrenergic antagonist. Propranolol has been used for MYOCARDIAL INFARCTION; ARRHYTHMIA; ANGINA PECTORIS; HYPERTENSION; HYPERTHYROIDISM; MIGRAINE; PHEOCHROMOCYTOMA; and ANXIETY but adverse effects instigate replacement by newer drugs.
Compounds based on N-phenylacetamide, that are similar in structure to 2-PHENYLACETAMIDES. They are precursors of many other compounds. They were formerly used as ANALGESICS and ANTIPYRETICS, but often caused lethal METHEMOGLOBINEMIA.
The restoration of blood supply to the myocardium. (From Dorland, 28th ed)
A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment.
Motion pictures of the passage of contrast medium through blood vessels.
A beta-1 adrenergic antagonist that has been used in the emergency treatment of CARDIAC ARRYTHMIAS.
An episode of MYOCARDIAL ISCHEMIA that generally lasts longer than a transient anginal episode that ultimately may lead to MYOCARDIAL INFARCTION.
The number of times the HEART VENTRICLES contract per unit of time, usually per minute.
Radiography of the heart and great vessels after injection of a contrast medium.
A beta-adrenergic antagonist used in the treatment of hypertension, angina pectoris, arrhythmias, and anxiety.
Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion.
Graphic registration of the heart sounds picked up as vibrations and transformed by a piezoelectric crystal microphone into a varying electrical output according to the stresses imposed by the sound waves. The electrical output is amplified by a stethograph amplifier and recorded by a device incorporated into the electrocardiograph or by a multichannel recording machine.
The circulation of blood through the CORONARY VESSELS of the HEART.
Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.
A derivative of the NIACINAMIDE that is structurally combined with an organic nitrate. It is a potassium-channel opener that causes vasodilatation of arterioles and large coronary arteries. Its nitrate-like properties produce venous vasodilation through stimulation of guanylate cyclase.
Method in which prolonged electrocardiographic recordings are made on a portable tape recorder (Holter-type system) or solid-state device ("real-time" system), while the patient undergoes normal daily activities. It is useful in the diagnosis and management of intermittent cardiac arrhythmias and transient myocardial ischemia.
Measurable and quantifiable biological parameters (e.g., specific enzyme concentration, specific hormone concentration, specific gene phenotype distribution in a population, presence of biological substances) which serve as indices for health- and physiology-related assessments, such as disease risk, psychiatric disorders, environmental exposure and its effects, disease diagnosis, metabolic processes, substance abuse, pregnancy, cell line development, epidemiologic studies, etc.
A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations.
Works about pre-planned studies of the safety, efficacy, or optimum dosage schedule (if appropriate) of one or more diagnostic, therapeutic, or prophylactic drugs, devices, or techniques selected according to predetermined criteria of eligibility and observed for predefined evidence of favorable and unfavorable effects. This concept includes clinical trials conducted both in the U.S. and in other countries.
Drugs that inhibit the actions of the sympathetic nervous system by any mechanism. The most common of these are the ADRENERGIC ANTAGONISTS and drugs that deplete norepinephrine or reduce the release of transmitters from adrenergic postganglionic terminals (see ADRENERGIC AGENTS). Drugs that act in the central nervous system to reduce sympathetic activity (e.g., centrally acting alpha-2 adrenergic agonists, see ADRENERGIC ALPHA-AGONISTS) are included here.
Drugs used to cause dilation of the blood vessels.
Lesions formed within the walls of ARTERIES.
Severe cellulitis of the submaxillary space with secondary involvement of the sublingual and submental space. It usually results from infection in the lower molar area or from a penetrating injury to the mouth floor. (From Dorland, 27th ed)
Propiophenones are a group of synthetic compounds characterized by a phenone functional group attached to a propyl chain, which have been used in various applications including as intermediates in chemical synthesis and as pharmaceutical ingredients with sedative and hypnotic properties.
A cardioselective beta-1 adrenergic blocker possessing properties and potency similar to PROPRANOLOL, but without a negative inotropic effect.
A class of drugs that act by selective inhibition of calcium influx through cellular membranes.
A calcium channel blocker that is a class IV anti-arrhythmia agent.
The use of ultrasound to guide minimally invasive surgical procedures such as needle ASPIRATION BIOPSY; DRAINAGE; etc. Its widest application is intravascular ultrasound imaging but it is useful also in urology and intra-abdominal conditions.
Elements of limited time intervals, contributing to particular results or situations.
PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS.
Narrowing or constriction of a coronary artery.
A plasma protein that circulates in increased amounts during inflammation and after tissue damage.
Application of electric current to the spine for treatment of a variety of conditions involving innervation from the spinal cord.
Any dummy medication or treatment. Although placebos originally were medicinal preparations having no specific pharmacological activity against a targeted condition, the concept has been extended to include treatments or procedures, especially those administered to control groups in clinical trials in order to provide baseline measurements for the experimental protocol.
AMINO ALCOHOLS containing the propanolamine (NH2CH2CHOHCH2) group and its derivatives.
Agents that affect the rate or intensity of cardiac contraction, blood vessel diameter, or blood volume.
In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.
The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM.
The use of photothermal effects of LASERS to coagulate, incise, vaporize, resect, dissect, or resurface tissue.
The natural enzymatic dissolution of FIBRIN.
One of the three polypeptide chains that make up the TROPONIN complex. It is a cardiac-specific protein that binds to TROPOMYOSIN. It is released from damaged or injured heart muscle cells (MYOCYTES, CARDIAC). Defects in the gene encoding troponin T result in FAMILIAL HYPERTROPHIC CARDIOMYOPATHY.
The return of a sign, symptom, or disease after a remission.
Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.
Application of electric current in treatment without the generation of perceptible heat. It includes electric stimulation of nerves or muscles, passage of current into the body, or use of interrupted current of low intensity to raise the threshold of the skin to pain.
Procedures in which placement of CARDIAC CATHETERS is performed for therapeutic or diagnostic procedures.
A salicylamide derivative that is a non-cardioselective blocker of BETA-ADRENERGIC RECEPTORS and ALPHA-1 ADRENERGIC RECEPTORS.
Maintenance of blood flow to an organ despite obstruction of a principal vessel. Blood flow is maintained through small vessels.
A pteridine derivative present in body fluids; elevated levels result from immune system activation, malignant disease, allograft rejection, and viral infections. (From Stedman, 26th ed) Neopterin also serves as a precursor in the biosynthesis of biopterin.
The exercise capacity of an individual as measured by endurance (maximal exercise duration and/or maximal attained work load) during an EXERCISE TEST.
Coagulation of blood in any of the CORONARY VESSELS. The presence of a blood clot (THROMBUS) often leads to MYOCARDIAL INFARCTION.
The hollow, muscular organ that maintains the circulation of the blood.
A moderately lipophilic beta blocker (ADRENERGIC BETA-ANTAGONISTS). It is non-cardioselective and has intrinsic sympathomimetic actions, but little membrane-stabilizing activity. (From Martindale, The Extra Pharmocopoeia, 30th ed, p638)
A vasodilator used in angina of effort or ischemic heart disease.
Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care. (Dictionary of Health Services Management, 2d ed)
Therapy with two or more separate preparations given for a combined effect.
A benzothiazepine derivative with vasodilating action due to its antagonism of the actions of CALCIUM ion on membrane functions.
Ocular disorders attendant upon non-ocular disease or injury.
Dosage forms of a drug that act over a period of time by controlled-release processes or technology.
Methods and procedures for the diagnosis of diseases or dysfunction of the cardiovascular system or its organs or demonstration of their physiological processes.
A drug formerly used in the treatment of angina pectoris but superseded by less hazardous drugs. Prenylamine depletes myocardial catecholamine stores and has some calcium channel blocking activity. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1406)
An alpha-1 adrenergic antagonist that is commonly used as an antihypertensive agent.
Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting.
The abrupt cessation of all vital bodily functions, manifested by the permanent loss of total cerebral, respiratory, and cardiovascular functions.
The amount of BLOOD pumped out of the HEART per beat, not to be confused with cardiac output (volume/time). It is calculated as the difference between the end-diastolic volume and the end-systolic volume.
A clinical syndrome with intermittent abdominal pain characterized by sudden onset and cessation that is commonly seen in infants. It is usually associated with obstruction of the INTESTINES; of the CYSTIC DUCT; or of the URINARY TRACT.
Plasma glycoprotein clotted by thrombin, composed of a dimer of three non-identical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products.
A vasodilator with general properties similar to NITROGLYCERIN but with a more prolonged duration of action. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1025)
Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable.
Propylamines are organic compounds consisting of an amino group (-NH2) attached to a propyl group (CH3CH2CH2-), which can act as central nervous system stimulants, local anesthetics, or vasopressors, depending on their specific chemical structure.
A phosphodiesterase inhibitor that blocks uptake and metabolism of adenosine by erythrocytes and vascular endothelial cells. Dipyridamole also potentiates the antiaggregating action of prostacyclin. (From AMA Drug Evaluations Annual, 1994, p752)
A distribution in which a variable is distributed like the sum of the squares of any given independent random variable, each of which has a normal distribution with mean of zero and variance of one. The chi-square test is a statistical test based on comparison of a test statistic to a chi-square distribution. The oldest of these tests are used to detect whether two or more population distributions differ from one another.
Recording of the moment-to-moment electromotive forces of the heart on a plane of the body surface delineated as a vector function of time.
Drugs or agents which antagonize or impair any mechanism leading to blood platelet aggregation, whether during the phases of activation and shape change or following the dense-granule release reaction and stimulation of the prostaglandin-thromboxane system.
Studies which start with the identification of persons with a disease of interest and a control (comparison, referent) group without the disease. The relationship of an attribute to the disease is examined by comparing diseased and non-diseased persons with regard to the frequency or levels of the attribute in each group.
The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from PREVALENCE, which refers to all cases, new or old, in the population at a given time.
A transferase that catalyzes formation of PHOSPHOCREATINE from ATP + CREATINE. The reaction stores ATP energy as phosphocreatine. Three cytoplasmic ISOENZYMES have been identified in human tissues: the MM type from SKELETAL MUSCLE, the MB type from myocardial tissue and the BB type from nervous tissue as well as a mitochondrial isoenzyme. Macro-creatine kinase refers to creatine kinase complexed with other serum proteins.
Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.
A method of computed tomography that uses radionuclides which emit a single photon of a given energy. The camera is rotated 180 or 360 degrees around the patient to capture images at multiple positions along the arc. The computer is then used to reconstruct the transaxial, sagittal, and coronal images from the 3-dimensional distribution of radionuclides in the organ. The advantages of SPECT are that it can be used to observe biochemical and physiological processes as well as size and volume of the organ. The disadvantage is that, unlike positron-emission tomography where the positron-electron annihilation results in the emission of 2 photons at 180 degrees from each other, SPECT requires physical collimation to line up the photons, which results in the loss of many available photons and hence degrades the image.
A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables.
Inorganic or organic salts and esters of nitric acid. These compounds contain the NO3- radical.
2-(2,2-Dicyclohexylethyl)piperidine. Coronary vasodilator used especially for angina of effort. It may cause neuropathy and hepatitis.
Computed tomography where there is continuous X-ray exposure to the patient while being transported in a spiral or helical pattern through the beam of irradiation. This provides improved three-dimensional contrast and spatial resolution compared to conventional computed tomography, where data is obtained and computed from individual sequential exposures.
The formation of clumps of RED BLOOD CELLS under low or non-flow conditions, resulting from the attraction forces between the red blood cells. The cells adhere to each other in rouleaux aggregates. Slight mechanical force, such as occurs in the circulation, is enough to disperse these aggregates. Stronger or weaker than normal aggregation may result from a variety of effects in the ERYTHROCYTE MEMBRANE or in BLOOD PLASMA. The degree of aggregation is affected by ERYTHROCYTE DEFORMABILITY, erythrocyte membrane sialylation, masking of negative surface charge by plasma proteins, etc. BLOOD VISCOSITY and the ERYTHROCYTE SEDIMENTATION RATE are affected by the amount of erythrocyte aggregation and are parameters used to measure the aggregation.
The lower right and left chambers of the heart. The right ventricle pumps venous BLOOD into the LUNGS and the left ventricle pumps oxygenated blood into the systemic arterial circulation.
#### I must clarify that 'Northern Ireland' is not a medical term and does not have a medical definition. It is a geographical and political term referring to a part of the United Kingdom located in the northeastern portion of the island of Ireland, consisting of six of the nine counties of the historic province of Ulster.
Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from DRUG RESISTANCE wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from MAXIMUM TOLERATED DOSE and NO-OBSERVED-ADVERSE-EFFECT LEVEL.
Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic.
The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)
The process which spontaneously arrests the flow of BLOOD from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements (eg. ERYTHROCYTE AGGREGATION), and the process of BLOOD COAGULATION.
The internal resistance of the BLOOD to shear forces. The in vitro measure of whole blood viscosity is of limited clinical utility because it bears little relationship to the actual viscosity within the circulation, but an increase in the viscosity of circulating blood can contribute to morbidity in patients suffering from disorders such as SICKLE CELL ANEMIA and POLYCYTHEMIA.
Abdominal symptoms after removal of the GALLBLADDER. The common postoperative symptoms are often the same as those present before the operation, such as COLIC, bloating, NAUSEA, and VOMITING. There is pain on palpation of the right upper quadrant and sometimes JAUNDICE. The term is often used, inaccurately, to describe such postoperative symptoms not due to gallbladder removal.

