Displaying publications 1 - 20 of 21 in total

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  1. Angina pectoris - some new aspects of management in an old disease
    Eravelly J
    Family Practitioner, 1976;2:16-24.
    Matched MeSH terms: Angina Pectoris
  2. Cardiac angina
    Wingfield A
    Malayan Medical Journal, 1937;12:116-8.
    Matched MeSH terms: Angina Pectoris
  3. Fulltext Descriptive terms used by Malay patients for exertional angina pectoris
    Khalid Y, Malina O, Rofiah A, Latinah M, Thahirahtul AZ, Zaridah MS, et al.
    Med J Malaysia, 1994 Sep;49(3):209-11.
    PMID: 7845267
    Description of the chest pain of angina pectoris by patients is commonly used in the diagnosis, evaluation and monitoring of ischaemic heart disease. Whilst certain descriptive terms have been identified as describing angina and not other causes of chest pain, these terms have not been systematically evaluated among local Malaysian patients. Reliance on a translation of the description used by Western patients may not be totally correct in the local context. Seventy-one Malay patients with documented ischaemic heart disease were asked, by questionnaire and by interview, to identify the descriptive terms they used for their angina pectoris. Common terms used by these patients were sempit (constrictive) [56.3%], mencuck (pricking) [54.9%], berat (heavy) [53.5%], panas (burning) [50.7%], menekan (pressing) [46.4%], and pedih (smarting) [43.7%]. Other less common descriptions used were tajam (sharp), mencengkam (strangulating), hempap (compressive), ngilu, hiris (knife-like), lengoh (aching). Two-thirds of the patients used more than three terms to describe their angina pectoris. Direct translation of the description of angina may not only be inaccurate but could also be misleading. It is suggested that the actual words used by the patients in Bahasa Malaysia be recorded in the patient's notes rather than a translation of these. More studies are required to determine whether the terms used by the patients in this study are related to local dialect (in this case Terengganu) or are actually common in Malaysia. Further, similar studies among Chinese and Indian patients are also required.
    Matched MeSH terms: Angina Pectoris/diagnosis; Angina Pectoris/ethnology*
  4. Fulltext Total occlusion of left main coronary artery in a patient with chronic, stable angina
    Soo CS, Choo M, Sim E, Ling LH, Tan K, Lee CN
    Med J Malaysia, 1992 Mar;47(1):74-6.
    PMID: 1387455
    We report a case of total occlusion of the left main coronary artery (LMCA) in a patient with chronic, stable angina. Total occlusion of the LMCA is rare and survival depends on the existence of collateral circulation. In LMCA disease, there is usually also disease in other parts of the coronary arterial tree.
    Matched MeSH terms: Angina Pectoris/diagnosis*
  5. Fulltext Sociocultural influences on disease perception
    Yusoff K
    Med J Malaysia, 1994 Sep;49(3):197-8.
    PMID: 7845264
    Matched MeSH terms: Angina Pectoris/diagnosis; Angina Pectoris/ethnology; Angina Pectoris/psychology
  6. Fulltext Current trends in the surgical management of coronary artery disease
    Saw Huat Seong
    Med J Malaysia, 1987 Dec;42(4):252-63.
    PMID: 3331407
    Coronary artery surgery as we know it today, has undergone rapid evolution since its introduction in the late 1960's, resulting, not surprisingly, in much confusion. In an attempt to present the state of the art, a collective review of the literature, coupled with the experiences with 118 patients is presented and discussed. The modern surgical management of patients with obliterative coronary artery disease is designed to relieve symptoms, prolong life and identify patients at high risk of premature death or myocardial infarction if they were to continue with medical management. Though the most common indication for surgery is persistent limitation of life style by severe symptoms, management is influenced by the strong association between such symptoms and increased mortality. During the short history of coronary bypass surgery, other indications for operation have been influenced by a combination of lessons from the past and hopes for the future. In addition, advances in technology have produced an enormous impetus for improvements in patient evaluation, surgical technique and postoperative care. As these advances continue and as more and more late results of surgery become available, answers to questions about surgery may increasingly be deduced from lessons rather than from hopes. As a result of these changes, an aura of confusion has gradually crept into the scene. It is hoped that this collective review, together with experiences gained from a personal series of 118 patients over a 3 year period from 1984 to 1986, will put into proper perspective, the state of the art of surgical management of coronary artery disease today.
    Matched MeSH terms: Angina Pectoris/surgery
  7. Fulltext Syndrome X: an uncommon cause of angina
    Ong HT
    Med J Malaysia, 1991 Dec;46(4):379-83.
    PMID: 1840450
    A 61-year old lady presented clinically in unstable angina with ST-segment depression typical of myocardial ischemia. However, coronary arteries were completely normal at angiography. Exercise testing reproduced symptoms and ST-segment depression. A diagnosis of Syndrome X was made, an uncommon disorder of myocardial ischemia with normal coronary anatomy and excellent prognosis.
    Matched MeSH terms: Angina Pectoris/etiology*
  8. Vascular Remodeling in Coronary Microvascular Dysfunction
    Collet C, Sakai K, Mizukami T, Ohashi H, Bouisset F, Caglioni S, et al.
    JACC Cardiovasc Imaging, 2024 Dec;17(12):1463-1476.
    PMID: 39269414 DOI: 10.1016/j.jcmg.2024.07.018
    BACKGROUND: Approximately one-half of the patients with angina and nonobstructive coronary artery disease (ANOCA) have evidence of coronary microvascular dysfunction (CMD).

