The electrocardiogram during attacks of angina pectoris; Its characteristics and diagnostic significance

Riseman, Joseph E. F.; Waller, John V.; Brown, Morton G.

doi:10.1016/s0002-8703(40)90614-7

Cited by 60 publications

(7 citation statements)

References 38 publications

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“…The most striking change in lead 4R was observed immediately (within 15 seconds) after the cessation of exercise and consisted of a depression of the RS-T segments; this is in accord with previous studies. 25 In these five patients, nitroglycerin not only prevented attacks of angina, but also decreased markedly the RS-T depression. The average RS-T depression following exercise was 2.1 mm.…”

Section: Electrocardiographic Studiesmentioning

confidence: 76%

“…This indicates that compared with the maximum amount of work which could be performed while taking placebos, the exercise tolerance in the laboratory was increased either by at least 50 per cent before the patient was forced to stop because of pain or by at least 25 The usual number of trips which could be performed under standardized conditions by each patient while taking placebos and the change following medication are shown in table 2. The change in ability to work following medication is expressed as the percentage increase (or decrease) in exercise tolerance as compared with the maximum number of trips which could be performed while taking placebos.…”

Section: Evaluation Of Resultsmentioning

confidence: 99%

“…Of the remaining 26, a moderate or marked response was shown by 10 (38 per cent); these 10 were all patients of groups 1 and 2 and constituted 47 per cent of the 21 patients in these two The comparative value of quinine and quinidine is best shown by the 25 patients whose response to both drugs was tested (table 5). Of these 25 patients, the results in 15 (60 per cent) were identical; four additional patients (16 per cent) showed a response to both drugs but a better response to one than to the other. The remaining six patients (24 per cent), showed a moderate or marked response to one drug but no appreciable response to the other.…”

Section: Miscellaneous Control Studiesmentioning

confidence: 99%

“…After the therapeutic value of the drugs had been determined as above, electrocardiographic studies were carried out in some patients who showed a beneficial result in order to determine if the effect was accompanied by objective evidence of a decrease in myocardial anoxia.18, 25 In order to obtain tracings with a minimum of somatic tremor or wandering of the base line during and immediately after exercise, the arm electrodes were applied just below the insert-on of the deltoids; the leg electrodes were applied over the bony prominence of the iliac crests; a precordial electrode (measuring 212 by 112 inches) was applied in the fifth left intercostal space at the midelavicular line, and the cable was held in the patient's right hand against his body. A direct recording Sanborn Electrocardiograph was used.…”

Section: Electrocardiographic Studiesmentioning

confidence: 99%

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Treatment of Angina Pectoris with Cinchona Alkaloids

Riseman¹,

Steinberg²,

Altman³

1954

Circulation

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Reports indicating the value of quinidine sulfate in angina pectoris led to (1) a search for related drugs which were equally effective but less toxic, and (2) a study of the mode of action of these drugs. It was found that quinidine, quinine, cinchonadine, and cinchamidine decrease the frequency of attacks in daily life and increase the exercise tolerance as measured by a standardized test. Quinine sulfate (0.3 to 0.4 Gm. every eight hours) appears to be the drug of choice from the standpoint of availability and low toxicity as well as effectiveness. The value of these drugs is apparently due to a vasodilating action which in turn is dependent on the presence of the quinoline ring.P REVIOUS studies1-6 have demonstrated the value of quinidine sulfate in the treatment of some patients with angina pectoris. However, most general practitioners and, in fact, many cardiologists hesitate to use quinidine in angina because of the complications which occasionally follow its use in the treatment of cardiac arrhythmias. Furthermore, many physicians hesitate to use quinidine in angina pectoris because its mode of action in this condition is not clear. It seemed worthwhile, therefore, to study the activity of drugs related to quinidine in an attempt to find a substance equally effective but possibly less toxic and also to throw some light on the mechanism of action in the treatment of angina pectoris.The comparative value of 12 pharmaceutical preparations was investigated in patients with angina pectoris. Five of these 12 were cinchona alkaloids (the sulfate salts of quinidine, quinine, cinchonine, cinchonidine, and cinchamidine); these were studied to determine whether drugs which were similar to quinidine in chemical structure but different in cardiodynamic and cardiotoxic effects were of therapeutic value in angina. Procaine amide (Pronestyl) was included because, like quinidine, it is of value in eliminating ectopic ventricular beats. Three

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Section: Electrocardiographic Studiesmentioning

confidence: 76%

Section: Evaluation Of Resultsmentioning

confidence: 99%

Section: Miscellaneous Control Studiesmentioning

confidence: 99%

Section: Electrocardiographic Studiesmentioning

confidence: 99%

See 2 more Smart Citations

Treatment of Angina Pectoris with Cinchona Alkaloids

Riseman¹,

Steinberg²,

Altman³

1954

Circulation

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“…Nos primórdios do teste ergométrico os registros eletrocardiográficos eram realizados apenas após o exercício devido à dificuldades técnicas 1,2 . Com o desenvolvimento da monitorização contínua, os traçados durante o exercício passaram a ser valorizados e a maioria dos autores da atualidade tem destacado as alterações do segmento ST durante esforço como preditivas da doença coronária 3,4,5 .…”

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Teste de esforço: alterações do segmento ST restritas à fase de recuperação

Fo¹,

Fo²,

Salles³

et al. 1999

Rev. Assoc. Med. Bras.

