Obstructive coronary artery disease

Retinal detachment, adhesions between iris and lens, acute ocular inflammation, must avoid systemic absorption of drug with coronary artery disease, obstruction of GI/GU tract, epilepsy, asthma... 

These drugp are contraindicated in patients with known hypersensitivity to die drugs, asthma, peptic ulcer disease, coronary artery disease, and hyperthyroidism. Bethanecol is contraindicated in those with mechanical obstruction of die gastrointestinal or genitourinary tracts. Fhtients with secondary glaucoma, iritis, corneal abrasion, or any acute inflammatory disease of the eye should not use die ophtiialmic cholinergic preparations. 

Many disorders benefit from exercise (Pederson Saltin, 2005). These include asthma, cancer, chronic heart failure, coronary artery disease, chronic obstructive pulmonary disease (COPD), depression, type 1 diabetes melUtus, type 2 diabetes melUtus, hypertension, intermittent claudication, osteoarthritis, osteoporosis, rheumatoid arthritis and obesity. 

As the prevalence of obesity increases worldwide, so does the prevalence of associated co-morbidities type-2 diabetes, chronic obstructive sleep apnoea, cardiovascular disease (hyper-tension, coronary artery disease and congestive heart failure, stroke and peripheral vascular disease), fatty liver disease, various malignancies (Table 7.2), gallstones, subfertility, musculo-skeletal problems and depression. 

Bethanechol should not be used in patients with possible mechanical obstruction of the bladder or gastrointestinal tract or when contraction of smooth muscles in these tissues may be harmful (e.g., recent intestinal resection). It is also contraindicated in patients with bronchial asthma, peptic ulcer disease, coronary artery disease, gastrointestinal hypermotility or inflammatory disease, hypotension or marked bradycardia, hyperthyroidism, parkinsonism, or epilepsy. Care should be exercised in administering pilocarpine to elderly patients because it can enter the CNS and affect memory and cognition, even when applied topically to the eye. 

Patients with the non-obstructive form of hypetrophic cardiomyopathy should not undergo septal ablation. Patients with congential anomalies of the mitral valve apparatus, associated heart lesions (e.g., advanced multivessel coronary artery disease) requiring surgical correction, unfavorable distribution of septal hypertrophy with mild proximal thickening, basal septal wall thickness < 18 mm, or anatomically unsuitable septal perforators should not be candidates for septal ablation. 

In a study from the Mayo Clinic (M4), a group of male patients undergoing diagnostic coronary angiography for chest pain or suspected coronary artery disease had plasma cholesterol and triglyceride, HDL cholesterol, and apoA-I concentrations measured. Whereas HDL cholesterol discriminated to some extent between those with and those without important coronary artery disease (and total cholesterol and triglyceride did not discriminate at all), apoA-I levels provided an almost perfect prediction of obstructive coronary artery disease. Some caveats on the interpretation of apoA-I levels in this and other studies have been noted by Blackburn (B34). 

The practicability of dipyridamole A-ammonia myocardial positron emission tomography for perioperative risk assessment of coronary artery disease in patients with severe chronic obstructive pulmonary disease undergoing lung volume reduction surgery has been studied in 13 men and 7 women (mean age 57 years) without symptoms of coronary artery disease (12). Nine patients had intolerable dyspnea due to bronchoconstriction and required intravenous aminophylline. Dipyridamole cannot be recommended as a pharmacological stress in this setting. 

Key M male F female DM diabetes mellltus HTN hypertension CAD coronary artery disease COPD chronic obstructive pulmonary disease CHF congestive heart failure ESRD end stage renal disease OSPS oral sodium phosphate solution PEG polyethylene glycol AKI acute kidney Injury na not available HD hemodialysis. 

Hyperthyroidism, peptic ulcer, latent or active bronchial asthma, mechanical GI and urinary obstruction or recent GI resection, acute inflammatory GI tract conditions, anastomosis, bladder wall instability, pronounced bradycardia, hypotension, hypertension, cardiac disease, coronary artery disease, vasomotor instability, epilepsy, Parkinsonism. 

