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Predicate | Object |
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rdf:type | |
lifeskim:mentions | |
pubmed:issue |
10
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pubmed:dateCreated |
1983-7-8
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pubmed:abstractText |
In 18 consecutive patients without a history of myocardial infarction (MI), prolonged angina pectoris with persistent negative T waves in the precordial leads was associated with a high frequency of in-hospital spontaneous angina (14 of 18, 78%), usually accompanied by S-T segment elevation, and occasionally in-hospital MI (4 of 18, 22%). Angina and MI always involved the electrocardiographic leads with negative T waves. Coronary arteriography, performed in 16 patients, revealed greater than or equal to 90% proximal diameter reduction of the left anterior descending (LAD) coronary artery in 14 patients. No patient had severe narrowing of all 3 major coronary arteries, but the 3 who had 100% LAD occlusion lacked collateral circulation. The ejection fraction was greater than or equal to 50% in 13 patients. Atrial pacing performed in 11 patients at an average rate of 142 beats/min produced a 1.0 mm S-T segment change in only 5 patients (45%), 3 of whom had an associated lactate production. Arterial systemic hypertension induced by methoxamine in 14 patients caused reversal of negative T waves without significant S-T segment shifts or chest pain and failed to elicit lactate extraction abnormalities in each of the 5 patients in whom it was determined. Thus, prolonged angina with persistent negative T waves in the precordial leads is almost invariably associated with a critical and proximal LAD obstruction, severe narrowing of 1 or 2 coronary arteries, and poor or absent collateral vessels. The relatively preserved coronary reserve in 55% of our patients suggests that negative T waves do not represent active myocardial ischemia. The study also suggests that transient "positivization" of the negative T waves may not necessarily relate to myocardial ischemia when associated with acute systemic hypertension.
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pubmed:language |
eng
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pubmed:journal | |
pubmed:citationSubset |
AIM
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pubmed:chemical |
http://linkedlifedata.com/resource/pubmed/chemical/Methoxamine,
http://linkedlifedata.com/resource/pubmed/chemical/Technetium,
http://linkedlifedata.com/resource/pubmed/chemical/Technetium Tc 99m Pyrophosphate,
http://linkedlifedata.com/resource/pubmed/chemical/Tin Polyphosphates,
http://linkedlifedata.com/resource/pubmed/chemical/technetium Tc 99m stannous...
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pubmed:status |
MEDLINE
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pubmed:month |
Jun
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pubmed:issn |
0002-9149
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pubmed:author | |
pubmed:issnType |
Print
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pubmed:volume |
51
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
1599-607
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pubmed:dateRevised |
2004-11-17
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pubmed:meshHeading |
pubmed-meshheading:6858864-Adult,
pubmed-meshheading:6858864-Aged,
pubmed-meshheading:6858864-Angina Pectoris,
pubmed-meshheading:6858864-Cardiac Pacing, Artificial,
pubmed-meshheading:6858864-Collateral Circulation,
pubmed-meshheading:6858864-Coronary Angiography,
pubmed-meshheading:6858864-Electrocardiography,
pubmed-meshheading:6858864-Female,
pubmed-meshheading:6858864-Humans,
pubmed-meshheading:6858864-Hypertension,
pubmed-meshheading:6858864-Male,
pubmed-meshheading:6858864-Methoxamine,
pubmed-meshheading:6858864-Middle Aged,
pubmed-meshheading:6858864-Stroke Volume,
pubmed-meshheading:6858864-Technetium,
pubmed-meshheading:6858864-Technetium Tc 99m Pyrophosphate,
pubmed-meshheading:6858864-Tin Polyphosphates
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pubmed:year |
1983
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pubmed:articleTitle |
Prolonged angina pectoris and persistent negative T waves in the precordial leads: response to atrial pacing and to methoxamine-induced hypertension.
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pubmed:publicationType |
Journal Article
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