The authors demonstrate the case of a female patient with hypothyroid myopathy where they recorded repeatedly a rise of enzymes used for the diagnosis of acute myocardial infarction, whereby myocardial infarction was not revealed. The authors followed up the disease for two years. They evaluated the relationship between the state of substitution and the activity of the mentioned enzymes and myoglobin.
In 1991-1993 the authors made at the Second Medical Clinic of the Faculty Hospital in Hradec Králové 651 coronarographic examinations: in 460 patients they detected ischaemic heart disease, of the latter 44 (9.6%) suffered from stenosis of the trunk of the left coronary. During the premorbid period the authors evaluated the grade of stenocardia according to the Canadian cardiovascular classification and also the incidence, number of coronary attacks and reason for indicating coronarography. In 29 patients (66%) the authors made an ergometric examination--in 82.8% the finding was positive and in 17.2 negative. The loading test was unequivocally positive only in complete obstruction of the left coronary, in case of multiarterial affection almost in all cases. Coronarography revealed only in 4 patients (9%) isolated stenosis of the trunk of the left coronary, most frequently the finding was also on two other (36.4%) or 3 (34.1%) arteries. Complete occlusion of the trunk of the left coronary was recorded in 6.8%. An ejection fraction of 50% or more was recorded in 75% of the patients. Surgical revascularization was performed in 35 patients. Twenty-nine patients are followed up after operation on a long-term basis (on average for 7.8 months), 23 of the patients report improvement of their complaints (65.7%). The investigation provided evidence that stenosis of the trunk of the left coronary is a relatively frequent finding in the patient population with ischaemic heart disease and that it is most frequently associated with affection of two and three arteries.(ABSTRACT TRUNCATED AT 250 WORDS)
The authors present an integrated view on the role of stents in different indications in patients with IHD from the aspect of recently published or presented randomized trials.
One-year open Multicentric Isradipine Study (MIS) performed in 7 centres in Czechoslovakia included 144 patients with mild and moderate hypertension. Isradipine was given at a dose of 2.5 mg daily. If normalization of diastolic blood pressure (BP) had not been reached, the dosage was increased to 5 mg. Monotherapy with isradipine normalized diastolic BP in 44% of patients. Isradipine (5 mg daily) was combined with bopindolol in patients in whom isradipine alone failed to normalize diastolic BP. These had higher mean systolic and diastolic BP, body weight, erythrocyte and platelet counts at the beginning of the study. The combination of isradipine with bopindolol normalized diastolic BP in 87% of the group at the end of 48 weeks' treatment. Tolerance was excellent in 82% of patients. Treatment was discontinued in 8% patients, undesirable effects being the reason in 2%, ineffective therapy in 2% and poor adherence to therapy in 4%. Isradipine in monotherapy or in combination with bopindolol did not exert an adverse effect on the metabolic risk factors of ischaemic heart disease (cholesterol, glycaemia).