Lansky A, Elashoff MR, Ng V et al (2012) A gender-specific blood-based gene expression score for assessing obstructive coronary artery disease in nondiabetic patients results of the Personalized Risk Evaluation and Diagnosis in the Coronary Tree (PREDICT) trial. Am Heart J 164 320-326... 

In patients at risk for obstructive coronary artery disease, levels of SIP in the plasma were found to increase with severity and degree of stenosis from 634 (in control subjects from a different study) to 894 (in patients with mild symptoms) to 1035 pmol/ml (in severe stenosis) (n = 308) (Deutschman et al., 2003). SIP... 

Deutschman, D.H., Carstens, J.S., Klepper, R.L., Smith, W.S., Page, M.T., Young, T.R., Gleason, L.A., Nakajima, N., and Sabbadini, R.A., Predicting obstructive coronary artery disease with serum sphingosine-l-phosphate. Am Heart J, 146 (2003) 62-68. 

ADHD, attention-deficit/hyperactivity disorder AV, atrioventricular BPH, benign prostatic hypertrophy CAD, coronary artery disease CHF, congestive heart failure COPD, chronic obstructive pulmonary disease CV, cardiovascular DA, dopamine Dl, subtype 1 dopamine receptor Epi, epinephrine FFA, free fatty acids 5-HT, serotonin ISA, intrinsic sympathomimetic activity MI, myocardial infarction NE, norepinephrine NO, nitric oxide PVR, peripheral vascular resistance. 

The term angina describes a crushing or compressive pain. The term angina pectoris is used when this pain is located in the center of the chest, often radiating to the neck or arms. The most common mechanism for the latter symptom is a decreased supply of oxygen to the heart muscle caused by atherosclerotic coronary artery disease, which results in obstruction of the vessels that supply aterial blood to cardiac muscle. 

X rd 0 V 1 1 Coronary artery disease Hyperthyroidism (atrial fibrillation) Asthma Mechanical bladder obstruction At M2 receptors T K+ conduction (SA node), i cAMP (atria and AV node), cGMP (other organs) At M3 receptors, phosphatidyl inositol At nicotinic receptor opens sodium channel. Influx depolarizes cell. ... 

Myocardial revascularization, when obstructive coronary artery disease is causing active ischemia, or valve replacement, for aortic stenosis, can reduce risk in these select patient subgroups (80,99-107). Unfortunately, these therapies, although effective, do not eliminate the risk of death. The risk can remain high in patients with underlying cardiovascular disease who have congestive heart failure or ventricular dysfunction. 

Coronary artery disease remains the main killer. The mortality from coronary artery disease has decreased by 28% in the last 20 years. A first acute myocardial infarction had mortality of 28% in 1963 and today it is about 7%. The price of life has become more and more valuable. We are only on the threshold of understanding the pathogenic and biological principles of the generation of atheroma, but once established, obstructive lesions need coronary artery dilatation, coronary artery bypass or arterial replacement. The saphenous vein is an excellent bypass conduit but its life expectancy is 3 to 10 years only until it thromboses, or becomes atheromatous and is blocked or obliterated by cholesterol filled intima or clot. The internal mammary artery is ideal but flow is too small to sustain adequate flow to the entire heart. Here too, there is the need for new non-thrombogenic materials to reconstruct artificial arteries, substances which are durable, non-thrombotic and do not promote atherogenesis. There is also the need for simple, non-invasive techniques to measure coronary blood flow and the anatomy of the coronary arteries to plan subsequent surgical procedures. 

Absence of obstructive coronary artery disease or evidence of acute plaque rupture. 

A 62-year-old male smoker presented to emergency department with anaphylaxis, due to oral diclcfenac for toothache. He developed acute anterior wall myocardial infarction following adrenaline (i.m.) Img 1 1000. Primary percutaneous coronary intervention was done, which showed a thrombus in the mid left anterior descending artery with no evidetwe of obstructive coronary artery disease after thrombus aspiration [14 ]. 

Coronary stents are placed during a percutaneous coronary intervention procedure, also known as an angioplasty, usually as a treatment for coronary artery disease (CAD). CAD is commonly characterized by atherosclerotic obstruction of vessels responsible... 

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