    OBJECTIVES: This study aims to characterize patients with ANOCA by measuring their minimal microvascular resistance and to examine the pattern of vascular remodeling associated with these measurements.

    METHODS: The authors prospectively included patients with ANOCA undergoing continuous thermodilution assessment. Lumen volume and vessel-specific myocardial mass were quantified using coronary computed tomography angiography (CTA). CMD was defined as coronary flow reserve <2.5 and high minimal microvascular resistance as >470 WU.

    RESULTS: A total of 153 patients were evaluated; 68 had CMD, and 22 of them showed high microvascular resistance. In patients with CMD, coronary flow reserve was 1.9 ± 0.38 vs 3.2 ± 0.81 in controls (P < 0.001). Lumen volume was significantly correlated with minimal microvascular resistance (r = -0.59 [95% CI: -0.45 to -0.71]; P < 0.001). In patients with CMD and high microvascular resistance, lumen volume was 40% smaller than in controls (512.8 ± 130.3 mm3 vs 853.2 ± 341.2 mm3; P < 0.001). Epicardial lumen volume assessed by coronary CTA was independently associated with minimal microvascular resistance (P < 0.001). The predictive capacity of lumen volume from coronary CTA for detecting high microvascular resistance showed an area under the curve of 0.79 (95% CI: 0.69-0.88).

    CONCLUSIONS: Patients with CMD and high minimal microvascular resistance have smaller epicardial vessels than those without CMD. Coronary CTA detected high minimal microvascular resistance with very good diagnostic capacity. Coronary CTA could potentially aid in the diagnostic pathway for patients with ANOCA.

    Matched MeSH terms: Angina Pectoris/etiology; Angina Pectoris/physiopathology
  9. Fulltext Extracorporeal shockwave myocardial therapy is efficacious in improving symptoms in patients with refractory angina pectoris--a multicenter study
    Prasad M, Wan Ahmad WA, Sukmawan R, Magsombol EB, Cassar A, Vinshtok Y, et al.
    Coron Artery Dis, 2015 May;26(3):194-200.
    PMID: 25734606 DOI: 10.1097/MCA.0000000000000218
    OBJECTIVE: Medically refractory angina remains a significant health concern despite major advances in revascularization techniques and emerging medical therapies. We aimed to determine the safety and efficacy of extracorporeal shockwave myocardial therapy (ESMT) in managing angina pectoris.

    METHODS: A single-arm multicenter prospective study was designed aiming to determine the safety and efficacy of ESMT. Patients of functional Canadian Cardiovascular Society class II-IV, despite stable and optimal medical management, with documented myocardial segments with reversible ischemia and/or hibernation on the basis of echocardiography/single-photon emission computerized tomography (SPECT) were enrolled from 2010 to 2012. A total of 111 patients were enrolled, 33 from Indonesia, 21 from Malaysia, and 57 from Philippines. Patients underwent nine cycles of ESMT over 9 weeks. Patients were followed up for 3-6 months after ESMT treatment. During follow-up, patients were subjected to clinical evaluation, the Seattle Angina Questionnaire, assessment of nitrate intake, the 6-min walk test, echocardiography, and SPECT.

