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Actual Patient Cases of CHD and MI from My Practice
Published in Mark C Houston, The Truth About Heart Disease, 2023
This patient was found to have “microvascular angina”, which means that the very small arteries of the heart are diseased and do not dilate well with exercise. As a result, the heart muscle does not get enough blood, nutrients, or oxygen. This is what caused the shortness of breath. This type of angina can only be treated with medication, lifestyle changes, and control of the CHD risk factors. There is no surgery for this disease.
Wearable Sensors for Blood Perfusion Monitoring in Patients with Diabetes Mellitus
Published in Andrey V. Dunaev, Valery V. Tuchin, Biomedical Photonics for Diabetes Research, 2023
Evgenii A. Zherebtsov, Elena V. Zharkikh, Yulia I. Loktionova, Angelina I. Zherebtsova, Viktor V. Sidorov, Alexander I. Krupatkin, Andrey V. Dunaev
Capillary bed depletion in patients with DM can be functional (a loss of perfused capillaries) or structural (a loss of vessels in the tissue) [14]. This suggestion is of particular importance for the bodies’ most essential organs, namely, the heart. In DM, the depletion of the myocardial microvascular bed is not only functional but also structural later. This can trigger refractory or microvascular angina; coronary arteries remain relatively intact [15,16].
Rational Medical Therapy of Functional GI Disorders
Published in Kevin W. Olden, Handbook of Functional Gastrointestinal Disorders, 2020
Richard M. Sperling, Kenneth R. McQuaid
Recurrent chest pain is an important clinical problem that causes great distress for patients and physicians. Coronary artery disease must be excluded before pursuing other causes because it is potentially life-threatening and is treatable. Microvascular angina should also be considered in patients with abnormalities on noninvasive cardiac testing. Rheumatological causes of chest pain are readily diagnosed and treated but easily overlooked. Other entities associated with CPUE include gastroesophageal reflux, esophageal dysmotility, psychological disorders, and heightened visceral nocioception. There appears to be a great deal of overlap between these abnormalities, and their cause-and-effect relationship to CPUE requires further elucidation.
Angiography derived assessment of the coronary microcirculation: is it ready for prime time?
Published in Expert Review of Cardiovascular Therapy, 2022
Jinying Zhou, Yoshinobu Onuma, Scot Garg, Nozomi Kotoku, Shigetaka Kageyama, Shinichiro Masuda, Kai Ninomiya, Yunlong Huo, Johan H.C. Reiber, Shengxian Tu, Jan J. Piek, Javier Escaned, Divaka Perera, Christos Bourantas, Hongbing Yan, Patrick W. Serruys
Recently, several angiography-derived indexes of microvascular resistance [6–13] have been proposed rekindling interest in the assessment and management of non-obstructive coronary artery disease (NOCA). When NOCA is characterized by angina, certain authors refer to it as angina with NOCA (ANOCA) while others recommend ischemia with NOCA (INOCA) to avoid the carved link between ‘angina’ and ischemia caused by epicardial vessels [14]. In this review, we revisit the clinical importance of coronary microvascular disease (CMD), also referred to in the literature as microvascular angina and/or impaired vasodilation, and invasive parameters of coronary microcirculation assessment, and review novel angiography-derived indexes of microvascular resistance. We will discuss the strengths and weaknesses of these novel noninvasive indexes and evaluate their usefulness in different clinical scenarios.
Pre-treatment with compound Danshen dripping pills prevents lipid infusion-induced microvascular dysfunction in mice
Published in Pharmaceutical Biology, 2020
Yanda Zhang, Jian Zhao, Ru Ding, Wenhao Niu, Zhiqing He, Chun Liang
CDDP is a modernized pharmacological preparation based on traditional Chinese medicine therapeutic theory. It came into market in 1994 and has completed its II phase and III phase clinical trials in the USA (Liao et al. 2019). The active pharmacodynamic substances consist mainly of phenolic acids, saponins and borneol. As previously described, CDDP has inhibiting cardiac cell apoptosis, anti-oxidative, anti-inflammatory and endothelium-protective effects (Jun et al. 2014; Chinese Geriatrics Society 2017). CDDP could enhance a metabolic shift towards fatty acids metabolism in order to modulate the perturbed energy metabolism in a rat model of acute myocardial ischaemia, and it could also protect cardiomyocytes and inhibit apoptosis by activating Akt-eNOS signalling pathway (Ren-an et al. 2014; Guo et al. 2016). Clinical trial has presented that CDDP as a supplement to general therapy for microvascular angina can increase treatment efficacy and plasma NO level (Fang 2015).
Interventional Cardiology at a Pivot Point
Published in Structural Heart, 2018
In view of the foregoing, it would seem critical to identify patients in whom both microvascular dysfunction and coronary obstruction are present. A consensus document by the Coronary Vasodilation Disorders International Study Group (COVADIS) defined four criteria for the diagnosis of microvascular angina, one of which is the detection of abnormal microvascular function.8 Several invasive techniques exist by which this can be done, including the measurement of coronary velocity and blood flow reserve, quantitation of microvascular resistance, and detection of coronary spasm by intracoronary Doppler and thermodilution methods or acetylcholine injection. More techniques need to be defined. The important point is that interventional cardiologists will have to become more oriented to physiology in the future. It is likely that the future role of PCI in patients with stable angina will depend upon identifying those patients in whom ischemia and angina are due to coronary obstruction rather than some other mechanism, and that this will require detailed evaluation of coronary physiology on a level that is not typically applied at the current time. As such, this will represent a bit of pivot.