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RESUMO -OBJETIVO. Determinar a incidência de doença coronária aterosclerótica (DCA) e/ou isquemia miocárdica em pacientes (pt) com alterações do segmento ST restritas à fase de recuperação (ASTRR) do teste ergométrico.CASUÍSTICA E MÉTODO. Estudo retrospectivo em 19 pacientes não consecutivos com ASTRR, através da cinecoronariografia e/ou cintigrafia de esforço planar. Amostra de 18 homens, uma mulher, com idade de 58 ± 9 anos, 18 sintomáticos.RESULTADOS. ASTRR correspondem a segmentos ST infra-desnivelados de 1 a 4 mm da linha de base, com inversão da onda T durante a recuperação precoce (2pt), tardia (14 pt). Foi documentada DCA em 14 pt (nove submetidos à cirurgia de revascularização); miocardiopatia hipertensiva INTRODUÇÃONos primórdios do teste ergométrico os registros eletrocardiográficos eram realizados apenas após o exercício devido à dificuldades técnicas 1,2 . Com o desenvolvimento da monitorização contínua, os traçados durante o exercício passaram a ser valorizados e a maioria dos autores da atualidade tem destacado as alterações do segmento ST durante esforço como preditivas da doença coronária 3,4,5 . Estudos mais recentes têm demonstrado o valor das alterações de ST restritas à fase de recuperação (ASTRR) no diagnóstico da doença coronária em pacientes sintomáticos 6-10 e assintomáticos 11 . A fisiopatologia destas alterações permanece obscura; tem sido relacionada a espasmo coronário 12 ,à níveis elevados de catecolaminas plasmáticas 6,13 e à hipopotassemia 14,15,16 . Descreveram-se abolições destas respostas após angioplastia coronária e correção da hipopotassemia 15 .Na prática clínica diária, ASTRR tem sido encontrada com certa freqüência, registrando-se na literatura especializada prevalência entre 2,3 a 7,9% 6-8 . Entretanto, dado ao pequeno número de publicações 6-9 , ASTRR não tem sido devidamente valorizada, permanecendo a investigação cardiológica restrita apenas aos casos de maior gravidade.Neste estudo retrospectivo, descrevemos uma amostra de pacientes não-sucessivos, portadores de alterações de ST restritas à fase de recuperação. É feita revisão da literatura, a qual mostra escasso número de publicações 6-9 e citações 10-12 relativas à ASTRR. MÉTODO E CASUÍSTICAEm levantamento retrospectivo, entre 1986 e 1993, detectaram-se 32 casos não-consecutivos de pacientes em cujo TE existiam alterações de ST restritas à fase de recuperação (ASTRR). Em 13 casos, ASTRR não foram valorizadas pelos médi-cos assistentes e os respectivos pacientes não foram investigados quanto à presença ou não de cardiopatia. Este estudo se baseia nos 19 casos submetidos à investigação clínica (tabela 1). Nossa casuística compreendeu 18 homens e uma mulher com idade de 58 ± 9 anos; 18 pacientes eram sintomáticos, com sintomas de dor torácica. Em 18 pacientes havia estudo cinecoronariográfico; em oito casos o intervalo de tempo entre a cinecoronariografia e o TE era inferior a seis meses (casos 1,2,3,4,5,6,7,8). Doze pacientes tinham se submetido à cintigrafia de esforço; em seis casos (casos 8,9,10,11,12,13) a cinti...

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Controlled Hypoxemia Test for Coronary Insufficiency Employing the Millikan Oximeter

TEWELL¹

1952

AMA Arch Intern Med

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The electrocardiogram during attacks of angina pectoris; Its characteristics and diagnostic significance

Cited by 60 publications

References 38 publications

Treatment of Angina Pectoris with Cinchona Alkaloids

Treatment of Angina Pectoris with Cinchona Alkaloids

Teste de esforço: alterações do segmento ST restritas à fase de recuperação

Controlled Hypoxemia Test for Coronary Insufficiency Employing the Millikan Oximeter

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