    RESULTS: The mean age of the population was 62.9±10.9 years. The summed difference score on pharmacologically induced stress SPECT improved from 9.53±17.87 at baseline to 7.77±11.83 at follow-up (P=0.0086). Improvement in the total Seattle Angina Questionnaire score was seen in 83% of patients (P<0.0001). Sublingual nitroglycerin use significantly decreased (1.14±1.01 tablets per week at baseline to 0.52±0.68 tablets per week at follow-up; P=0.0215). There were no changes in left ventricular function on echocardiography (0.33±9.97, P=0.93). The Canadian Cardiovascular Society score improved in 74.1% of patients.

    CONCLUSION: This multicenter prospective trial demonstrated that ESMT is both a safe and an efficacious means of managing medically refractory angina.

    Matched MeSH terms: Angina Pectoris/diagnosis; Angina Pectoris/physiopathology; Angina Pectoris/therapy*
  10. Fulltext Diagnosing angina using a simple neural network architecture
    Bulgiba, A.M.
    JUMMEC, 2006;9(1):39-43.
    MyJurnal
    The aim of the study was to research the use of a simple neural network in diagnosing angina in patients complaining of chest pain. A total of 887 records were extracted from the electronic medical record system (EMR) in Selayang Hospital, Malaysia. Simple neural networks (simple perceptrons) were built and trained using a subset of 470 records with and without pre-processing using principal components analysis (PCA). These were subsequently tested on another subset of 417 records. Average sensitivity of 80.75% (95% CI 79.54%, 81.96%), specificity of 41.64% (95% CI 40.13%, 43.15%), PPV of 46.73% (95% CI 45.20%, 48.26%) and NPV of 77.39% (95% CI 76.11%, 78.67%) were achieved with the simple perceptron. When PCA pre-processing was used, the perceptrons had a sensitivity of 1.43% (95% CI 1.06%, 1.80%), specificity of 98.32% (95% CI 97.92%, 98.72%), PPV of 32.95% (95% CI 31.51%, 34.39%) and NPV of 61.33% (95% CI 59.84%, 62.82%). These results show that it is possible for a simple neural network to have respectable sensitivity and specificity levels for angina.
    Matched MeSH terms: Angina Pectoris
  11. Total occlusion of left main coronary artery in Orientals: profile of 4 cases
    Soo CS, Ling LH, Yeoh JK, Choo M, Kannan P
    Angiology, 1993 Dec;44(12):929-32.
    PMID: 8285368
    The authors report 4 Oriental cases of total occlusion of the left main coronary artery (LMCA) with differing presentations. The first patient had a twelve-year history of stable angina pectoris. The second patient had angina for a year, which became unstable two months prior to diagnosis. The third patient had myocardial infarction seven years ago and presented with a one-month history of rest angina. The fourth patient had stable effort angina for six years but presented with accelerated angina three months prior to diagnosis. The incidence of total occlusion of the LMCA is rare and survival depends on the existence of collateral circulation. In LMCA disease, there is usually disease in other parts of the coronary arterial tree, and hence, the need for urgent coronary bypass surgery.
    Matched MeSH terms: Angina Pectoris/etiology
  12. Fulltext Association of diabetic autonomic neuropathy with painless myocardial ischaemia induced by exercise
    Quek DK, Khor PG, Ong SB
    Singapore Med J, 1992 Apr;33(2):177-81.
    PMID: 1621124
    Silent myocardial ischaemia is now well-recognised in patients with symptomatic coronary artery disease. Its pathogenesis remains speculative, though diminished sensitivity to pain is thought to be one of the mechanisms involved. Because cardiovascular autonomic dysfunction occurs frequently in diabetic patients, we postulate that it contributes towards painless myocardial ischaemia among them. Forty consecutive diabetic (type II) male patients and ten normal volunteers were studied. Using 5 previously-validated noninvasive tests for autonomic dysfunction, 14 of these diabetic men had definite autonomic neuropathy (at least 2 abnormal tests). All 50 subjects were then exercised on a motor-driven treadmill to either exhaustion or chest pains. Thirty-three diabetic subjects were tested positive, with significant (greater than 1 mm) ST segment depression over at least 2 contiguous leads. Of these, 18 were associated with typical angina but the other 15 stopped because of fatigue or exhaustion (ie painless). Thirteen subjects who had definite autonomic neuropathy (AN+) had positive exercise ECG tests-10 had painless ischaemia, and only 3 had angina. This contrasted with 15 patients who had painful ischaemia and 5 who had painless ischaemia among the group without (AN-)autonomic dysfunction (p = 0.0047, Fisher's exact test). There were no significant differences among the various groups for peak rate-pressure-product, all subjects attaining similar maximal oxygen consumption states during which ischaemic ST segment changes were noted (painful AN+: 21917 +/- 4753; painless AN+: 20117 +/- 6752; painful AN-: 16544 +/- 4063; painless AN-: 22220 +/- 4341, p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)
    Matched MeSH terms: Angina Pectoris/diagnosis
  13. Are examination findings important in screening for angina in the Malaysian patient?
    Bulgiba AM
    Prev Med, 2005 Jun;40(6):696-701.
    PMID: 15850867
    The objective of this study is to look at how well patient history and examination findings can be used in screening for angina.
    Matched MeSH terms: Angina Pectoris/diagnosis*; Angina Pectoris/epidemiology
  14. Fulltext Coronary artery spasm: A quandary
    Ngow, H.A., Wan Khairina, W.M.N.