The effect of race and sex on physicians' recommendations for cardiac catheterization. (1/2517)

BACKGROUND: Epidemiologic studies have reported differences in the use of cardiovascular procedures according to the race and sex of the patient. Whether the differences stem from differences in the recommendations of physicians remains uncertain. METHODS: We developed a computerized survey instrument to assess physicians' recommendations for managing chest pain. Actors portrayed patients with particular characteristics in scripted interviews about their symptoms. A total of 720 physicians at two national meetings of organizations of primary care physicians participated in the survey. Each physician viewed a recorded interview and was given other data about a hypothetical patient. He or she then made recommendations about that patient's care. We used multivariate logistic-regression analysis to assess the effects of the race and sex of the patients on treatment recommendations, while controlling for the physicians' assessment of the probability of coronary artery disease as well as for the age of the patient, the level of coronary risk, the type of chest pain, and the results of an exercise stress test. RESULTS: The physicians' mean (+/-SD) estimates of the probability of coronary artery disease were lower for women (probability, 64.1+/-19.3 percent, vs. 69.2+/-18.2 percent for men; P<0.001), younger patients (63.8+/-19.5 percent for patients who were 55 years old, vs. 69.5+/-17.9 percent for patients who were 70 years old; P<0.001), and patients with nonanginal pain (58.3+/-19.0 percent, vs. 64.4+/-18.3 percent for patients with possible angina and 77.1+/-14.0 percent for those with definite angina; P=0.001). Logistic-regression analysis indicated that women (odds ratio, 0.60; 95 percent confidence interval, 0.4 to 0.9; P=0.02) and blacks (odds ratio, 0.60; 95 percent confidence interval, 0.4 to 0.9; P=0.02) were less likely to be referred for cardiac catheterization than men and whites, respectively. Analysis of race-sex interactions showed that black women were significantly less likely to be referred for catheterization than white men (odds ratio, 0.4; 95 percent confidence interval, 0.2 to 0.7; P=0.004). CONCLUSIONS: Our findings suggest that the race and sex of a patient independently influence how physicians manage chest pain.  (+info)

Fibrinolytic activation markers predict myocardial infarction in the elderly. The Cardiovascular Health Study. (2/2517)

Coagulation factor levels predict arterial thrombosis in epidemiological studies, but studies of older persons are needed. We studied 3 plasma antigenic markers of fibrinolysis, viz, plasminogen activator inhibitor-1 (PAI-1), fibrin fragment D-dimer, and plasmin-antiplasmin complex (PAP) for the prediction of arterial thrombosis in healthy elderly persons over age 65. The study was a nested case-control study in the Cardiovascular Health Study cohort of 5201 men and women >/=65 years of age who were enrolled from 1989 to 1990. Cases were 146 participants without baseline clinical vascular disease who developed myocardial infarction, angina, or coronary death during a follow-up of 2.4 years. Controls remained free of cardiovascular events and were matched 1:1 to cases with respect to sex, duration of follow-up, and baseline subclinical vascular disease status. With increasing quartile of D-dimer and PAP levels but not of PAI-1, there was an independent increased risk of myocardial infarction or coronary death, but not of angina. The relative risk for D-dimer above versus below the median value (>/=120 microg/L) was 2.5 (95% confidence interval, 1.1 to 5.9) and for PAP above the median (>/=5.25 nmol/L), 3.1 (1.3 to 7.7). Risks were independent of C-reactive protein and fibrinogen concentrations. There were no differences in risk by sex or presence of baseline subclinical disease. D-dimer and PAP, but not PAI-1, predicted future myocardial infarction in men and women over age 65. Relationships were independent of other risk factors, including inflammation markers. Results indicate a major role for these markers in identifying a high risk of arterial disease in this age group.  (+info)

Randomised controlled trial of follow up care in general practice of patients with myocardial infarction and angina: final results of the Southampton heart integrated care project (SHIP). The SHIP Collaborative Group. (3/2517)

OBJECTIVE: To assess the effectiveness of a programme to coordinate and support follow up care in general practice after a hospital diagnosis of myocardial infarction or angina. DESIGN: Randomised controlled trial; stratified random allocation of practices to intervention and control groups. SETTING: All 67 practices in Southampton and south west Hampshire, England. SUBJECTS: 597 adult patients (422 with myocardial infarction and 175 with a new diagnosis of angina) who were recruited during hospital admission or attendance at a chest pain clinic between April 1995 and September 1996. INTERVENTION: Programme to coordinate preventive care led by specialist liaison nurses which sought to improve communication between hospital and general practice and to encourage general practice nurses to provide structured follow up. MAIN OUTCOME MEASURES: Serum total cholesterol concentration, blood pressure, distance walked in 6 minutes, confirmed smoking cessation, and body mass index measured at 1 year follow up. RESULTS: Of 559 surviving patients at 1 year, 502 (90%) were followed up. There was no significant difference between the intervention and control groups in smoking (cotinine validated quit rate 19% v 20%), lipid concentrations (serum total cholesterol 5.80 v 5.93 mmol/l), blood pressure (diastolic pressure 84 v 85 mm Hg), or fitness (distance walked in 6 minutes 443 v 433 m). Body mass index was slightly lower in the intervention group (27.4 v 28.2; P=0.08). CONCLUSIONS: Although the programme was effective in promoting follow up in general practice, it did not improve health outcome. Simply coordinating and supporting existing NHS care is insufficient. Ischaemic heart disease is a chronic condition which requires the same systematic approach to secondary prevention applied in other chronic conditions such as diabetes mellitus.  (+info)

The transmyocardial laser revascularization international registry report. (4/2517)

AIMS: This report aimed to provide an analysis of the data submitted from Europe and Asia on transmyocardial laser revascularization. METHODS AND RESULTS: Prospective data was recorded on 967 patients with intractable angina not amenable to conventional revascularization in 21 European and Asian centres performing transmyocardial laser revascularization using the PLC Medical Systems CO2 laser. Patient characteristics, operative details and early complications following transmyocardial laser revascularization were recorded. The in-hospital death rate was 9.7% (95% confidence interval 7.8% to 11.6%). Other early complications were consistent with similar cardiothoracic surgical procedures. There was a decrease of two or more Canadian Cardiovascular Score angina classes in 47.3%, 45.4% and 34.0% of survivors at 3, 6 and 12 months follow-up, respectively (P=0.001 for each). Treadmill exercise time increased by 42 s at 3 months (P=0.008), 1 min 43 s at 6 months (P<0.001) and 1 min 50 s at 12 months (P<0.001) against pre-operative times of 6 min. CONCLUSION: Uncontrolled registry data suggest that transmyocardial laser revascularization may lead to a decrease in angina and improved exercise tolerance. It does, however, have a risk of peri-operative morbidity and mortality. Definitive results from randomized controlled trials are awaited.  (+info)

Heart rate variability and ischaemia in patients with coronary heart disease and stable angina pectoris; influence of drug therapy and prognostic value. TIBBS Investigators Group. Total Ischemic Burden Bisoprolol Study. (5/2517)

AIMS: Determination of the influence of therapy with bisoprolol and nifedipine on the heart rate variability of patients from the Total Ischemic Burden Bisoprolol Study and examination of the prognostic value. METHODS AND RESULTS: Four hundred and twenty-two patients with stable angina were included. The heart rate variability was determined over a period of 24 h. Parameters determined: standard deviation of the mean of all corrected RR intervals, standard deviation of all 5 min mean cycle lengths, square root of the mean of the squared differences of successive corrected RR intervals. Nifedipine reduced the mean values of all heart rate variability parameters tested. Square root of the mean of the square differences of successive corrected RR intervals increased under bisoprolol. Standard deviation of the mean of all corrected RR intervals and standard deviation of all 5 min mean cycle lengths increased from low baseline values and declined from higher baseline values. The increase in heart rate variability under therapy was accompanied by a tendency towards a better prognosis. Patients with an increase in heart rate variability and simultaneous complete suppression of ischaemia under therapy displayed no serious events in the course of one year. CONCLUSIONS: The increase in the heart rate variability, which can be regarded as prognostically favourable, was predominantly observed under bisoprolol. The parameter constellation of an increase in heart rate variability and complete ischaemia suppression on the 48-h Holter ECG was associated with the greatest benefit.  (+info)

Evaluation of technician supervised treadmill exercise testing in a cardiac chest pain clinic. (6/2517)

OBJECTIVE: To determine the efficacy and safety of trained cardiac technicians independently performing treadmill exercise stress tests as part of the assessment of patients with suspected angina pectoris. DESIGN: Retrospective comparison of 250 exercise tests performed by cardiac technicians and 225 tests performed by experienced cardiology clinical assistants (general practitioners who perform regular NHS cardiology duties), and consultant cardiologists over the same time period. SETTING: Regional cardiac centre with a dedicated cardiac chest pain clinic. PATIENTS: All patients were referred by their general practitioners with a history of recent onset of chest pain, which was suspected to be angina pectoris. OUTCOME MEASURES: Peak workload achieved, symptoms, indications for termination, complications. RESULTS: The diagnostic yield of technician supervised tests (percentage positive or negative) was similar to that of medically supervised tests (76% v 69%, NS). The average peak workload achieved by patients was less by 1.2 mets (p < 0.005). This was probably due to more tests being terminated earlier due to chest pain and ST segment depression in the technician group compared with doctors (10% and 16% v 5% and 11% respectively, p = 0.06 and 0.07). One patient in the technician supervised group developed a supraventricular tachycardia during the recovery phase of the exercise test. CONCLUSIONS: Technician supervised stress testing is associated with a high diagnostic rate and low complication rate in patients with suspected ischaemic heart disease. Its efficacy is comparable to tests supervised by experienced doctors and its use should be encouraged.  (+info)

Follow-up care in general practice of patients with myocardial infarction or angina pectoris: initial results of the SHIP trial. Southampton Heart Integrated Care Project. (7/2517)

OBJECTIVE: We aimed to assess the effectiveness of a nurse-led programme to ensure that follow-up care is provided in general practice after hospital diagnosis of myocardial infarction (MI) or angina pectoris. METHODS: We conducted a randomized controlled trial with stratified random allocation of practices to intervention and control groups within all 67 practices in Southampton and South-West Hampshire, England. The subjects were 422 adult patients with a MI and 175 patients with a new diagnosis of angina recruited during hospital admission or chest pain clinic attendance between April 1995 and September 1996. Intervention involved a programme of secondary preventive care led by specialist liaison nurses in which we sought to improve communication between hospital and general practice and to encourage general practice nurses to provide structured follow-up. The main outcome measures were: extent of general practice follow-up; attendance for cardiac rehabilitation; medication prescribed at hospital discharge; self-reported smoking, diet and exercise; and symptoms of chest pain and shortness of breath. Follow-ups of 90.1 % of subjects at 1 month and 80.6% at 4 months were carried out. RESULTS: Median attendance for nurse follow-up in the 4 months following diagnosis was 3 (IQR 2-5) in intervention practices and 0 (IQR 0-1) in control practices; the median number of visits to a doctor was the same in both groups. At hospital discharge, levels of prescribing of preventive medication were low in both intervention and control groups: aspirin 77 versus 74% (P = 0.32), cholesterol lowering agents 9 versus 10% (P = 0.8). Conversely, 1 month after diagnosis, the vast majority of patients in both groups reported healthy lifestyles: 90 versus 84% reported eating healthy food (P = 0.53); 73 versus 67% taking regular exercise (P = 0.13); 89 versus 92% not smoking (P = 0.77). Take up of cardiac rehabilitation was 37% in the intervention group and 22% in the control group (P = 0.001); the median number of sessions attended was also higher (5 versus 3 out of 6). CONCLUSIONS: The intervention of a liaison nurse is effective in ensuring that general practice nurses follow-up patients after hospital discharge. It does not alter the number of follow-up visits made by the patient to the doctor. Levels of prescribing and reported changes in behaviour at hospital discharge indicate that the main tasks facing practice nurses during follow-up are to help patients to sustain changes in behaviour, to encourage doctors to prescribe appropriate medication and to encourage patients to adhere to medication while returning to an active life. These are very different tasks to those traditionally undertaken by practice nurses in relation to primary prevention, where the emphasis has been on identifying risk and motivating change. Assessment of the effectiveness of practice nurses in undertaking these new tasks requires a longer follow-up.  (+info)

The economic consequences of available diagnostic and prognostic strategies for the evaluation of stable angina patients: an observational assessment of the value of precatheterization ischemia. Economics of Noninvasive Diagnosis (END) Multicenter Study Group. (8/2517)

OBJECTIVES: The study aim was to determine observational differences in costs of care by the coronary disease diagnostic test modality. BACKGROUND: A number of diagnostic strategies are available with few data to compare the cost implications of the initial test choice. METHODS: We prospectively enrolled 11,372 consecutive stable angina patients who were referred for stress myocardial perfusion tomography or cardiac catheterization. Stress imaging patients were matched by their pretest clinical risk of coronary disease to a series of patients referred to cardiac catheterization. Composite 3-year costs of care were compared for two patients management strategies: 1) direct cardiac catheterization (aggressive) and 2) initial stress myocardial perfusion tomography and selective catheterization of high risk patients (conservative). Analysis of variance techniques were used to compare costs, adjusting for treatment propensity and pretest risk. RESULTS: Observational comparisons of aggressive as compared with conservative testing strategies reveal that costs of care were higher for direct cardiac catheterization in all clinical risk subsets (range: $2,878 to $4,579), as compared with stress myocardial perfusion imaging plus selective catheterization (range: $2,387 to $3,010, p < 0.0001). Coronary revascularization rates were higher for low, intermediate and high risk direct catheterization patients as compared with the initial stress perfusion imaging cohort (13% to 50%, p < 0.0001); cardiac death or myocardial infarction rates were similar (p > 0.20). CONCLUSIONS: Observational assessments reveal that stable chest pain patients who undergo a more aggressive diagnostic strategy have higher diagnostic costs and greater rates of intervention and follow-up costs. Cost differences may reflect a diminished necessity for resource consumption for patients with normal test results.  (+info)

Angina pectoris is a medical term that describes chest pain or discomfort caused by an inadequate supply of oxygen-rich blood to the heart muscle. This condition often occurs due to coronary artery disease, where the coronary arteries become narrowed or blocked by the buildup of cholesterol, fatty deposits, and other substances, known as plaques. These blockages can reduce blood flow to the heart, causing ischemia (lack of oxygen) and leading to angina symptoms.

There are two primary types of angina: stable and unstable. Stable angina is predictable and usually occurs during physical exertion or emotional stress when the heart needs more oxygen-rich blood. The pain typically subsides with rest or after taking prescribed nitroglycerin medication, which helps widen the blood vessels and improve blood flow to the heart.

Unstable angina, on the other hand, is more severe and unpredictable. It can occur at rest, during sleep, or with minimal physical activity and may not be relieved by rest or nitroglycerin. Unstable angina is considered a medical emergency, as it could indicate an imminent heart attack.

Symptoms of angina pectoris include chest pain, pressure, tightness, or heaviness that typically radiates to the left arm, neck, jaw, or back. Shortness of breath, nausea, sweating, and fatigue may also accompany angina symptoms. Immediate medical attention is necessary if you experience chest pain or discomfort, especially if it's new, severe, or persistent, as it could be a sign of a more serious condition like a heart attack.

Unstable angina is a term used in cardiology to describe chest pain or discomfort that occurs suddenly and unexpectedly, often at rest or with minimal physical exertion. It is caused by an insufficient supply of oxygen-rich blood to the heart muscle due to reduced blood flow, typically as a result of partial or complete blockage of the coronary arteries.

Unlike stable angina, which tends to occur predictably during physical activity and can be relieved with rest or nitroglycerin, unstable angina is more severe, unpredictable, and may not respond to traditional treatments. It is considered a medical emergency because it can be a sign of an impending heart attack or other serious cardiac event.

Unstable angina is often treated in the hospital with medications such as nitroglycerin, beta blockers, calcium channel blockers, and antiplatelet agents to improve blood flow to the heart and prevent further complications. In some cases, more invasive treatments such as coronary angioplasty or bypass surgery may be necessary to restore blood flow to the affected areas of the heart.

Angina pectoris, variant (also known as Prinzmetal's angina or vasospastic angina) is a type of chest pain that results from reduced blood flow to the heart muscle due to spasms in the coronary arteries. These spasms cause the arteries to narrow, temporarily reducing the supply of oxygen-rich blood to the heart. This can lead to symptoms such as chest pain, shortness of breath, and fatigue.

Variant angina is typically more severe than other forms of angina and can occur at rest or with minimal physical exertion. It is often treated with medications that help relax the coronary arteries and prevent spasms, such as calcium channel blockers and nitrates. In some cases, additional treatments such as angioplasty or bypass surgery may be necessary to improve blood flow to the heart.

It's important to note that chest pain can have many different causes, so it is essential to seek medical attention if you experience any symptoms of angina or other types of chest pain. A healthcare professional can help determine the cause of your symptoms and develop an appropriate treatment plan.

Stable angina is a type of chest pain or discomfort that typically occurs during physical exertion or emotional stress. It is caused by reduced blood flow to the heart muscle, which can occur when the coronary arteries become narrowed or blocked due to the buildup of cholesterol and other substances (a condition known as atherosclerosis).

The symptoms of stable angina are usually predictable and may include chest pain or discomfort that is:

* Described as a squeezing, pressure, heaviness, or tightness in the chest
* Typically located in the center of the chest, but may radiate to the shoulders, arms, neck, jaw, or back
* Lasts for a few minutes and is usually relieved by rest or nitroglycerin

Stable angina is considered "stable" because the symptoms tend to occur predictably and can be managed with medication, lifestyle changes, and sometimes medical procedures such as angioplasty or bypass surgery. However, it is still a serious condition that requires proper diagnosis and treatment to prevent complications such as heart attack or stroke.

Nitroglycerin, also known as glyceryl trinitrate, is a medication used primarily for the treatment of angina pectoris (chest pain due to coronary artery disease) and hypertensive emergencies (severe high blood pressure). It belongs to a class of drugs called nitrates or organic nitrites.

