To study the physiopathology of myocardial bridges, we assessed the degree of systolic coronary artery constriction (%SC) in different hemodynamic situations in six patients submitted for coronary angiograms. There was an increase of %SC (p less than 0.05) with sodium nitroprusside (NP), no modification during fast atrial stimulation (AS), and a decrease (p less than 0.05) during noradrenaline infusion (Nor). Hemodynamic studies indicate an inverse relation (p less than 0.05) between %SC and systolic and diastolic aortic pressure and left ventricular dP/dt. There was no correlation between changes in %SC and changes in Vmax or heart rate. Thus we conclude that changes in systemic arterial pressure and coronary perfusion pressure may significantly affect the degree of severity of myocardial bridges, possibly through an influence upon intraluminal coronary pressure and an intramyocardial tension relationship.

Adult↗

PubMed1984

Cross-sectional echocardiographic features of "absent" pulmonary valve. Report of two cases.

"Absence" of the pulmonary valve was recognized by cross-sectional echocardiography in two infants having relatively atypical clinical manifestations for this cardiac malformation. Both had associated lesions: tetralogy of Fallot and ventricular septal defect, respectively, which were also detected by this non-invasive technique. The findings which strongly suggested the diagnosis were the presence of a ridge of rudimentary pulmonary valvular tissue at the level of the pulmonary annulus and the aneurysmal dilation of the pulmonary arteries. The short axis view at the level of the great arteries was the best approach for visualization of these anatomical abnormalities. The parasternal long axis and sub-costal four-chamber views were also helpful in detecting the associated lesions. In both cases the diagnoses were confirmed at autopsy.

Echocardiography↗

PubMed1984

A technique of anastomosis of the right internal mammary artery to the circumflex artery and its branches.

A new technique for direct revascularization of the left circumflex artery and its ventricular branches through anastomosis with the right internal mammary artery (RIMA) was applied in 56 patients. Postoperative angiographic studies in 17 patients showed that positioned behind the aorta, the RIMA can reach the circumflex artery with no tension, allowing adequate distal filling.

Humans↗

PubMed1984

Right ventricular endomyocardial biopsy in undetermined form of Chagas' disease.

Right ventricular endomyocardial biopsy was carried out in thirty three patients with undetermined form of Chagas' disease. Fragments obtained by this method were analysed under light microscopy with hematoxilin-eosin, and Masson trichromic stains. Thirteen (39.4%) patients showed normal myocardial fragments and twenty patients (60.6%) had them altered. Alterations included fiber degeneration, volume changes, interstitial edema, inflammatory infiltrates and fibrosis. These data permit to conclude that only part of patients with this form of Chagas' disease have an incipient myocardial attack and that the alterations found in the fragments obtained are mild. The remaining patients would be either individuals with chagasic infection without cardiac disease or have spontaneous healing. This should be considered in the future treatment of the disease.

Adult↗

PubMed1984