    International Medical Journal Malaysia, 2011;10(1):53-55.
    MyJurnal
    Coronary artery spasm can result in acute coronary syndrome. This vasospastic syndrome can cause profound morbidity and mortality as a significant proportion of patients continue to have angina despite optimal medical therapy. We illustrate the dilemma in managing a young woman who presented with non ST-segment myocardial infarction as a result of it. She did not have the conventional risks for coronary artery disease except the family history of myocardial infarction. Vasospasm was demonstrated at the mid right coronary artery which resolved with intracoronary nitroglycerine during angiogram. Most women with no significant heart disease following demonstration of normal or “near normal” coronary arteries after angiography are offered no treatment beyond reassurance each year. New data suggest that this approach may no longer be appropriate and the prognosis in such patient is not as benign as previously thought. We discuss the management dilemma of such patient with associated mild atherosclerotic plaque.
    Matched MeSH terms: Angina Pectoris
  15. Fulltext Wellen's syndrome: Challenges in diagnosis
    Agarwal A, Vyas S, Kumar R
    Malays Fam Physician, 2015;10(3):35-7.
    PMID: 27570607
    Wellen's syndrome is a pre-infarction stage of coronary artery disease characterised by predefined clinical and electrocardiographic (ECG) criteria of a subgroup of patients with myocardial ischaemia. Early recognition and appropriate intervention of this syndrome carry significant diagnostic and prognostic value. We report this unusual syndrome in an elderly man who presented with recurrent angina and characteristic ECG changes as T-waves inversion in the precordial leads, especially in V2-V6 during pain-free periods and ECG obtained during episodes of pain demonstrating upright T-waves with possible elevated ST segments from V1-V4. Cardiac enzymes were positive and coronary angiography revealed critical stenosis in the proximal left anterior descending artery. It is important to timely identify this condition and intervene appropriately as these patients may develop extensive myocardial infarction that carries a significant morbidity and mortality.
    Matched MeSH terms: Angina Pectoris
  16. Prevalence and risk factors of retinal arteriolar emboli: the Singapore Malay Eye Study
    Cheung N, Lim L, Wang JJ, Islam FM, Mitchell P, Saw SM, et al.
    Am J Ophthalmol, 2008 Oct;146(4):620-4.
    PMID: 18639861 DOI: 10.1016/j.ajo.2008.05.033
    To examine the prevalence and risk factors of retinal arteriolar emboli, a risk predictor of stroke, in an Asian population.
    Matched MeSH terms: Angina Pectoris/ethnology
  17. Contrast media induced transient cortical blindness
    Balasingam S, Azman RR, Nazri M
    QJM, 2016 Feb;109(2):121-2.
    PMID: 26101228 DOI: 10.1093/qjmed/hcv121
    Matched MeSH terms: Angina Pectoris/diagnosis*
  18. [Long-term treatment using Arwin of patients with chronic peripheral arterial blood circulation disorders]
    Ehrly AM
    Subsid Med, 1974;4:56-7.
    PMID: 4548779
    Matched MeSH terms: Angina Pectoris/etiology
  19. Ancrod decreases the frequency of cyclic flow variations and causes thrombolysis following acute coronary thrombosis
    Apprill PG, Ashton J, Guerrero J, Glas-Greenwalt P, Buja LM, Willerson JT
    Am Heart J, 1987 Apr;113(4):898-906.
    PMID: 3565240
    The potential use of ancrod, a purified isolate from the venom of the Malaysian pit viper, Agkistrodon rhodostoma, in decreasing the frequency of cyclic flow variations in severely stenosed canine coronary arteries and causing thrombolysis of an acute coronary thrombus induced by a copper coil was evaluated. Open-chest, anesthetized dogs were used. Ancrod was given intravenously (8 U/kg) over 1 hour and caused a significant reduction in the frequency of cyclic flow variations (5.8 +/- 0.7 to 3.6 +/- 0.8 cyclic flow variations per 30 minutes, p less than 0.05), whereas control animals failed to decrease the frequency of their cyclic flow variations over the same time period (5.3 +/- 0.3 to 5.0 +/- 0.4 cyclic flow variations per 30-minute period). Twenty-seven dogs had a coronary thrombus induced by a copper coil positioned directly in a major coronary artery; of these, four died of ventricular fibrillation prior to treatment, eight received an infusion of saline and showed no thrombolysis over 5 hours, and three died of ventricular fibrillation during the initial part of an intravenous infusion of ancrod. The remaining 12 dogs received ancrod intravenously (16 U/kg); six demonstrated lysis of the coronary thrombus (mean time to lysis, 65 +/- 20 minutes). The concentrations of ancrod used in these studies produced a severe decrease in systemic fibrinogen concentration and a significant decrease in the inhibitor of plasminogen activator levels. Thus, ancrod decreases the frequency of cyclic flow variations in stenosed canine coronary arteries and may cause coronary thrombolysis in approximately 50% of animals within 65 +/- 20 minutes of its intravenous administration.
    Matched MeSH terms: Angina Pectoris/drug therapy
  20. Fulltext The validity and reliability of the Turkish version of the Seattle Angina Questionnaire
    Duruöz MT, Şanal Toprak C, Ulutatar F, Suhaimi A, Agirbasli M
    Turk Kardiyol Dern Ars, 2020 Nov;48(8):731-738.
    PMID: 33257610 DOI: 10.5543/tkda.2020.24583
    OBJECTIVE: The purpose of this study was to assess the validity and reliability of a Turkish version of the Seattle Angina Questionnaire (SAQ) in patients with coronary heart disease (CHD) and angina.