Nitroglycerin works by relaxing and dilating the smooth muscle in blood vessels, which leads to decreased workload on the heart and increased oxygen delivery to the myocardium (heart muscle). This results in reduced symptoms of angina and improved cardiac function during hypertensive emergencies.

The drug is available in various forms, including sublingual tablets, sprays, transdermal patches, ointments, and intravenous solutions. The choice of formulation depends on the specific clinical situation and patient needs. Common side effects of nitroglycerin include headache, dizziness, and hypotension (low blood pressure).

Counterpulsation is a medical treatment used in critical care medicine, particularly in the management of cardiovascular conditions. It refers to a technique that involves delivering therapies that counter or oppose the patient's own cardiac cycle. The most common form of counterpulsation is through the use of an intra-aortic balloon pump (IABP).

During IABP, a catheter with a sausage-shaped balloon at its tip is inserted into the patient's aorta, usually through the femoral artery in the groin. The balloon is then connected to a console that controls its inflation and deflation. The console is programmed to detect the patient's cardiac cycle using either the ECG or arterial pressure waveform.

During diastole (when the heart muscle relaxes and fills with blood), the balloon inflates, increasing the volume of blood in the aorta and improving coronary artery perfusion. This helps to increase oxygen delivery to the myocardium (heart muscle) and reduce its workload.

During systole (when the heart muscle contracts and ejects blood), the balloon deflates, reducing afterload (the resistance against which the heart must pump). This reduces the workload of the left ventricle, allowing it to fill more easily during diastole and improving overall cardiac output.

In summary, counterpulsation is a medical intervention that uses therapies, such as intra-aortic balloon pumps, to counter or oppose the patient's own cardiac cycle. This technique aims to improve coronary artery perfusion, reduce afterload, and enhance overall cardiac function.

Coronary angiography is a medical procedure that uses X-ray imaging to visualize the coronary arteries, which supply blood to the heart muscle. During the procedure, a thin, flexible catheter is inserted into an artery in the arm or groin and threaded through the blood vessels to the heart. A contrast dye is then injected through the catheter, and X-ray images are taken as the dye flows through the coronary arteries. These images can help doctors diagnose and treat various heart conditions, such as blockages or narrowing of the arteries, that can lead to chest pain or heart attacks. It is also known as coronary arteriography or cardiac catheterization.

Microvascular angina, also known as cardiac syndrome X or microvascular ischemia, is a type of angina (chest pain) that results from reduced blood flow to the heart muscle due to dysfunction in the small coronary arteries (microvasculature). These vessels are too small to be visualized during conventional diagnostic tests like coronary angiography.

The medical definition of microvascular angina is:

A clinical syndrome characterized by the presence of anginal chest pain, often accompanied by evidence of myocardial ischemia (insufficient blood flow to the heart muscle), in the absence of obstructive coronary artery disease on conventional diagnostic imaging. The underlying mechanism involves dysfunction and impaired regulation of the microvasculature, leading to reduced vasodilatory capacity, increased vasoconstriction, and ultimately, inadequate oxygen supply to meet the metabolic demands of the heart muscle.

Microvascular angina is more prevalent in women, especially those with risk factors such as hypertension, diabetes, hyperlipidemia, and smoking. Diagnosis often requires specialized testing like coronary flow reserve assessment using positron emission tomography (PET) or cardiac magnetic resonance imaging (MRI). Treatment typically involves a combination of lifestyle modifications, medications to improve blood vessel function and reduce chest pain, and sometimes, invasive treatments such as transmyocardial laser revascularization.

Myocardial infarction (MI), also known as a heart attack, is a medical condition characterized by the death of a segment of heart muscle (myocardium) due to the interruption of its blood supply. This interruption is most commonly caused by the blockage of a coronary artery by a blood clot formed on the top of an atherosclerotic plaque, which is a buildup of cholesterol and other substances in the inner lining of the artery.

The lack of oxygen and nutrients supply to the heart muscle tissue results in damage or death of the cardiac cells, causing the affected area to become necrotic. The extent and severity of the MI depend on the size of the affected area, the duration of the occlusion, and the presence of collateral circulation.

Symptoms of a myocardial infarction may include chest pain or discomfort, shortness of breath, nausea, lightheadedness, and sweating. Immediate medical attention is necessary to restore blood flow to the affected area and prevent further damage to the heart muscle. Treatment options for MI include medications, such as thrombolytics, antiplatelet agents, and pain relievers, as well as procedures such as percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG).

An exercise test, also known as a stress test or an exercise stress test, is a medical procedure used to evaluate the heart's function and response to physical exertion. It typically involves walking on a treadmill or pedaling a stationary bike while being monitored for changes in heart rate, blood pressure, electrocardiogram (ECG), and sometimes other variables such as oxygen consumption or gas exchange.

During the test, the patient's symptoms, such as chest pain or shortness of breath, are also closely monitored. The exercise test can help diagnose coronary artery disease, assess the severity of heart-related symptoms, and evaluate the effectiveness of treatments for heart conditions. It may also be used to determine a person's safe level of physical activity and fitness.

There are different types of exercise tests, including treadmill stress testing, stationary bike stress testing, nuclear stress testing, and stress echocardiography. The specific type of test used depends on the patient's medical history, symptoms, and overall health status.

Coronary artery disease, often simply referred to as coronary disease, is a condition in which the blood vessels that supply oxygen-rich blood to the heart become narrowed or blocked due to the buildup of fatty deposits called plaques. This can lead to chest pain (angina), shortness of breath, or in severe cases, a heart attack.

The medical definition of coronary artery disease is:

A condition characterized by the accumulation of atheromatous plaques in the walls of the coronary arteries, leading to decreased blood flow and oxygen supply to the myocardium (heart muscle). This can result in symptoms such as angina pectoris, shortness of breath, or arrhythmias, and may ultimately lead to myocardial infarction (heart attack) or heart failure.

Risk factors for coronary artery disease include age, smoking, high blood pressure, high cholesterol, diabetes, obesity, physical inactivity, and a family history of the condition. Lifestyle changes such as quitting smoking, exercising regularly, eating a healthy diet, and managing stress can help reduce the risk of developing coronary artery disease. Medical treatments may include medications to control blood pressure, cholesterol levels, or irregular heart rhythms, as well as procedures such as angioplasty or bypass surgery to improve blood flow to the heart.

Electrocardiography (ECG or EKG) is a medical procedure that records the electrical activity of the heart. It provides a graphic representation of the electrical changes that occur during each heartbeat. The resulting tracing, called an electrocardiogram, can reveal information about the heart's rate and rhythm, as well as any damage to its cells or abnormalities in its conduction system.

During an ECG, small electrodes are placed on the skin of the chest, arms, and legs. These electrodes detect the electrical signals produced by the heart and transmit them to a machine that amplifies and records them. The procedure is non-invasive, painless, and quick, usually taking only a few minutes.

ECGs are commonly used to diagnose and monitor various heart conditions, including arrhythmias, coronary artery disease, heart attacks, and electrolyte imbalances. They can also be used to evaluate the effectiveness of certain medications or treatments.

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Coronary vasospasm refers to a sudden constriction (narrowing) of the coronary arteries, which supply oxygenated blood to the heart muscle. This constriction can reduce or block blood flow, leading to symptoms such as chest pain (angina) or, in severe cases, a heart attack (myocardial infarction). Coronary vasospasm can occur spontaneously or be triggered by various factors, including stress, smoking, and certain medications. It is also associated with conditions such as coronary artery disease and variant angina. Prolonged or recurrent vasospasms can cause damage to the heart muscle and increase the risk of cardiovascular events.

Coronary artery disease (CAD) is a medical condition in which the coronary arteries, which supply oxygen-rich blood to the heart muscle, become narrowed or blocked due to the buildup of cholesterol, fatty deposits, and other substances, known as plaque. Over time, this buildup can cause the arteries to harden and narrow (a process called atherosclerosis), reducing blood flow to the heart muscle.

The reduction in blood flow can lead to various symptoms and complications, including:

1. Angina (chest pain or discomfort) - This occurs when the heart muscle doesn't receive enough oxygen-rich blood, causing pain, pressure, or discomfort in the chest, arms, neck, jaw, or back.
2. Shortness of breath - When the heart isn't receiving adequate blood flow, it can't pump blood efficiently to meet the body's demands, leading to shortness of breath during physical activities or at rest.
3. Heart attack - If a piece of plaque ruptures or breaks off in a coronary artery, a blood clot can form and block the artery, causing a heart attack (myocardial infarction). This can damage or destroy part of the heart muscle.
4. Heart failure - Chronic reduced blood flow to the heart muscle can weaken it over time, leading to heart failure, a condition in which the heart can't pump blood efficiently to meet the body's needs.
5. Arrhythmias - Reduced blood flow and damage to the heart muscle can lead to abnormal heart rhythms (arrhythmias), which can be life-threatening if not treated promptly.

Coronary artery disease is typically diagnosed through a combination of medical history, physical examination, and diagnostic tests such as electrocardiograms (ECGs), stress testing, cardiac catheterization, and imaging studies like coronary computed tomography angiography (CCTA). Treatment options for CAD include lifestyle modifications, medications, medical procedures, and surgery.

Myocardial ischemia is a condition in which the blood supply to the heart muscle (myocardium) is reduced or blocked, leading to insufficient oxygen delivery and potential damage to the heart tissue. This reduction in blood flow typically results from the buildup of fatty deposits, called plaques, in the coronary arteries that supply the heart with oxygen-rich blood. The plaques can rupture or become unstable, causing the formation of blood clots that obstruct the artery and limit blood flow.

Myocardial ischemia may manifest as chest pain (angina pectoris), shortness of breath, fatigue, or irregular heartbeats (arrhythmias). In severe cases, it can lead to myocardial infarction (heart attack) if the oxygen supply is significantly reduced or cut off completely, causing permanent damage or death of the heart muscle. Early diagnosis and treatment of myocardial ischemia are crucial for preventing further complications and improving patient outcomes.

Isosorbide dinitrate is a medication that belongs to a class of drugs called nitrates. It is primarily used in the prevention and treatment of angina pectoris, which is chest pain caused by reduced blood flow to the heart muscle.

The medical definition of Isosorbide dinitrate is:

A soluble nitrate ester used in the prevention and treatment of anginal attacks. It acts by dilating coronary and peripheral arteries and veins, thereby reducing cardiac workload and increasing oxygen delivery to the heart muscle. Its therapeutic effects are attributed to its conversion to nitric oxide, a potent vasodilator, in the body. Isosorbide dinitrate is available in various forms, including tablets, capsules, and oral solutions, and is typically taken 2-3 times daily for optimal effect.

Ergonovine is a medication that belongs to a class of drugs called ergot alkaloids. It is derived from the ergot fungus and is used in medical settings as a uterotonic agent, which means it causes the uterus to contract. Ergonovine is often used after childbirth to help the uterus return to its normal size and reduce bleeding.

Ergonovine works by binding to specific receptors in the smooth muscle of the uterus, causing it to contract. It has a potent effect on the uterus and can also cause vasoconstriction (narrowing of blood vessels) in other parts of the body. This is why ergonovine is sometimes used to treat severe bleeding caused by conditions such as uterine fibroids or ectopic pregnancy.

Like other ergot alkaloids, ergonovine can have serious side effects if not used carefully. It should be administered under the close supervision of a healthcare provider and should not be used in women with certain medical conditions, such as high blood pressure or heart disease. Ergonovine can also interact with other medications, so it's important to inform your healthcare provider of all medications you are taking before receiving this drug.

Coronary vessels refer to the network of blood vessels that supply oxygenated blood and nutrients to the heart muscle, also known as the myocardium. The two main coronary arteries are the left main coronary artery and the right coronary artery.

The left main coronary artery branches off into the left anterior descending artery (LAD) and the left circumflex artery (LCx). The LAD supplies blood to the front of the heart, while the LCx supplies blood to the side and back of the heart.

The right coronary artery supplies blood to the right lower part of the heart, including the right atrium and ventricle, as well as the back of the heart.

Coronary vessel disease (CVD) occurs when these vessels become narrowed or blocked due to the buildup of plaque, leading to reduced blood flow to the heart muscle. This can result in chest pain, shortness of breath, or a heart attack.

Amino alcohols are organic compounds containing both amine and hydroxyl (alcohol) functional groups. They have the general structure R-NH-OH, where R represents a carbon-containing group. Amino alcohols can be primary, secondary, or tertiary, depending on the number of alkyl or aryl groups attached to the nitrogen atom.

These compounds are important in many chemical and biological processes. For example, some amino alcohols serve as intermediates in the synthesis of pharmaceuticals, dyes, and polymers. In biochemistry, certain amino alcohols function as neurotransmitters or components of lipids.

Some common examples of amino alcohols include:

* Ethanolamine (monoethanolamine, MEA): a primary amino alcohol used in the production of detergents, emulsifiers, and pharmaceuticals
* Serinol: a primary amino alcohol that occurs naturally in some foods and is used as a flavoring agent
* Choline: a quaternary ammonium compound with a hydroxyl group, essential for human nutrition and found in various foods such as eggs, liver, and peanuts
* Trimethylamine (TMA): a tertiary amino alcohol that occurs naturally in some marine animals and is responsible for the "fishy" odor of their flesh.

Adrenergic beta-antagonists, also known as beta blockers, are a class of medications that block the effects of adrenaline and noradrenaline (also known as epinephrine and norepinephrine) on beta-adrenergic receptors. These receptors are found in various tissues throughout the body, including the heart, lungs, and blood vessels.

Beta blockers work by binding to these receptors and preventing the activation of certain signaling pathways that lead to increased heart rate, force of heart contractions, and relaxation of blood vessels. As a result, beta blockers can lower blood pressure, reduce heart rate, and decrease the workload on the heart.

Beta blockers are used to treat a variety of medical conditions, including hypertension (high blood pressure), angina (chest pain), heart failure, irregular heart rhythms, migraines, and certain anxiety disorders. Some common examples of beta blockers include metoprolol, atenolol, propranolol, and bisoprolol.

It is important to note that while beta blockers can have many benefits, they can also cause side effects such as fatigue, dizziness, and shortness of breath. Additionally, sudden discontinuation of beta blocker therapy can lead to rebound hypertension or worsening chest pain. Therefore, it is important to follow the dosing instructions provided by a healthcare provider carefully when taking these medications.

Follow-up studies are a type of longitudinal research that involve repeated observations or measurements of the same variables over a period of time, in order to understand their long-term effects or outcomes. In medical context, follow-up studies are often used to evaluate the safety and efficacy of medical treatments, interventions, or procedures.

In a typical follow-up study, a group of individuals (called a cohort) who have received a particular treatment or intervention are identified and then followed over time through periodic assessments or data collection. The data collected may include information on clinical outcomes, adverse events, changes in symptoms or functional status, and other relevant measures.

The results of follow-up studies can provide important insights into the long-term benefits and risks of medical interventions, as well as help to identify factors that may influence treatment effectiveness or patient outcomes. However, it is important to note that follow-up studies can be subject to various biases and limitations, such as loss to follow-up, recall bias, and changes in clinical practice over time, which must be carefully considered when interpreting the results.

Prospective studies, also known as longitudinal studies, are a type of cohort study in which data is collected forward in time, following a group of individuals who share a common characteristic or exposure over a period of time. The researchers clearly define the study population and exposure of interest at the beginning of the study and follow up with the participants to determine the outcomes that develop over time. This type of study design allows for the investigation of causal relationships between exposures and outcomes, as well as the identification of risk factors and the estimation of disease incidence rates. Prospective studies are particularly useful in epidemiology and medical research when studying diseases with long latency periods or rare outcomes.

