The long-term safety and tolerability of transdermal glyceryl trinitrate, when used with a patch-free interval in patients with stable angina.

The safety and tolerability of intermittent (16 hours on/8 hours off) nitrate patch therapy (0.2, 0.4 or 0.6 mg/hr: dose adjusted as required) was studied for a median duration of 356 days in 106 patients (mean age 60.9 +/- 8.6 years) with angina pectoris. Most patients (82%) were on existing beta-blocker and/or calcium antagonist therapy. Safety, tolerability and efficacy data were obtained by means of patient diary cards and regular clinic visits. Almost 90 treatment years revealed no significant or serious adverse events, and there were no changes in haematology or biochemistry associated with intermittent nitrate patch therapy. The most frequently reported side-effects were headache, skin reactions and dizziness (53%, 20% and 8% of patients respectively). Treatment resulted in a sustained reduction in the frequency and severity of angina attacks, reduced sublingual GTN consumption, an improvement in general wellbeing and a rise in the proportion of patients in whom angina was controlled.

Metastatic cardiac malignant fibrous histiocytoma presenting as right ventricular outflow tract obstruction.

An unusual case of metastatic disease of the right ventricle is described in a 74-year-old woman who had presented with a malignant fibrous histiocytoma of the right thigh previously treated with surgery and radiotherapy. Two years later she presented with signs and symptoms of tricuspid regurgitation and right ventricular outflow tract obstruction. The diagnosis of right ventricular tumor was made by echocardiographic and angiographic studies and confirmed on postmortem examination.

Tenolol in angina pectoris.

Selective Beta Blocker Tenolol (IPCA) 50 mg. (A50) and 100 mg. (A100) single dose drug therapy was tried in 25 cases of angina pectoris. Hypertensives were excluded from trial. There were 4 diabetics. Drug trial over a period of 4 weeks revealed subjective and objective improvement with A50 and A100 assessed at the end of 2 and 4 weeks. The average angina attacks/2 wks. was 13.12 +/- 11.26 in basal state whereas the reduction in angina attacks was 6.285 +/- 8.80 with Tenolol 50 mg. and 3.72 +/- 2.86 with 100 mg which was statistically significant. Objective assessment of each patient done by Computerised Stress Test (CST) at the end of 2 and 4 weeks of Tenolol 50 mg and 100 mg revealed statistically significant improvement in their ST depression i.e. 3.645 +/- 1.463 mm basal ST depression, 1.692 +/- 1.680 after Tenolol 50 mg and 2.318 +/- 1.270 after Tenolol 100 mg. There was statistically significant fall in systolic BP (SBP) and double product (DP) both with A50 and 100 mg. Only one patient had slow ventricular tachycardia and mild hypotension during CST.