    METHODS: The SAQ was translated from English to Turkish using the back-translation method. It contains 19 questions scored from 1 to either 5 or 6 in 5 domains (physical limitation, angina stability, angina frequency, disease perception, and treatment satisfaction). Cronbach's alpha coefficient was used to evaluate internal consistency. Spearman's rank correlation coefficient was calculated to assess the construct validity. Convergent validity was examined using correlations between the SAQ and the MacNew Heart Disease Health-related Quality of Life Questionnaire (MacNew) and the Nottingham Health Profile. Divergent validity was evaluated using correlations between the SAQ and age, body mass index (BMI), gender, and the marital status of patients. A value of p<0.05 was considered statistically significant.

    RESULTS: Sixty-seven patients were enrolled in the study. The mean age of the study patients was 58.7 years (SD: 10.2). Cronbach's alpha scores of the SAQ, ranging in value from 0.715 to 0.910, demonstrated that this scale is reliable. All of the SAQ scales had a significant correlation with all of the MacNew scales, which indicated that the scale has convergent validity. Insignificant correlations with age, BMI, gender, and marital status illustrated the good divergent validity of the scale.

    CONCLUSION: The Turkish version of the SAQ is a valid and reliable instrument. It is a useful and practical tool to evaluate patients with angina and CHD.

    Matched MeSH terms: Angina Pectoris
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