Coronary balloon angioplasty is a minimally invasive medical procedure used to widen narrowed or obstructed coronary arteries (the blood vessels that supply oxygen-rich blood to the heart muscle) and improve blood flow to the heart. This procedure is typically performed in conjunction with the insertion of a stent, a small mesh tube that helps keep the artery open.

During coronary balloon angioplasty, a thin, flexible catheter with a deflated balloon at its tip is inserted into a blood vessel, usually through a small incision in the groin or arm. The catheter is then guided to the narrowed or obstructed section of the coronary artery. Once in position, the balloon is inflated to compress the plaque against the artery wall and widen the lumen (the inner space) of the artery. This helps restore blood flow to the heart muscle.

The procedure is typically performed under local anesthesia and conscious sedation to minimize discomfort. Coronary balloon angioplasty is a relatively safe and effective treatment for many people with coronary artery disease, although complications such as bleeding, infection, or re-narrowing of the artery (restenosis) can occur in some cases.

Chest pain is a discomfort or pain that you feel in the chest area. The pain can be sharp, dull, burning, crushing, heaviness, or tightness. It may be accompanied by other symptoms such as shortness of breath, sweating, nausea, dizziness, or pain that radiates to the arm, neck, jaw, or back.

Chest pain can have many possible causes, including heart-related conditions such as angina or a heart attack, lung conditions such as pneumonia or pleurisy, gastrointestinal problems such as acid reflux or gastritis, musculoskeletal issues such as costochondritis or muscle strain, and anxiety or panic attacks.

It is important to seek immediate medical attention if you experience chest pain that is severe, persistent, or accompanied by other concerning symptoms, as it may be a sign of a serious medical condition. A healthcare professional can evaluate your symptoms, perform tests, and provide appropriate treatment.

Nifedipine is an antihypertensive and calcium channel blocker medication. It works by relaxing the muscles of the blood vessels, which helps to lower blood pressure and improve the supply of oxygen and nutrients to the heart. Nifedipine is used to treat high blood pressure (hypertension), angina (chest pain), and certain types of heart rhythm disorders.

In medical terms, nifedipine can be defined as: "A dihydropyridine calcium channel blocker that is used in the treatment of hypertension, angina pectoris, and Raynaud's phenomenon. It works by inhibiting the influx of calcium ions into vascular smooth muscle and cardiac muscle, which results in relaxation of the vascular smooth muscle and decreased workload on the heart."

Physical exertion is defined as the act of applying energy to physically demandable activities or tasks, which results in various body systems working together to produce movement and maintain homeostasis. It often leads to an increase in heart rate, respiratory rate, and body temperature, among other physiological responses. The level of physical exertion can vary based on the intensity, duration, and frequency of the activity.

It's important to note that engaging in regular physical exertion has numerous health benefits, such as improving cardiovascular fitness, strengthening muscles and bones, reducing stress, and preventing chronic diseases like obesity, diabetes, and heart disease. However, it is also crucial to balance physical exertion with adequate rest and recovery time to avoid overtraining or injury.

Metoprolol is a type of medication known as a beta blocker. According to the US National Library of Medicine's MedlinePlus, metoprolol is used to treat high blood pressure, angina (chest pain), and heart conditions that may occur after a heart attack. It works by blocking the action of certain natural chemicals in your body, such as epinephrine, on the heart and blood vessels. This helps to reduce the heart's workload, lower its blood pressure, and regulate its rhythm.

Metoprolol is available under various brand names, including Lopressor and Toprol-XL. It can be taken orally as a tablet or an extended-release capsule. As with any medication, metoprolol should be used under the supervision of a healthcare provider, who can monitor its effectiveness and potential side effects.

It is important to note that this definition is intended to provide a general overview of the medical use of metoprolol and should not be considered a substitute for professional medical advice.

Medical Definition:

"Risk factors" are any attribute, characteristic or exposure of an individual that increases the likelihood of developing a disease or injury. They can be divided into modifiable and non-modifiable risk factors. Modifiable risk factors are those that can be changed through lifestyle choices or medical treatment, while non-modifiable risk factors are inherent traits such as age, gender, or genetic predisposition. Examples of modifiable risk factors include smoking, alcohol consumption, physical inactivity, and unhealthy diet, while non-modifiable risk factors include age, sex, and family history. It is important to note that having a risk factor does not guarantee that a person will develop the disease, but rather indicates an increased susceptibility.

Atherectomy, coronary, is a medical procedure used to treat narrowed or blocked coronary arteries due to the buildup of plaque (atherosclerosis). The goal of coronary atherectomy is to improve blood flow to the heart muscle by removing the obstructive material within the vessel.

During the procedure, a specialized catheter with a cutting device on its tip is inserted into a peripheral artery, usually in the groin or arm, and advanced to the affected coronary artery. The cutting device can be a rotating blade, a high-speed spinning burr, or a laser fiber that is used to shave, drill, or vaporize the plaque, respectively. The removed material is collected in a chamber within the catheter or washed away by blood flow.

There are different types of coronary atherectomy devices, including:

1. Directional atherectomy (DCA): A rotating blade cuts and removes the plaque in a targeted direction.
2. Rotational atherectomy (Rotablator): A high-speed spinning burr is used to abrade and pulverize the plaque into tiny particles that can be safely carried away by blood flow.
3. Laser atherectomy: A laser fiber is used to vaporize or break down the plaque into gaseous or small particle form.

Coronary atherectomy is typically performed in conjunction with angioplasty and stenting, as it helps prepare the narrowed artery for these procedures by creating a larger lumen and reducing the risk of complications like dissections or restenosis (re-narrowing). However, its use may be limited to specific cases due to the potential risks, such as vessel trauma, distal embolization, or perforation.

It is essential to consult with a medical professional for detailed information and personalized treatment recommendations regarding coronary atherectomy.

Propranolol is a medication that belongs to a class of drugs called beta blockers. Medically, it is defined as a non-selective beta blocker, which means it blocks the effects of both epinephrine (adrenaline) and norepinephrine (noradrenaline) on the heart and other organs. These effects include reducing heart rate, contractility, and conduction velocity, leading to decreased oxygen demand by the myocardium. Propranolol is used in the management of various conditions such as hypertension, angina pectoris, arrhythmias, essential tremor, anxiety disorders, and infants with congenital heart defects. It may also be used to prevent migraines and reduce the risk of future heart attacks. As with any medication, it should be taken under the supervision of a healthcare provider due to potential side effects and contraindications.

Acetanilides are a group of chemical compounds that consist of an acetic acid molecule (CH3COO-) linked to aniline (C6H5NH2) through an amide bond (-CONH-). The most well-known member of this class is acetanilide itself (N-phenylacetamide, C8H9NO), which has been used historically as a pain reliever and fever reducer. However, its use in medicine has largely been abandoned due to the discovery of serious side effects, including the potential for causing methemoglobinemia, a condition that can lead to tissue hypoxia and even death.

Acetanilides have also been used as intermediates in the synthesis of other chemical compounds, such as dyes and pharmaceuticals. Some derivatives of acetanilide continue to be used in medicine today, including certain antipyretic and analgesic agents. However, these drugs are carefully designed and tested to minimize the risk of adverse effects associated with acetanilide itself.

Myocardial revascularization is a medical term that refers to the restoration of blood flow to the heart muscle (myocardium), typically through a surgical or interventional procedure. This is often performed in patients with coronary artery disease, where the buildup of plaque in the coronary arteries restricts blood flow to the heart muscle, causing symptoms such as chest pain (angina) or shortness of breath, and increasing the risk of a heart attack (myocardial infarction).

There are two main types of myocardial revascularization:

1. Coronary artery bypass grafting (CABG): This is a surgical procedure in which a healthy blood vessel from another part of the body is used to create a detour around the blocked or narrowed coronary artery, allowing blood to flow more freely to the heart muscle.
2. Percutaneous coronary intervention (PCI), also known as angioplasty and stenting: This is a minimally invasive procedure in which a thin catheter is inserted into an artery in the groin or arm and threaded up to the blocked or narrowed coronary artery. A balloon is then inflated to widen the artery, and a stent may be placed to keep it open.

Both procedures aim to improve symptoms, reduce the risk of heart attack, and prolong survival in appropriately selected patients with coronary artery disease.

The double-blind method is a study design commonly used in research, including clinical trials, to minimize bias and ensure the objectivity of results. In this approach, both the participants and the researchers are unaware of which group the participants are assigned to, whether it be the experimental group or the control group. This means that neither the participants nor the researchers know who is receiving a particular treatment or placebo, thus reducing the potential for bias in the evaluation of outcomes. The assignment of participants to groups is typically done by a third party not involved in the study, and the codes are only revealed after all data have been collected and analyzed.

Cineangiography is a medical imaging technique used to visualize the blood flow in the heart and cardiovascular system. It involves the injection of a contrast agent into the bloodstream while X-ray images are taken in quick succession, creating a movie-like sequence that shows the movement of the contrast through the blood vessels and chambers of the heart. This technique is often used to diagnose and evaluate various heart conditions, such as coronary artery disease, valvular heart disease, and congenital heart defects.

The procedure typically involves threading a catheter through a blood vessel in the arm or leg and guiding it to the heart. Once in place, the contrast agent is injected, and X-ray images are taken using a specialized X-ray machine called a fluoroscope. The images captured during cineangiography can help doctors identify areas of narrowing or blockage in the coronary arteries, abnormalities in heart valves, and other cardiovascular problems.

Cineangiography is an invasive procedure that carries some risks, such as bleeding, infection, and reactions to the contrast agent. However, it can provide valuable information for diagnosing and treating heart conditions, and may be recommended when other diagnostic tests have been inconclusive.

Pracitolol is not a medical condition, it's a medication. Practolol is a beta blocker drug that is primarily used to treat various cardiovascular conditions such as hypertension (high blood pressure), angina (chest pain due to reduced blood flow to the heart), and certain types of arrhythmias (irregular heart rhythms).

Beta blockers like practolol work by blocking the effects of certain hormones, such as adrenaline, on the heart and blood vessels. This helps to reduce the heart rate, lower blood pressure, and decrease the force of heart contractions, which can improve overall cardiovascular function and reduce the risk of heart-related complications.

It's important to note that practolol is not commonly used in clinical practice due to its association with a rare but serious side effect known as the "practolol syndrome." This condition can cause various symptoms such as dry eyes, skin rashes, and abnormalities of the thyroid gland. As a result, other beta blockers are generally preferred over practolol for the treatment of cardiovascular conditions.

Acute Coronary Syndrome (ACS) is a term used to describe a range of conditions associated with sudden, reduced blood flow to the heart muscle. This reduction in blood flow, commonly caused by blood clots forming in coronary arteries, can lead to damage or death of the heart muscle and is often characterized by symptoms such as chest pain, shortness of breath, and fatigue.

There are three main types of ACS:

1. Unstable Angina: This occurs when there is reduced blood flow to the heart muscle, causing chest pain or discomfort, but the heart muscle is not damaged. It can be a warning sign for a possible future heart attack.
2. Non-ST Segment Elevation Myocardial Infarction (NSTEMI): This type of heart attack occurs when there is reduced blood flow to the heart muscle, causing damage or death of some of the muscle cells. However, the electrical activity of the heart remains relatively normal.
3. ST Segment Elevation Myocardial Infarction (STEMI): This is a serious and life-threatening type of heart attack that occurs when there is a complete blockage in one or more of the coronary arteries, causing extensive damage to the heart muscle. The electrical activity of the heart is significantly altered, which can lead to dangerous heart rhythms and even cardiac arrest.

Immediate medical attention is required for anyone experiencing symptoms of ACS, as prompt treatment can help prevent further damage to the heart muscle and reduce the risk of complications or death. Treatment options may include medications, lifestyle changes, and procedures such as angioplasty or bypass surgery.

Heart rate is the number of heartbeats per unit of time, often expressed as beats per minute (bpm). It can vary significantly depending on factors such as age, physical fitness, emotions, and overall health status. A resting heart rate between 60-100 bpm is generally considered normal for adults, but athletes and individuals with high levels of physical fitness may have a resting heart rate below 60 bpm due to their enhanced cardiovascular efficiency. Monitoring heart rate can provide valuable insights into an individual's health status, exercise intensity, and response to various treatments or interventions.

Angiocardiography is a medical procedure used to examine the heart and blood vessels, particularly the chambers of the heart and the valves between them. It involves injecting a contrast agent into the bloodstream and taking X-ray images as the agent flows through the heart. This allows doctors to visualize any abnormalities such as blockages, narrowing, or leakage in the heart valves or blood vessels.

There are different types of angiocardiography, including:

* Left heart catheterization (LHC): A thin tube called a catheter is inserted into a vein in the arm or groin and threaded through to the left side of the heart to measure pressure and oxygen levels.
* Right heart catheterization (RHC): Similar to LHC, but the catheter is threaded through to the right side of the heart to measure pressure and oxygen levels there.
* Selective angiocardiography: A catheter is used to inject the contrast agent into specific blood vessels or chambers of the heart to get a more detailed view.

Angiocardiography can help diagnose and evaluate various heart conditions, including congenital heart defects, coronary artery disease, cardiomyopathy, and valvular heart disease. It is an invasive procedure that carries some risks, such as bleeding, infection, and damage to blood vessels or heart tissue. However, it can provide valuable information for diagnosing and treating heart conditions.

Oxprenolol is a non-selective beta blocker and partial agonist of beta-adrenergic receptors. It works by blocking the effects of certain chemicals on the heart and blood vessels, which can help to reduce heart rate, blood pressure, and strain on the heart. Oxprenolol is used to treat angina (chest pain), high blood pressure, irregular heartbeats, and tremors. It may also be used for other purposes not listed here.

It's important to note that oxprenolol should only be taken under the supervision of a medical professional, as it can have significant interactions with other medications and medical conditions. Additionally, sudden discontinuation of oxprenolol should be avoided, as it can lead to rebound effects such as increased heart rate and blood pressure.

Coronary artery bypass surgery, also known as coronary artery bypass grafting (CABG), is a surgical procedure used to improve blood flow to the heart in patients with severe coronary artery disease. This condition occurs when the coronary arteries, which supply oxygen-rich blood to the heart muscle, become narrowed or blocked due to the buildup of fatty deposits, called plaques.

During CABG surgery, a healthy blood vessel from another part of the body is grafted, or attached, to the coronary artery, creating a new pathway for oxygen-rich blood to flow around the blocked or narrowed portion of the artery and reach the heart muscle. This bypass helps to restore normal blood flow and reduce the risk of angina (chest pain), shortness of breath, and other symptoms associated with coronary artery disease.

There are different types of CABG surgery, including traditional on-pump CABG, off-pump CABG, and minimally invasive CABG. The choice of procedure depends on various factors, such as the patient's overall health, the number and location of blocked arteries, and the presence of other medical conditions.

It is important to note that while CABG surgery can significantly improve symptoms and quality of life in patients with severe coronary artery disease, it does not cure the underlying condition. Lifestyle modifications, such as regular exercise, a healthy diet, smoking cessation, and medication therapy, are essential for long-term management and prevention of further progression of the disease.

Phonocardiography is a non-invasive medical procedure that involves the graphical representation and analysis of sounds produced by the heart. It uses a device called a phonocardiograph to record these sounds, which are then displayed as waveforms on a screen. The procedure is often used in conjunction with other diagnostic techniques, such as electrocardiography (ECG), to help diagnose various heart conditions, including valvular heart disease and heart murmurs.

During the procedure, a specialized microphone called a phonendoscope is placed on the chest wall over the area of the heart. The microphone picks up the sounds generated by the heart's movements, such as the closing and opening of the heart valves, and transmits them to the phonocardiograph. The phonocardiograph then converts these sounds into a visual representation, which can be analyzed for any abnormalities or irregularities in the heart's function.

