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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*
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
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
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
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*
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*
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