![]() Three grades of malignancy are usually recognized: G1, low grade G2, intermediate grade G3, high grade. ![]() ![]() The precise prevalence of primary cardiac tumors in the general population is mostly based on old postmortem studies and it is generally agreed that autopsy prevalence of primary cardiac tumors is 1/2,000 and that of secondary cardiac tumors is 1/100 autopsies, with a secondary/primary cardiac tumors ratio of 20:1.Īccording to the last WHO classification, cardiac tumors are grouped in three categories, i.e., benign tumors and tumor-like lesions malignant tumors and pericardial tumors.Īs far as malignant cardiac tumors are concerned, there is no a grading system specifically referring to malignant cardiac tumors and we have to refer to the criteria used for soft tissue neoplasms. Whether these associations are causal is unclear. Anxiety disorders are associated with an elevated risk of a range of different cardiovascular events, including stroke, coronary heart disease, heart failure and cardiovascular death. Results were broadly consistent in sensitivity analyses. Phobic anxiety was associated with a higher risk of coronary heart disease than other anxiety disorders and PTSD was associated with a higher risk of stroke. Anxiety was not significantly associated with major cardiovascular events or atrial fibrillation, although confidence intervals were wide. Anxiety was associated with a significantly elevated risk of cardiovascular mortality (RR 1.41 CI 1.13, 1.76), coronary heart disease (RR 1.41 CI 1.23, 1.61), stroke (RR 1.71 CI 1.18, 2.50) and heart failure (RR 1.35 CI 1.11, 1.64). We identified 46 cohort studies containing 2017276 participants and 222253 individuals with anxiety. We examined the association of anxiety with cardiovascular mortality, major cardiovascular events (defined as the composite of cardiovascular death, stroke, coronary heart disease and heart failure), stroke, coronary heart disease, heart failure and atrial fibrillation. MEDLINE and EMBASE were searched for cohort studies that included participants with and without anxiety, including individuals with anxiety, worry, post-traumatic stress disorder, phobic anxiety and panic disorder. We aimed to determine the association between anxiety and a range of cardiovascular diseases. Whether anxiety is a risk factor for a range of cardiovascular diseases is unclear. This is confirmed in several large AMI registries7–9 where 1–13% of AMI's occurred in the absence of obstructive CAD thereby eliciting an important set of questions-what is the mechanism of the myocardial damage in these patients? Do these patients differ from those with obstructive CAD? Should they be … These pioneering studies demonstrated that, in patients presenting with ST elevation myocardial infarction (STEMI), almost 90% had an occluded coronary artery provided that angiography was undertaken within 4 h of chest pain onset.5 In contrast, in AMI patients who did not present with ST elevation (non-ST elevation myocardial infarction or NSTEMI), only 26% had an occluded coronary artery when angiography was performed within 24 h of symptom onset.6 In both of these landmark studies,5,6 >90% of the acute MI patients had angiographic evidence of obstructive coronary artery disease (CAD), underscoring the importance of the atherosclerotic process in the pathogenesis of AMI.Īlthough DeWood's studies underscore the importance of obstructive CAD in AMI, it is fascinating that ∼10% had no significant CAD on coronary angiography. Pivotal in the evolution of these contemporary strategies were the early AMI coronary angiography studies undertaken by DeWood et al. These innovations are the foundation of contemporary AMI management strategies that include a diagnosis centred on elevated troponin values associated with corroborative clinical evidence,1 early use of coronary angiography, and reperfusion therapies.2–4 Important milestones include the development of the electrocardiogram, coronary care units, coronary angiography, reperfusion therapies, and troponin assays. The management of acute myocardial infarction (AMI)1 has evolved over the past century and particularly in the past 50 years.
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