Phonocardiography is a valuable tool for healthcare professionals, as it can provide important insights into the health and functioning of the heart. By analyzing the waveforms produced during phonocardiography, doctors can identify any potential issues with the heart's valves or other structures, which may require further investigation or treatment. Overall, phonocardiography is an essential component of modern cardiac diagnostics, helping to ensure that patients receive accurate and timely diagnoses for their heart conditions.

Coronary circulation refers to the circulation of blood in the coronary vessels, which supply oxygenated blood to the heart muscle (myocardium) and drain deoxygenated blood from it. The coronary circulation system includes two main coronary arteries - the left main coronary artery and the right coronary artery - that branch off from the aorta just above the aortic valve. These arteries further divide into smaller branches, which supply blood to different regions of the heart muscle.

The left main coronary artery divides into two branches: the left anterior descending (LAD) artery and the left circumflex (LCx) artery. The LAD supplies blood to the front and sides of the heart, while the LCx supplies blood to the back and sides of the heart. The right coronary artery supplies blood to the lower part of the heart, including the right ventricle and the bottom portion of the left ventricle.

The veins that drain the heart muscle include the great cardiac vein, the middle cardiac vein, and the small cardiac vein, which merge to form the coronary sinus. The coronary sinus empties into the right atrium, allowing deoxygenated blood to enter the right side of the heart and be pumped to the lungs for oxygenation.

Coronary circulation is essential for maintaining the health and function of the heart muscle, as it provides the necessary oxygen and nutrients required for proper contraction and relaxation of the myocardium. Any disruption or blockage in the coronary circulation system can lead to serious consequences, such as angina, heart attack, or even death.

Treatment outcome is a term used to describe the result or effect of medical treatment on a patient's health status. It can be measured in various ways, such as through symptoms improvement, disease remission, reduced disability, improved quality of life, or survival rates. The treatment outcome helps healthcare providers evaluate the effectiveness of a particular treatment plan and make informed decisions about future care. It is also used in clinical research to compare the efficacy of different treatments and improve patient care.

Nicorandil is a medication that belongs to a class of drugs known as potassium channel activators. It works by relaxing and widening blood vessels, which improves blood flow and reduces the workload on the heart. Nicorandil is primarily used to treat chronic stable angina, a type of chest pain caused by reduced blood flow to the heart muscle.

The medical definition of Nicorandil can be described as:

A synthetic derivative of nicotinamide with vasodilatory properties, acting as an opener of ATP-sensitive potassium channels in vascular smooth muscle and cardiomyocytes. It is used in the management of chronic stable angina, providing both antianginal and antiischemic effects through a dual mechanism that includes coronary and peripheral vasodilation. By reducing afterload and preload, Nicorandil decreases myocardial oxygen demand while increasing supply, leading to improved exercise tolerance and reduced frequency of anginal episodes.

Ambulatory electrocardiography, also known as ambulatory ECG or Holter monitoring, is a non-invasive method of recording the electrical activity of the heart over an extended period of time (typically 24 hours or more) while the patient goes about their daily activities. The device used to record the ECG is called a Holter monitor, which consists of a small, portable recorder that is attached to the patient's chest with electrodes.

The recorded data provides information on any abnormalities in the heart's rhythm or electrical activity during different stages of activity and rest, allowing healthcare providers to diagnose and evaluate various cardiac conditions such as arrhythmias, ischemia, and infarction. The ability to monitor the heart's activity over an extended period while the patient performs their normal activities provides valuable information that may not be captured during a standard ECG, which only records the heart's electrical activity for a few seconds.

In summary, ambulatory electrocardiography is a diagnostic tool used to evaluate the electrical activity of the heart over an extended period, allowing healthcare providers to diagnose and manage various cardiac conditions.

A biological marker, often referred to as a biomarker, is a measurable indicator that reflects the presence or severity of a disease state, or a response to a therapeutic intervention. Biomarkers can be found in various materials such as blood, tissues, or bodily fluids, and they can take many forms, including molecular, histologic, radiographic, or physiological measurements.

In the context of medical research and clinical practice, biomarkers are used for a variety of purposes, such as:

1. Diagnosis: Biomarkers can help diagnose a disease by indicating the presence or absence of a particular condition. For example, prostate-specific antigen (PSA) is a biomarker used to detect prostate cancer.
2. Monitoring: Biomarkers can be used to monitor the progression or regression of a disease over time. For instance, hemoglobin A1c (HbA1c) levels are monitored in diabetes patients to assess long-term blood glucose control.
3. Predicting: Biomarkers can help predict the likelihood of developing a particular disease or the risk of a negative outcome. For example, the presence of certain genetic mutations can indicate an increased risk for breast cancer.
4. Response to treatment: Biomarkers can be used to evaluate the effectiveness of a specific treatment by measuring changes in the biomarker levels before and after the intervention. This is particularly useful in personalized medicine, where treatments are tailored to individual patients based on their unique biomarker profiles.

It's important to note that for a biomarker to be considered clinically valid and useful, it must undergo rigorous validation through well-designed studies, including demonstrating sensitivity, specificity, reproducibility, and clinical relevance.

Prognosis is a medical term that refers to the prediction of the likely outcome or course of a disease, including the chances of recovery or recurrence, based on the patient's symptoms, medical history, physical examination, and diagnostic tests. It is an important aspect of clinical decision-making and patient communication, as it helps doctors and patients make informed decisions about treatment options, set realistic expectations, and plan for future care.

Prognosis can be expressed in various ways, such as percentages, categories (e.g., good, fair, poor), or survival rates, depending on the nature of the disease and the available evidence. However, it is important to note that prognosis is not an exact science and may vary depending on individual factors, such as age, overall health status, and response to treatment. Therefore, it should be used as a guide rather than a definitive forecast.

Clinical trials are research studies that involve human participants and are designed to evaluate the safety and efficacy of new medical treatments, drugs, devices, or behavioral interventions. The purpose of clinical trials is to determine whether a new intervention is safe, effective, and beneficial for patients, as well as to compare it with currently available treatments. Clinical trials follow a series of phases, each with specific goals and criteria, before a new intervention can be approved by regulatory authorities for widespread use.

Clinical trials are conducted according to a protocol, which is a detailed plan that outlines the study's objectives, design, methodology, statistical analysis, and ethical considerations. The protocol is developed and reviewed by a team of medical experts, statisticians, and ethicists, and it must be approved by an institutional review board (IRB) before the trial can begin.

Participation in clinical trials is voluntary, and participants must provide informed consent before enrolling in the study. Informed consent involves providing potential participants with detailed information about the study's purpose, procedures, risks, benefits, and alternatives, as well as their rights as research subjects. Participants can withdraw from the study at any time without penalty or loss of benefits to which they are entitled.

Clinical trials are essential for advancing medical knowledge and improving patient care. They help researchers identify new treatments, diagnostic tools, and prevention strategies that can benefit patients and improve public health. However, clinical trials also pose potential risks to participants, including adverse effects from experimental interventions, time commitment, and inconvenience. Therefore, it is important for researchers to carefully design and conduct clinical trials to minimize risks and ensure that the benefits outweigh the risks.

Sympatholytics are a class of drugs that block the action of the sympathetic nervous system, which is the part of the autonomic nervous system responsible for preparing the body for the "fight or flight" response. Sympatholytics achieve this effect by binding to and blocking alpha-adrenergic receptors or beta-adrenergic receptors located in various organs throughout the body, including the heart, blood vessels, lungs, gastrointestinal tract, and urinary system.

Examples of sympatholytic drugs include:

* Alpha blockers (e.g., prazosin, doxazosin)
* Beta blockers (e.g., propranolol, metoprolol)
* Centrally acting sympatholytics (e.g., clonidine, methyldopa)

Sympatholytics are used to treat a variety of medical conditions, including hypertension, angina, heart failure, arrhythmias, and certain neurological disorders. They may also be used to manage symptoms associated with anxiety or withdrawal from alcohol or other substances.

Vasodilator agents are pharmacological substances that cause the relaxation or widening of blood vessels by relaxing the smooth muscle in the vessel walls. This results in an increase in the diameter of the blood vessels, which decreases vascular resistance and ultimately reduces blood pressure. Vasodilators can be further classified based on their site of action:

1. Systemic vasodilators: These agents cause a generalized relaxation of the smooth muscle in the walls of both arteries and veins, resulting in a decrease in peripheral vascular resistance and preload (the volume of blood returning to the heart). Examples include nitroglycerin, hydralazine, and calcium channel blockers.
2. Arterial vasodilators: These agents primarily affect the smooth muscle in arterial vessel walls, leading to a reduction in afterload (the pressure against which the heart pumps blood). Examples include angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and direct vasodilators like sodium nitroprusside.
3. Venous vasodilators: These agents primarily affect the smooth muscle in venous vessel walls, increasing venous capacitance and reducing preload. Examples include nitroglycerin and other organic nitrates.

Vasodilator agents are used to treat various cardiovascular conditions such as hypertension, heart failure, angina, and pulmonary arterial hypertension. It is essential to monitor their use carefully, as excessive vasodilation can lead to orthostatic hypotension, reflex tachycardia, or fluid retention.

Atherosclerotic plaque is a deposit of fatty (cholesterol and fat) substances, calcium, and other substances in the inner lining of an artery. This plaque buildup causes the artery to narrow and harden, reducing blood flow through the artery, which can lead to serious cardiovascular conditions such as coronary artery disease, angina, heart attack, or stroke. The process of atherosclerosis develops gradually over decades and can start in childhood.

Ludwig's angina is a severe cellulitis (a bacterial infection of the connective tissues) of the floor of the mouth, below the tongue, and around the neck area. It's named after Wilhelm Friedrich von Ludwig, who first described it in 1836. The condition can lead to airway obstruction and significant swelling in the neck, making swallowing difficult or impossible. If not treated promptly with antibiotics and sometimes surgical drainage, it can be life-threatening due to the potential for spread of infection to the brain or other critical areas. It's typically caused by mixed oral flora, often including Streptococcus species, Staphylococcus aureus, and anaerobes.

Propionophenones are a group of chemical compounds that contain a propanone (or methyl ketone) substituent and a phenyl group. In medical terms, some propionophenones have been used as pharmaceuticals, such as the antipsychotic drug perphenazine. However, it's important to note that not all propionophenones have medicinal uses, and some may even be harmful or toxic. Therefore, specific propionophenones should be evaluated on a case-by-case basis for their medical relevance or potential hazards.

Atenolol is a beta-blocker medication that is primarily used to treat hypertension (high blood pressure), angina (chest pain), and certain types of heart rhythm disorders. It works by blocking the action of certain hormones in the body, such as adrenaline, on the heart and blood vessels. This helps to reduce the heart's workload, lower its rate and force of contractions, and improve blood flow.

Beta-blockers like atenolol are also sometimes used to prevent migraines or to treat symptoms of anxiety, such as rapid heartbeat or tremors. Atenolol is available in immediate-release and extended-release forms, and it is typically taken orally once or twice a day. As with any medication, atenolol can have side effects, including dizziness, fatigue, and gastrointestinal symptoms, and it may interact with other medications or medical conditions. It is important to use atenolol only under the supervision of a healthcare provider.

Calcium channel blockers (CCBs) are a class of medications that work by inhibiting the influx of calcium ions into cardiac and smooth muscle cells. This action leads to relaxation of the muscles, particularly in the blood vessels, resulting in decreased peripheral resistance and reduced blood pressure. Calcium channel blockers also have anti-arrhythmic effects and are used in the management of various cardiovascular conditions such as hypertension, angina, and certain types of arrhythmias.

Calcium channel blockers can be further classified into two main categories based on their chemical structure: dihydropyridines (e.g., nifedipine, amlodipine) and non-dihydropyridines (e.g., verapamil, diltiazem). Dihydropyridines are more selective for vascular smooth muscle and have a greater effect on blood pressure than heart rate or conduction. Non-dihydropyridines have a more significant impact on cardiac conduction and contractility, in addition to their vasodilatory effects.

It is important to note that calcium channel blockers may interact with other medications and should be used under the guidance of a healthcare professional. Potential side effects include dizziness, headache, constipation, and peripheral edema.

Verapamil is a calcium channel blocker medication that is primarily used to treat hypertension (high blood pressure), angina (chest pain), and certain types of cardiac arrhythmias (irregular heart rhyats). It works by relaxing the smooth muscle cells in the walls of blood vessels, which causes them to dilate or widen, reducing the resistance to blood flow and thereby lowering blood pressure. Verapamil also slows down the conduction of electrical signals within the heart, which can help to regulate the heart rate and rhythm.

In addition to its cardiovascular effects, verapamil is sometimes used off-label for the treatment of other conditions such as migraine headaches, Raynaud's phenomenon, and certain types of tremors. It is available in various forms, including immediate-release tablets, extended-release capsules, and intravenous (IV) injection.

It is important to note that verapamil can interact with other medications, so it is essential to inform your healthcare provider about all the drugs you are taking before starting this medication. Additionally, verapamil should be used with caution in people with certain medical conditions, such as heart failure, liver disease, and low blood pressure.

Interventional ultrasonography is a medical procedure that involves the use of real-time ultrasound imaging to guide minimally invasive diagnostic and therapeutic interventions. This technique combines the advantages of ultrasound, such as its non-ionizing nature (no radiation exposure), relatively low cost, and portability, with the ability to perform precise and targeted procedures.

In interventional ultrasonography, a specialized physician called an interventional radiologist or an interventional sonographer uses high-frequency sound waves to create detailed images of internal organs and tissues. These images help guide the placement of needles, catheters, or other instruments used during the procedure. Common interventions include biopsies (tissue sampling), fluid drainage, tumor ablation, and targeted drug delivery.

The real-time visualization provided by ultrasonography allows for increased accuracy and safety during these procedures, minimizing complications and reducing recovery time compared to traditional surgical approaches. Additionally, interventional ultrasonography can be performed on an outpatient basis, further contributing to its appeal as a less invasive alternative in many clinical scenarios.

In the field of medicine, "time factors" refer to the duration of symptoms or time elapsed since the onset of a medical condition, which can have significant implications for diagnosis and treatment. Understanding time factors is crucial in determining the progression of a disease, evaluating the effectiveness of treatments, and making critical decisions regarding patient care.

For example, in stroke management, "time is brain," meaning that rapid intervention within a specific time frame (usually within 4.5 hours) is essential to administering tissue plasminogen activator (tPA), a clot-busting drug that can minimize brain damage and improve patient outcomes. Similarly, in trauma care, the "golden hour" concept emphasizes the importance of providing definitive care within the first 60 minutes after injury to increase survival rates and reduce morbidity.

Time factors also play a role in monitoring the progression of chronic conditions like diabetes or heart disease, where regular follow-ups and assessments help determine appropriate treatment adjustments and prevent complications. In infectious diseases, time factors are crucial for initiating antibiotic therapy and identifying potential outbreaks to control their spread.

Overall, "time factors" encompass the significance of recognizing and acting promptly in various medical scenarios to optimize patient outcomes and provide effective care.

Blood pressure is the force exerted by circulating blood on the walls of the blood vessels. It is measured in millimeters of mercury (mmHg) and is given as two figures:

1. Systolic pressure: This is the pressure when the heart pushes blood out into the arteries.
2. Diastolic pressure: This is the pressure when the heart rests between beats, allowing it to fill with blood.

Normal blood pressure for adults is typically around 120/80 mmHg, although this can vary slightly depending on age, sex, and other factors. High blood pressure (hypertension) is generally considered to be a reading of 130/80 mmHg or higher, while low blood pressure (hypotension) is usually defined as a reading below 90/60 mmHg. It's important to note that blood pressure can fluctuate throughout the day and may be affected by factors such as stress, physical activity, and medication use.

Coronary stenosis is a medical condition that refers to the narrowing of the coronary arteries, which supply oxygen-rich blood to the heart muscle. This narrowing is typically caused by the buildup of plaque, made up of fat, cholesterol, and other substances, on the inner walls of the arteries. Over time, as the plaque hardens and calcifies, it can cause the artery to become narrowed or blocked, reducing blood flow to the heart muscle.

Coronary stenosis can lead to various symptoms and complications, including chest pain (angina), shortness of breath, irregular heart rhythms (arrhythmias), and heart attacks. Treatment options for coronary stenosis may include lifestyle changes, medications, medical procedures such as angioplasty or bypass surgery, or a combination of these approaches. Regular check-ups and diagnostic tests, such as stress testing or coronary angiography, can help detect and monitor coronary stenosis over time.

C-reactive protein (CRP) is a protein produced by the liver in response to inflammation or infection in the body. It is named after its ability to bind to the C-polysaccharide of pneumococcus, a type of bacteria. CRP levels can be measured with a simple blood test and are often used as a marker of inflammation or infection. Elevated CRP levels may indicate a variety of conditions, including infections, tissue damage, and chronic diseases such as rheumatoid arthritis and cancer. However, it is important to note that CRP is not specific to any particular condition, so additional tests are usually needed to make a definitive diagnosis.

Spinal cord stimulation (SCS) is a medical procedure that involves the use of an implanted device to deliver electrical pulses to the spinal cord. The pulses are intended to interrupt or mask the transmission of pain signals to the brain, thereby reducing the perception of pain. SCS is typically offered as a treatment option for patients with chronic pain who have not found relief from other therapies, such as medication or surgery.

During the procedure, electrodes are placed in the epidural space of the spinal cord, and connected to a pulse generator that is implanted under the skin, usually in the abdomen or buttocks. The patient can use a remote control to adjust the intensity and location of the stimulation, allowing them to customize the therapy to their individual pain patterns.

SCS is generally considered safe, although there are some risks associated with the procedure, such as infection, bleeding, and nerve damage. It is important for patients to discuss these risks with their healthcare provider before deciding whether to undergo SCS.

A placebo is a substance or treatment that has no inherent therapeutic effect. It is often used in clinical trials as a control against which the effects of a new drug or therapy can be compared. Placebos are typically made to resemble the active treatment, such as a sugar pill for a medication trial, so that participants cannot tell the difference between what they are receiving and the actual treatment.

The placebo effect refers to the phenomenon where patients experience real improvements in their symptoms or conditions even when given a placebo. This may be due to psychological factors such as belief in the effectiveness of the treatment, suggestion, or conditioning. The placebo effect is often used as a comparison group in clinical trials to help determine if the active treatment has a greater effect than no treatment at all.

Propanolamines are a class of pharmaceutical compounds that contain a propan-2-olamine functional group, which is a secondary amine formed by the replacement of one hydrogen atom in an ammonia molecule with a propan-2-ol group. They are commonly used as decongestants and bronchodilators in medical treatments.

Examples of propanolamines include:

* Phenylephrine: a decongestant used to relieve nasal congestion.
* Pseudoephedrine: a decongestant and stimulant used to treat nasal congestion and sinus pressure.
* Ephedrine: a bronchodilator, decongestant, and stimulant used to treat asthma, nasal congestion, and low blood pressure.

It is important to note that propanolamines can have side effects such as increased heart rate, elevated blood pressure, and insomnia, so they should be used with caution and under the supervision of a healthcare professional.

Cardiovascular agents are a class of medications that are used to treat various conditions related to the cardiovascular system, which includes the heart and blood vessels. These agents can be further divided into several subcategories based on their specific mechanisms of action and therapeutic effects. Here are some examples:

1. Antiarrhythmics: These drugs are used to treat abnormal heart rhythms or arrhythmias. They work by stabilizing the electrical activity of the heart and preventing irregular impulses from spreading through the heart muscle.
2. Antihypertensives: These medications are used to lower high blood pressure, also known as hypertension. There are several classes of antihypertensive drugs, including diuretics, beta-blockers, calcium channel blockers, and angiotensin-converting enzyme (ACE) inhibitors.
3. Anticoagulants: These drugs are used to prevent blood clots from forming or growing larger. They work by interfering with the coagulation cascade, which is a series of chemical reactions that lead to the formation of a blood clot.
4. Antiplatelet agents: These medications are used to prevent platelets in the blood from sticking together and forming clots. They work by inhibiting the aggregation of platelets, which are small cells in the blood that help form clots.
5. Lipid-lowering agents: These drugs are used to lower cholesterol and other fats in the blood. They work by reducing the production or absorption of cholesterol in the body or increasing the removal of cholesterol from the bloodstream. Examples include statins, bile acid sequestrants, and PCSK9 inhibitors.
6. Vasodilators: These medications are used to widen blood vessels and improve blood flow. They work by relaxing the smooth muscle in the walls of blood vessels, causing them to dilate or widen. Examples include nitrates, calcium channel blockers, and ACE inhibitors.
7. Inotropes: These drugs are used to increase the force of heart contractions. They work by increasing the sensitivity of heart muscle cells to calcium ions, which are necessary for muscle contraction.

These are just a few examples of cardiovascular medications that are used to treat various conditions related to the heart and blood vessels. It is important to note that these medications can have side effects and should be taken under the guidance of a healthcare provider.

The Predictive Value of Tests, specifically the Positive Predictive Value (PPV) and Negative Predictive Value (NPV), are measures used in diagnostic tests to determine the probability that a positive or negative test result is correct.

Positive Predictive Value (PPV) is the proportion of patients with a positive test result who actually have the disease. It is calculated as the number of true positives divided by the total number of positive results (true positives + false positives). A higher PPV indicates that a positive test result is more likely to be a true positive, and therefore the disease is more likely to be present.

Negative Predictive Value (NPV) is the proportion of patients with a negative test result who do not have the disease. It is calculated as the number of true negatives divided by the total number of negative results (true negatives + false negatives). A higher NPV indicates that a negative test result is more likely to be a true negative, and therefore the disease is less likely to be present.

The predictive value of tests depends on the prevalence of the disease in the population being tested, as well as the sensitivity and specificity of the test. A test with high sensitivity and specificity will generally have higher predictive values than a test with low sensitivity and specificity. However, even a highly sensitive and specific test can have low predictive values if the prevalence of the disease is low in the population being tested.

Hemodynamics is the study of how blood flows through the cardiovascular system, including the heart and the vascular network. It examines various factors that affect blood flow, such as blood volume, viscosity, vessel length and diameter, and pressure differences between different parts of the circulatory system. Hemodynamics also considers the impact of various physiological and pathological conditions on these variables, and how they in turn influence the function of vital organs and systems in the body. It is a critical area of study in fields such as cardiology, anesthesiology, and critical care medicine.

Laser therapy, also known as phototherapy or laser photobiomodulation, is a medical treatment that uses low-intensity lasers or light-emitting diodes (LEDs) to stimulate healing, reduce pain, and decrease inflammation. It works by promoting the increase of cellular metabolism, blood flow, and tissue regeneration through the process of photobiomodulation.

The therapy can be used on patients suffering from a variety of acute and chronic conditions, including musculoskeletal injuries, arthritis, neuropathic pain, and wound healing complications. The wavelength and intensity of the laser light are precisely controlled to ensure a safe and effective treatment.

During the procedure, the laser or LED device is placed directly on the skin over the area of injury or discomfort. The non-ionizing light penetrates the tissue without causing heat or damage, interacting with chromophores in the cells to initiate a series of photochemical reactions. This results in increased ATP production, modulation of reactive oxygen species, and activation of transcription factors that lead to improved cellular function and reduced pain.

In summary, laser therapy is a non-invasive, drug-free treatment option for various medical conditions, providing patients with an alternative or complementary approach to traditional therapies.

Fibrinolysis is the natural process in the body that leads to the dissolution of blood clots. It is a vital part of hemostasis, the process that regulates bleeding and wound healing. Fibrinolysis occurs when plasminogen activators convert plasminogen to plasmin, an enzyme that breaks down fibrin, the insoluble protein mesh that forms the structure of a blood clot. This process helps to prevent excessive clotting and maintains the fluidity of the blood. In medical settings, fibrinolysis can also refer to the therapeutic use of drugs that stimulate this process to dissolve unwanted or harmful blood clots, such as those that cause deep vein thrombosis or pulmonary embolism.

Troponin T is a subunit of the troponin complex, which is a protein complex that plays a crucial role in muscle contraction. In particular, Troponin T is responsible for binding the troponin complex to tropomyosin, another protein that helps regulate muscle contraction.

In the context of medical diagnostics, Troponin T is often measured as a biomarker for heart damage. When heart muscle cells are damaged or die, such as in a myocardial infarction (heart attack), troponin T is released into the bloodstream. Therefore, measuring the levels of Troponin T in the blood can help diagnose and assess the severity of heart damage.

It's important to note that Troponin T is specific to cardiac muscle cells, which makes it a more reliable biomarker for heart damage than other markers that may also be found in skeletal muscle cells. However, it's worth noting that Troponin T levels can also be elevated in conditions other than heart attacks, such as heart failure, myocarditis, and pulmonary embolism, so clinical context is important when interpreting test results.

Recurrence, in a medical context, refers to the return of symptoms or signs of a disease after a period of improvement or remission. It indicates that the condition has not been fully eradicated and may require further treatment. Recurrence is often used to describe situations where a disease such as cancer comes back after initial treatment, but it can also apply to other medical conditions. The likelihood of recurrence varies depending on the type of disease and individual patient factors.

A Severity of Illness Index is a measurement tool used in healthcare to assess the severity of a patient's condition and the risk of mortality or other adverse outcomes. These indices typically take into account various physiological and clinical variables, such as vital signs, laboratory values, and co-morbidities, to generate a score that reflects the patient's overall illness severity.

Examples of Severity of Illness Indices include the Acute Physiology and Chronic Health Evaluation (APACHE) system, the Simplified Acute Physiology Score (SAPS), and the Mortality Probability Model (MPM). These indices are often used in critical care settings to guide clinical decision-making, inform prognosis, and compare outcomes across different patient populations.

It is important to note that while these indices can provide valuable information about a patient's condition, they should not be used as the sole basis for clinical decision-making. Rather, they should be considered in conjunction with other factors, such as the patient's overall clinical presentation, treatment preferences, and goals of care.

Electric stimulation therapy, also known as neuromuscular electrical stimulation (NMES) or electromyostimulation, is a therapeutic treatment that uses electrical impulses to stimulate muscles and nerves. The electrical signals are delivered through electrodes placed on the skin near the target muscle group or nerve.

The therapy can be used for various purposes, including:

1. Pain management: Electric stimulation can help reduce pain by stimulating the release of endorphins, which are natural painkillers produced by the body. It can also help block the transmission of pain signals to the brain.
2. Muscle rehabilitation: NMES can be used to prevent muscle atrophy and maintain muscle tone in individuals who are unable to move their muscles due to injury or illness, such as spinal cord injuries or stroke.
3. Improving circulation: Electric stimulation can help improve blood flow and reduce swelling by contracting the muscles and promoting the movement of fluids in the body.
4. Wound healing: NMES can be used to promote wound healing by increasing blood flow, reducing swelling, and improving muscle function around the wound site.
5. Muscle strengthening: Electric stimulation can be used to strengthen muscles by causing them to contract and relax repeatedly, which can help improve muscle strength and endurance.

It is important to note that electric stimulation therapy should only be administered under the guidance of a trained healthcare professional, as improper use can cause harm or discomfort.

Cardiac catheterization is a medical procedure used to diagnose and treat cardiovascular conditions. In this procedure, a thin, flexible tube called a catheter is inserted into a blood vessel in the arm or leg and threaded up to the heart. The catheter can be used to perform various diagnostic tests, such as measuring the pressure inside the heart chambers and assessing the function of the heart valves.

Cardiac catheterization can also be used to treat certain cardiovascular conditions, such as narrowed or blocked arteries. In these cases, a balloon or stent may be inserted through the catheter to open up the blood vessel and improve blood flow. This procedure is known as angioplasty or percutaneous coronary intervention (PCI).

Cardiac catheterization is typically performed in a hospital cardiac catheterization laboratory by a team of healthcare professionals, including cardiologists, radiologists, and nurses. The procedure may be done under local anesthesia with sedation or general anesthesia, depending on the individual patient's needs and preferences.

Overall, cardiac catheterization is a valuable tool in the diagnosis and treatment of various heart conditions, and it can help improve symptoms, reduce complications, and prolong life for many patients.

Labetalol is an antihypertensive drug, which is a type of medication used to treat high blood pressure. It is classified as a non-selective beta blocker and selective alpha-1 receptor blocker. This means that it works by blocking the effects of certain hormones on the heart and blood vessels, leading to a decrease in heart rate and relaxation of the blood vessels, thereby reducing blood pressure.

Labetalol is available in oral (tablet) and injectable forms. It may be used alone or in combination with other medications to treat high blood pressure. Common side effects of labetalol include dizziness, lightheadedness, and fatigue. As with any medication, it should be taken under the supervision of a healthcare provider, who will consider the patient's medical history, current medications, and other factors before prescribing it.

Collateral circulation refers to the alternate blood supply routes that bypass an obstructed or narrowed vessel and reconnect with the main vascular system. These collateral vessels can develop over time as a result of the body's natural adaptation to chronic ischemia (reduced blood flow) caused by various conditions such as atherosclerosis, thromboembolism, or vasculitis.

The development of collateral circulation helps maintain adequate blood flow and oxygenation to affected tissues, minimizing the risk of tissue damage and necrosis. In some cases, well-developed collateral circulations can help compensate for significant blockages in major vessels, reducing symptoms and potentially preventing the need for invasive interventions like revascularization procedures. However, the extent and effectiveness of collateral circulation vary from person to person and depend on factors such as age, overall health status, and the presence of comorbidities.

Neopterin is a pteridine metabolite that is primarily produced by macrophages in response to the activation of the immune system, particularly in response to interferon-gamma (IFN-γ). It is commonly used as a biomarker for cellular immune activation and inflammation. Elevated levels of neopterin have been associated with various conditions such as infections, autoimmune diseases, cancer, and transplant rejection.

Exercise tolerance is a term used to describe the ability of an individual to perform physical activity or exercise without experiencing symptoms such as shortness of breath, chest pain, or undue fatigue. It is often used as a measure of cardiovascular fitness and can be assessed through various tests, such as a stress test or a six-minute walk test. Exercise intolerance may indicate the presence of underlying medical conditions, such as heart disease, lung disease, or deconditioning.

Coronary thrombosis is a medical condition that refers to the formation of a blood clot (thrombus) inside a coronary artery, which supplies oxygenated blood to the heart muscle. The development of a thrombus can partially or completely obstruct blood flow, leading to insufficient oxygen supply to the heart muscle. This can cause chest pain (angina) or a heart attack (myocardial infarction), depending on the severity and duration of the blockage.

Coronary thrombosis often results from the rupture of an atherosclerotic plaque, a buildup of cholesterol, fat, calcium, and other substances in the inner lining (endothelium) of the coronary artery. The ruptured plaque exposes the underlying tissue to the bloodstream, triggering the coagulation cascade and resulting in the formation of a thrombus.

Immediate medical attention is crucial for managing coronary thrombosis, as timely treatment can help restore blood flow, prevent further damage to the heart muscle, and reduce the risk of complications such as heart failure or life-threatening arrhythmias. Treatment options may include medications, such as antiplatelet agents, anticoagulants, and thrombolytic drugs, or interventional procedures like angioplasty and stenting to open the blocked artery. In some cases, surgical intervention, such as coronary artery bypass grafting (CABG), may be necessary.

In medical terms, the heart is a muscular organ located in the thoracic cavity that functions as a pump to circulate blood throughout the body. It's responsible for delivering oxygen and nutrients to the tissues and removing carbon dioxide and other wastes. The human heart is divided into four chambers: two atria on the top and two ventricles on the bottom. The right side of the heart receives deoxygenated blood from the body and pumps it to the lungs, while the left side receives oxygenated blood from the lungs and pumps it out to the rest of the body. The heart's rhythmic contractions and relaxations are regulated by a complex electrical conduction system.

Pindolol is a non-selective beta blocker that is used in the treatment of hypertension (high blood pressure) and certain types of arrhythmias (irregular heart rhythms). It works by blocking the action of certain hormones such as adrenaline and noradrenaline on the heart, which helps to reduce the heart rate, contractility, and conduction velocity, leading to a decrease in blood pressure.

Pindolol is also a partial agonist at beta-2 receptors, which means that it can stimulate these receptors to some extent, reducing the likelihood of bronchospasm (a side effect seen with other non-selective beta blockers). However, pindolol may still cause bronchospasm in patients with a history of asthma or chronic obstructive pulmonary disease (COPD), so it should be used with caution in these populations.

Pindolol is available in immediate-release and extended-release formulations, and the dosage is typically individualized based on the patient's response to therapy. Common side effects of pindolol include dizziness, fatigue, and gastrointestinal symptoms such as nausea and diarrhea.

Trimetazidine is a medication that belongs to the class of drugs known as anti-ischemic agents. It is primarily used in the management of angina pectoris, a type of chest pain caused by reduced blood flow to the heart muscle.

Trimetazidine works by improving the efficiency of heart muscle cells in utilizing energy and reducing the production of harmful oxygen free radicals during periods of reduced oxygen supply, such as during angina attacks. This helps to preserve the function of the heart muscle and reduce the severity and frequency of angina episodes.

It is important to note that Trimetazidine should only be used under the supervision of a healthcare provider, and it is not recommended for individuals with severe liver or kidney impairment.

A chronic disease is a long-term medical condition that often progresses slowly over a period of years and requires ongoing management and care. These diseases are typically not fully curable, but symptoms can be managed to improve quality of life. Common chronic diseases include heart disease, stroke, cancer, diabetes, arthritis, and COPD (chronic obstructive pulmonary disease). They are often associated with advanced age, although they can also affect children and younger adults. Chronic diseases can have significant impacts on individuals' physical, emotional, and social well-being, as well as on healthcare systems and society at large.

Combination drug therapy is a treatment approach that involves the use of multiple medications with different mechanisms of action to achieve better therapeutic outcomes. This approach is often used in the management of complex medical conditions such as cancer, HIV/AIDS, and cardiovascular diseases. The goal of combination drug therapy is to improve efficacy, reduce the risk of drug resistance, decrease the likelihood of adverse effects, and enhance the overall quality of life for patients.

In combining drugs, healthcare providers aim to target various pathways involved in the disease process, which may help to:

1. Increase the effectiveness of treatment by attacking the disease from multiple angles.
2. Decrease the dosage of individual medications, reducing the risk and severity of side effects.
3. Slow down or prevent the development of drug resistance, a common problem in chronic diseases like HIV/AIDS and cancer.
4. Improve patient compliance by simplifying dosing schedules and reducing pill burden.

Examples of combination drug therapy include:

1. Antiretroviral therapy (ART) for HIV treatment, which typically involves three or more drugs from different classes to suppress viral replication and prevent the development of drug resistance.
2. Chemotherapy regimens for cancer treatment, where multiple cytotoxic agents are used to target various stages of the cell cycle and reduce the likelihood of tumor cells developing resistance.
3. Cardiovascular disease management, which may involve combining medications such as angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, diuretics, and statins to control blood pressure, heart rate, fluid balance, and cholesterol levels.
4. Treatment of tuberculosis, which often involves a combination of several antibiotics to target different aspects of the bacterial life cycle and prevent the development of drug-resistant strains.

When prescribing combination drug therapy, healthcare providers must carefully consider factors such as potential drug interactions, dosing schedules, adverse effects, and contraindications to ensure safe and effective treatment. Regular monitoring of patients is essential to assess treatment response, manage side effects, and adjust the treatment plan as needed.

Diltiazem is a calcium channel blocker medication that is used to treat hypertension (high blood pressure), angina (chest pain), and certain heart rhythm disorders. It works by relaxing the muscles of the blood vessels, which lowers blood pressure and improves blood flow to the heart. Diltiazem may also be used to reduce the risk of heart attack in patients with coronary artery disease.

The medication is available in various forms, including immediate-release tablets, extended-release tablets, and extended-release capsules. It is usually taken orally, one to three times a day, depending on the formulation and the individual patient's needs. Diltiazem may cause side effects such as dizziness, headache, nausea, and constipation.

It is important to follow the dosage instructions provided by your healthcare provider and to inform them of any other medications you are taking, as well as any medical conditions you have, before starting diltiazem.

Eye manifestations refer to any changes or abnormalities in the eye that can be observed or detected. These manifestations can be related to various medical conditions, diseases, or disorders affecting the eye or other parts of the body. They can include structural changes, such as swelling or bulging of the eye, as well as functional changes, such as impaired vision or sensitivity to light. Examples of eye manifestations include cataracts, glaucoma, diabetic retinopathy, macular degeneration, and uveitis.

I couldn't find a medical definition specifically for "delayed-action preparations." However, in the context of pharmacology, it may refer to medications or treatments that have a delayed onset of action. These are designed to release the active drug slowly over an extended period, which can help to maintain a consistent level of the medication in the body and reduce the frequency of dosing.

Examples of delayed-action preparations include:

1. Extended-release (ER) or controlled-release (CR) formulations: These are designed to release the drug slowly over several hours, reducing the need for frequent dosing. Examples include extended-release tablets and capsules.
2. Transdermal patches: These deliver medication through the skin and can provide a steady rate of drug delivery over several days. Examples include nicotine patches for smoking cessation or fentanyl patches for pain management.
3. Injectable depots: These are long-acting injectable formulations that slowly release the drug into the body over weeks to months. An example is the use of long-acting antipsychotic injections for the treatment of schizophrenia.
4. Implantable devices: These are small, biocompatible devices placed under the skin or within a body cavity that release a steady dose of medication over an extended period. Examples include hormonal implants for birth control or drug-eluting stents used in cardiovascular procedures.

Delayed-action preparations can improve patient compliance and quality of life by reducing dosing frequency, minimizing side effects, and maintaining consistent therapeutic levels.

Diagnostic techniques in cardiovascular medicine refer to the various tests and methods used to diagnose and evaluate conditions related to the heart and blood vessels. These techniques can be non-invasive or invasive and are designed to provide critical information about a patient's cardiovascular health, such as heart function, blood flow, and the presence of any abnormalities or diseases. Here are some common diagnostic techniques used in cardiovascular medicine:

1. Electrocardiogram (ECG): An ECG is a non-invasive test that records the electrical activity of the heart. It can help detect heart conditions such as arrhythmias, heart attacks, and structural abnormalities.
2. Echocardiogram: This is a non-invasive ultrasound test that produces images of the heart's structures, including the chambers, valves, and major blood vessels. It can help assess heart function, identify damage from heart attacks, and detect various cardiovascular conditions.
3. Stress testing: A stress test involves exercising on a treadmill or stationary bike while being monitored by an ECG to evaluate the heart's response to physical exertion. It can help diagnose coronary artery disease, assess exercise capacity, and determine the need for further testing or treatment.
4. Cardiac catheterization: This is an invasive procedure where a thin, flexible tube (catheter) is inserted into a blood vessel in the arm or leg and guided to the heart. It can help diagnose and treat various cardiovascular conditions, such as blocked arteries, heart valve problems, and congenital heart defects.
5. Coronary angiography: During a cardiac catheterization, a special dye is injected into the coronary arteries to visualize blood flow using X-ray imaging. This can help identify blockages or narrowing in the coronary arteries and guide treatment decisions.
6. Nuclear stress testing: This test combines the use of a radioactive tracer with exercise or pharmacological stress to evaluate heart function and blood flow. It can help diagnose coronary artery disease, assess the effectiveness of treatments, and determine the need for further interventions.
7. Cardiac magnetic resonance imaging (MRI): This non-invasive imaging technique uses a strong magnetic field and radio waves to create detailed images of the heart's structure and function. It can help diagnose various cardiovascular conditions, such as heart muscle disorders, valve problems, and congenital heart defects.
8. Transesophageal echocardiography (TEE): This is a specialized ultrasound technique where a probe is inserted through the esophagus to obtain detailed images of the heart's structure and function. It can help diagnose conditions such as blood clots, valve problems, and infective endocarditis.
9. Positron emission tomography (PET) scanning: This imaging technique uses a small amount of radioactive tracer to evaluate the metabolic activity of the heart. It can help diagnose coronary artery disease, assess the effectiveness of treatments, and determine the need for further interventions.
10. Electrophysiology studies (EPS): These are invasive procedures where catheters are inserted into the heart to study its electrical system. They can help diagnose and treat various arrhythmias, such as atrial fibrillation, ventricular tachycardia, and Wolff-Parkinson-White syndrome.

Prenylamine is not a medical term in and of itself, but it is the chemical name for a medication that is sometimes used in the medical field. The drug is known as Phenelzine sulfate in its brand name form, with trade names including Nardil.

Phenelzine sulfate (Prenylamine) is a type of medication called a monoamine oxidase inhibitor (MAOI). It works by blocking the action of an enzyme called monoamine oxidase, which helps break down certain chemicals in the brain called neurotransmitters. By blocking this enzyme's action, phenelzine sulfate increases the levels of these neurotransmitters in the brain, which can help to improve mood and alleviate symptoms of depression.

Phenelzine sulfate is used primarily to treat depression that has not responded to other treatments. It may also be used off-label for other conditions, such as anxiety disorders or panic attacks. However, it is important to note that phenelzine sulfate can have serious side effects and interactions with certain foods and medications, so it should only be taken under the close supervision of a healthcare provider.

Indoramin is not a medical condition, but rather a medication. It is a second-generation antihistamine and alpha-1 receptor blocker. It is primarily used in the treatment of high blood pressure (hypertension) and occasionally for the short-term treatment of symptoms associated with menopause.

Indoramin works by blocking the action of certain chemicals, such as histamine and norepinephrine, in the body. This leads to a relaxation of the muscle in the walls of blood vessels, which results in decreased blood pressure. It also helps to relieve symptoms associated with menopause, such as hot flashes, by blocking the action of histamine in the brain.

It is important to note that Indoramin should only be used under the supervision of a healthcare provider and may cause side effects, including dizziness, dry mouth, and drowsiness.

A stent is a small mesh tube that's used to treat narrow or weak arteries. Arteries are blood vessels that carry blood away from your heart to other parts of your body. A stent is placed in an artery as part of a procedure called angioplasty. Angioplasty restores blood flow through narrowed or blocked arteries by inflating a tiny balloon inside the blocked artery to widen it.

The stent is then inserted into the widened artery to keep it open. The stent is usually made of metal, but some are coated with medication that is slowly and continuously released to help prevent the formation of scar tissue in the artery. This can reduce the chance of the artery narrowing again.

Stents are also used in other parts of the body, such as the neck (carotid artery) and kidneys (renal artery), to help maintain blood flow and prevent blockages. They can also be used in the urinary system to treat conditions like ureteropelvic junction obstruction or narrowing of the urethra.

Sudden death is a term used to describe a situation where a person dies abruptly and unexpectedly, often within minutes to hours of the onset of symptoms. It is typically caused by cardiac or respiratory arrest, which can be brought on by various medical conditions such as heart disease, stroke, severe infections, drug overdose, or trauma. In some cases, the exact cause of sudden death may remain unknown even after a thorough post-mortem examination.

It is important to note that sudden death should not be confused with "sudden cardiac death," which specifically refers to deaths caused by the abrupt loss of heart function (cardiac arrest). Sudden cardiac death is often related to underlying heart conditions such as coronary artery disease, cardiomyopathy, or electrical abnormalities in the heart.

Stroke volume is a term used in cardiovascular physiology and medicine. It refers to the amount of blood that is pumped out of the left ventricle of the heart during each contraction (systole). Specifically, it is the difference between the volume of blood in the left ventricle at the end of diastole (when the ventricle is filled with blood) and the volume at the end of systole (when the ventricle has contracted and ejected its contents into the aorta).

Stroke volume is an important measure of heart function, as it reflects the ability of the heart to pump blood effectively to the rest of the body. A low stroke volume may indicate that the heart is not pumping efficiently, while a high stroke volume may suggest that the heart is working too hard. Stroke volume can be affected by various factors, including heart disease, high blood pressure, and physical fitness level.

The formula for calculating stroke volume is:

Stroke Volume = End-Diastolic Volume - End-Systolic Volume

Where end-diastolic volume (EDV) is the volume of blood in the left ventricle at the end of diastole, and end-systolic volume (ESV) is the volume of blood in the left ventricle at the end of systole.

Colic is a term used to describe excessive, frequent crying or fussiness in a healthy infant, often lasting several hours a day and occurring several days a week. Although the exact cause of colic is unknown, it may be related to digestive issues, such as gas or indigestion. The medical community defines colic by the "Rule of Three": crying for more than three hours per day, for more than three days per week, and for longer than three weeks in an infant who is well-fed and otherwise healthy. It typically begins within the first few weeks of life and improves on its own, usually by age 3-4 months. While colic can be distressing for parents and caregivers, it does not cause any long-term harm to the child.

Fibrinogen is a soluble protein present in plasma, synthesized by the liver. It plays an essential role in blood coagulation. When an injury occurs, fibrinogen gets converted into insoluble fibrin by the action of thrombin, forming a fibrin clot that helps to stop bleeding from the injured site. Therefore, fibrinogen is crucial for hemostasis, which is the process of stopping bleeding and starting the healing process after an injury.

Pentaerythritol Tetranitrate (PETN) is a powerful explosive substance, rather than a medical term. However, it can be used in a medical context as an active ingredient in certain prescription medications.

Medically, Pentaerythritol Tetranitrate is classified as a nitrate vasodilator. It works by relaxing and widening blood vessels, which allows for increased oxygen delivery and improved blood flow, particularly to the heart muscle. This can help reduce the workload on the heart and alleviate symptoms of angina (chest pain) caused by coronary artery disease.

It is available in various forms, such as extended-release tablets or sublingual (under-the-tongue) tablets, under brand names like Nitrolingual®, Nitrostat®, and Pentaerythritol Tetranitrate ER®.

Please consult a healthcare professional for more information about this medication and its uses.

Regression analysis is a statistical technique used in medicine, as well as in other fields, to examine the relationship between one or more independent variables (predictors) and a dependent variable (outcome). It allows for the estimation of the average change in the outcome variable associated with a one-unit change in an independent variable, while controlling for the effects of other independent variables. This technique is often used to identify risk factors for diseases or to evaluate the effectiveness of medical interventions. In medical research, regression analysis can be used to adjust for potential confounding variables and to quantify the relationship between exposures and health outcomes. It can also be used in predictive modeling to estimate the probability of a particular outcome based on multiple predictors.

Propylamines are a class of organic compounds characterized by the presence of a propylamine group, which is a functional group consisting of a propyl chain (-C3H7) attached to an amino group (-NH2). Propylamines can be primary, secondary, or tertiary, depending on the number of organic substituents attached to the nitrogen atom.

In a medical context, propylamines may refer to certain drugs that contain this functional group and have pharmacological activity. For example, some local anesthetics, such as procaine (Novocain), are derivatives of propylamine. Procaine is a ester of p-aminobenzoic acid and diethylaminoethanol, where the amino group is part of a propylamine chain.

It's important to note that not all compounds containing propylamines have medical applications or uses, as this functional group can also be found in various chemicals with different properties and applications.

Dipyridamole is a medication that belongs to a class of drugs called antiplatelet agents. It works by preventing platelets in your blood from sticking together to form clots. Dipyridamole is often used in combination with aspirin to prevent stroke and other complications in people who have had a heart valve replacement or a type of irregular heartbeat called atrial fibrillation.

Dipyridamole can also be used as a stress agent in myocardial perfusion imaging studies, which are tests used to evaluate blood flow to the heart. When used for this purpose, dipyridamole is given intravenously and works by dilating the blood vessels in the heart, allowing more blood to flow through them and making it easier to detect areas of reduced blood flow.

The most common side effects of dipyridamole include headache, dizziness, and gastrointestinal symptoms such as diarrhea, nausea, and vomiting. In rare cases, dipyridamole can cause more serious side effects, such as allergic reactions, abnormal heart rhythms, or low blood pressure. It is important to take dipyridamole exactly as directed by your healthcare provider and to report any unusual symptoms or side effects promptly.

The Chi-square distribution is a continuous probability distribution that is often used in statistical hypothesis testing. It is the distribution of a sum of squares of k independent standard normal random variables. The resulting quantity follows a chi-square distribution with k degrees of freedom, denoted as χ²(k).

The probability density function (pdf) of the Chi-square distribution with k degrees of freedom is given by:

f(x; k) = (1/ (2^(k/2) * Γ(k/2))) \* x^((k/2)-1) \* e^(-x/2), for x > 0 and 0, otherwise.

Where Γ(k/2) is the gamma function evaluated at k/2. The mean and variance of a Chi-square distribution with k degrees of freedom are k and 2k, respectively.

The Chi-square distribution has various applications in statistical inference, including testing goodness-of-fit, homogeneity of variances, and independence in contingency tables.

Vectorcardiography (VCG) is a type of graphical recording that depicts the vector magnitude and direction of the electrical activity of the heart over time. It provides a three-dimensional view of the electrical activation pattern of the heart, as opposed to the one-dimensional view offered by a standard electrocardiogram (ECG).

In VCG, the electrical potentials are recorded using a special array of electrodes placed on the body surface. These potentials are then mathematically converted into vectors and plotted on a vector loop or a series of loops that represent different planes of the heart's electrical activity. The resulting tracing provides information about the magnitude, direction, and timing of the electrical activation of the heart, which can be helpful in diagnosing various cardiac arrhythmias, ischemic heart disease, and other cardiac conditions.

Overall, vectorcardiography offers a more detailed and comprehensive view of the heart's electrical activity than traditional ECG, making it a valuable tool in clinical cardiology.

Platelet aggregation inhibitors are a class of medications that prevent platelets (small blood cells involved in clotting) from sticking together and forming a clot. These drugs work by interfering with the ability of platelets to adhere to each other and to the damaged vessel wall, thereby reducing the risk of thrombosis (blood clot formation).

Platelet aggregation inhibitors are often prescribed for people who have an increased risk of developing blood clots due to various medical conditions such as atrial fibrillation, coronary artery disease, peripheral artery disease, stroke, or a history of heart attack. They may also be used in patients undergoing certain medical procedures, such as angioplasty and stenting, to prevent blood clot formation in the stents.

Examples of platelet aggregation inhibitors include:

1. Aspirin: A nonsteroidal anti-inflammatory drug (NSAID) that irreversibly inhibits the enzyme cyclooxygenase, which is involved in platelet activation and aggregation.
2. Clopidogrel (Plavix): A P2Y12 receptor antagonist that selectively blocks ADP-induced platelet activation and aggregation.
3. Prasugrel (Effient): A third-generation thienopyridine P2Y12 receptor antagonist, similar to clopidogrel but with faster onset and greater potency.
4. Ticagrelor (Brilinta): A direct-acting P2Y12 receptor antagonist that does not require metabolic activation and has a reversible binding profile.
5. Dipyridamole (Persantine): An antiplatelet agent that inhibits platelet aggregation by increasing cyclic adenosine monophosphate (cAMP) levels in platelets, which leads to decreased platelet reactivity.
6. Iloprost (Ventavis): A prostacyclin analogue that inhibits platelet aggregation and causes vasodilation, often used in the treatment of pulmonary arterial hypertension.
7. Cilostazol (Pletal): A phosphodiesterase III inhibitor that increases cAMP levels in platelets, leading to decreased platelet activation and aggregation, as well as vasodilation.
8. Ticlopidine (Ticlid): An older P2Y12 receptor antagonist with a slower onset of action and more frequent side effects compared to clopidogrel or prasugrel.

A case-control study is an observational research design used to identify risk factors or causes of a disease or health outcome. In this type of study, individuals with the disease or condition (cases) are compared with similar individuals who do not have the disease or condition (controls). The exposure history or other characteristics of interest are then compared between the two groups to determine if there is an association between the exposure and the disease.

Case-control studies are often used when it is not feasible or ethical to conduct a randomized controlled trial, as they can provide valuable insights into potential causes of diseases or health outcomes in a relatively short period of time and at a lower cost than other study designs. However, because case-control studies rely on retrospective data collection, they are subject to biases such as recall bias and selection bias, which can affect the validity of the results. Therefore, it is important to carefully design and conduct case-control studies to minimize these potential sources of bias.

In epidemiology, the incidence of a disease is defined as the number of new cases of that disease within a specific population over a certain period of time. It is typically expressed as a rate, with the number of new cases in the numerator and the size of the population at risk in the denominator. Incidence provides information about the risk of developing a disease during a given time period and can be used to compare disease rates between different populations or to monitor trends in disease occurrence over time.

Creatine kinase (CK) is a muscle enzyme that is normally present in small amounts in the blood. It is primarily found in tissues that require a lot of energy, such as the heart, brain, and skeletal muscles. When these tissues are damaged or injured, CK is released into the bloodstream, causing the levels to rise.

Creatine kinase exists in several forms, known as isoenzymes, which can be measured in the blood to help identify the location of tissue damage. The three main isoenzymes are:

1. CK-MM: Found primarily in skeletal muscle
2. CK-MB: Found primarily in heart muscle
3. CK-BB: Found primarily in the brain

Elevated levels of creatine kinase, particularly CK-MB, can indicate damage to the heart muscle, such as occurs with a heart attack. Similarly, elevated levels of CK-BB may suggest brain injury or disease. Overall, measuring creatine kinase levels is a useful diagnostic tool for assessing tissue damage and determining the severity of injuries or illnesses.

Retrospective studies, also known as retrospective research or looking back studies, are a type of observational study that examines data from the past to draw conclusions about possible causal relationships between risk factors and outcomes. In these studies, researchers analyze existing records, medical charts, or previously collected data to test a hypothesis or answer a specific research question.

Retrospective studies can be useful for generating hypotheses and identifying trends, but they have limitations compared to prospective studies, which follow participants forward in time from exposure to outcome. Retrospective studies are subject to biases such as recall bias, selection bias, and information bias, which can affect the validity of the results. Therefore, retrospective studies should be interpreted with caution and used primarily to generate hypotheses for further testing in prospective studies.

Emission-Computed Tomography, Single-Photon (SPECT) is a type of nuclear medicine imaging procedure that generates detailed, three-dimensional images of the distribution of radioactive pharmaceuticals within the body. It uses gamma rays emitted by a radiopharmaceutical that is introduced into the patient's body, and a specialized gamma camera to detect these gamma rays and create tomographic images. The data obtained from the SPECT imaging can be used to diagnose various medical conditions, evaluate organ function, and guide treatment decisions. It is commonly used to image the heart, brain, and bones, among other organs and systems.

Multivariate analysis is a statistical method used to examine the relationship between multiple independent variables and a dependent variable. It allows for the simultaneous examination of the effects of two or more independent variables on an outcome, while controlling for the effects of other variables in the model. This technique can be used to identify patterns, associations, and interactions among multiple variables, and is commonly used in medical research to understand complex health outcomes and disease processes. Examples of multivariate analysis methods include multiple regression, factor analysis, cluster analysis, and discriminant analysis.

Nitrates are chemical compounds that consist of a nitrogen atom bonded to three oxygen atoms (NO3-). In the context of medical science, nitrates are often discussed in relation to their use as medications or their presence in food and water.

As medications, nitrates are commonly used to treat angina (chest pain) caused by coronary artery disease. Nitrates work by relaxing and widening blood vessels, which improves blood flow and reduces the workload on the heart. Some examples of nitrate medications include nitroglycerin, isosorbide dinitrate, and isosorbide mononitrate.

In food and water, nitrates are naturally occurring compounds that can be found in a variety of vegetables, such as spinach, beets, and lettuce. They can also be present in fertilizers and industrial waste, which can contaminate groundwater and surface water sources. While nitrates themselves are not harmful, they can be converted into potentially harmful compounds called nitrites under certain conditions, particularly in the digestive system of young children or in the presence of bacteria such as those found in unpasteurized foods. Excessive levels of nitrites can react with hemoglobin in the blood to form methemoglobin, which cannot transport oxygen effectively and can lead to a condition called methemoglobinemia.

Perhexiline is a prescription medication that belongs to a class of drugs called anti-anginal agents. It works by increasing the supply of oxygen to the heart muscle and decreasing its demand for oxygen, which helps prevent angina (chest pain) caused by coronary artery disease.

The medical definition of Perhexiline is:

Perhexiline is a cardiac anti-anginal agent with a mechanism of action that involves inhibition of the mitochondrial enzyme carnitine palmitoyltransferase, which results in increased myocardial oxygen delivery and decreased myocardial oxygen demand. It is used in the management of chronic stable angina pectoris that is refractory to other anti-anginal therapies. Perhexiline has a narrow therapeutic index and requires careful monitoring of plasma concentrations to avoid toxicity, which can manifest as neurological, hepatic, or cardiac adverse effects.

Spiral Computed Tomography (CT), also known as Helical CT, is a type of computed tomography scan in which the X-ray tube and detector rotate around the patient in a spiral path, capturing data as the table moves the patient through the scanner. This continuous spiral motion allows for faster and more detailed volumetric imaging of internal organs and structures, reducing the need for multiple slices and providing improved image reconstruction. It is commonly used to diagnose and monitor various medical conditions, including cancer, heart disease, and trauma injuries.

Erythrocyte aggregation, also known as rouleaux formation, is the clumping together of red blood cells (erythrocytes) in a way that resembles a stack of coins. This phenomenon is typically observed under low-shear conditions, such as those found in small blood vessels and capillaries.

The aggregation of erythrocytes is influenced by several factors, including the concentration of plasma proteins, the charge and shape of the red blood cells, and the flow characteristics of the blood. One of the most important proteins involved in this process is fibrinogen, a large plasma protein that can bridge between adjacent red blood cells and cause them to stick together.

Erythrocyte aggregation can have significant effects on blood flow and rheology (the study of how blood flows), particularly in diseases such as diabetes, sickle cell disease, and certain types of anemia. Increased erythrocyte aggregation can lead to reduced oxygen delivery to tissues, increased blood viscosity, and impaired microcirculatory flow, all of which can contribute to tissue damage and organ dysfunction.

The heart ventricles are the two lower chambers of the heart that receive blood from the atria and pump it to the lungs or the rest of the body. The right ventricle pumps deoxygenated blood to the lungs, while the left ventricle pumps oxygenated blood to the rest of the body. Both ventricles have thick, muscular walls to generate the pressure necessary to pump blood through the circulatory system.

I'm sorry for any confusion, but "Northern Ireland" is a geographical location and political entity, and not a medical term or concept. It is one of the four constituent countries of the United Kingdom, located in the north-east of the island of Ireland. Therefore, it doesn't have a medical definition. If you have any questions related to health or medicine, I would be happy to try to help answer those!

Drug tolerance is a medical concept that refers to the decreased response to a drug following its repeated use, requiring higher doses to achieve the same effect. This occurs because the body adapts to the presence of the drug, leading to changes in the function or expression of targets that the drug acts upon, such as receptors or enzymes. Tolerance can develop to various types of drugs, including opioids, benzodiazepines, and alcohol, and it is often associated with physical dependence and addiction. It's important to note that tolerance is different from resistance, which refers to the ability of a pathogen to survive or grow in the presence of a drug, such as antibiotics.

Echocardiography is a medical procedure that uses sound waves to produce detailed images of the heart's structure, function, and motion. It is a non-invasive test that can help diagnose various heart conditions, such as valve problems, heart muscle damage, blood clots, and congenital heart defects.

During an echocardiogram, a transducer (a device that sends and receives sound waves) is placed on the chest or passed through the esophagus to obtain images of the heart. The sound waves produced by the transducer bounce off the heart structures and return to the transducer, which then converts them into electrical signals that are processed to create images of the heart.

There are several types of echocardiograms, including:

* Transthoracic echocardiography (TTE): This is the most common type of echocardiogram and involves placing the transducer on the chest.
* Transesophageal echocardiography (TEE): This type of echocardiogram involves passing a specialized transducer through the esophagus to obtain images of the heart from a closer proximity.
* Stress echocardiography: This type of echocardiogram is performed during exercise or medication-induced stress to assess how the heart functions under stress.
* Doppler echocardiography: This type of echocardiogram uses sound waves to measure blood flow and velocity in the heart and blood vessels.

Echocardiography is a valuable tool for diagnosing and managing various heart conditions, as it provides detailed information about the structure and function of the heart. It is generally safe, non-invasive, and painless, making it a popular choice for doctors and patients alike.

Risk assessment in the medical context refers to the process of identifying, evaluating, and prioritizing risks to patients, healthcare workers, or the community related to healthcare delivery. It involves determining the likelihood and potential impact of adverse events or hazards, such as infectious diseases, medication errors, or medical devices failures, and implementing measures to mitigate or manage those risks. The goal of risk assessment is to promote safe and high-quality care by identifying areas for improvement and taking action to minimize harm.

Hemostasis is the physiological process that occurs to stop bleeding (bleeding control) when a blood vessel is damaged. This involves the interaction of platelets, vasoconstriction, and blood clotting factors leading to the formation of a clot. The ultimate goal of hemostasis is to maintain the integrity of the vascular system while preventing excessive blood loss.

Blood viscosity is a measure of the thickness or flow resistance of blood. It is defined as the ratio of shear stress to shear rate within the flowing blood, which reflects the internal friction or resistance to flow. Blood viscosity is primarily determined by the concentration and size of red blood cells (hematocrit), plasma proteins, and other blood constituents. An increase in any of these components can raise blood viscosity, leading to impaired blood flow, reduced oxygen delivery to tissues, and potential cardiovascular complications if not managed appropriately.

Postcholecystectomy Syndrome is a condition that occurs in some patients following the surgical removal of the gallbladder (cholecystectomy). The syndrome encompasses a variety of symptoms such as abdominal pain, bloating, gas, indigestion, and diarrhea, which can be caused by several factors including:

1. Abnormal functioning or motility of the sphincter of Oddi (a muscle that controls the flow of bile and pancreatic juice into the small intestine)
2. Formation of gallstones in the bile ducts (choledocholithiasis)
3. Biliary dyskinesia (impaired functioning of the biliary tract muscles)
4. Persistent or recurrent infection or inflammation of the bile ducts (biliopathy)
5. Formation of abnormal bile-filled pouches (biliolethiasis or bile duct cysts)
6. Changes in bowel habits due to altered enterohepatic circulation of bile acids

The symptoms of Postcholecystectomy Syndrome can vary in severity and frequency, and they may appear soon after the surgery or develop months or even years later. The diagnosis of this condition typically involves a comprehensive medical evaluation, including a detailed history, physical examination, laboratory tests, and imaging studies such as ultrasound, CT scan, MRI, or endoscopic retrograde cholangiopancreatography (ERCP).

Treatment options for Postcholecystectomy Syndrome depend on the underlying cause of the symptoms and may include medications, dietary modifications, endoscopic procedures, or surgery. In some cases, the syndrome may resolve on its own without any specific treatment.

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