[The provocation of coronary spasm in man by ergonovine maleate. Angiographic demonstration (author's transl)].
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Biomedical subjects
Publications and source records attributed to L Angoli.
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Five cases with angiocardiographically diagnosed posterior mitral valve prolapse and without ausculatotory findings of midsystolic click or late systolic murmur were studied with phonocardiographic technique employing pharmacological tests and postural changes. A midsystolic click was thus obtained. Isoprenaline was the must helpful drug to achieve it. The accompanying electrocardiographic and coronarographic features of this syndrome are described and discussed.
The Authors report the results of a coronary angiographic study in 12 patients with acute myocardial infarction in which the necrosis was extended to the dorsal wall of the heart. The electrocardiographic and vectorcardiographic criteria applied in order to assess the involvement of the dorsal wall have been those suggested by Perloff and by Hoffman and coll. and Massie and Walsh, respectively. The diagnosis of dorsal involvement has been also confirmed by the esophageal electrocardiogram. Discussing their results, the Authors consider the variants of blood supply of the posterior wall of the heart. On the basis of their angiographic findings, they underline that significant lesions of the circumflex artery, either alone or associated with narrowing of other main coronary arteries, are the most frequent finding in cases of myocardial infarction involving the dorsal wall of the heart.
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The authors report fifty-nine cases of non-transmural myocardial infarction. The diagnosis was made on the basis of clinical electrocardiographic data and enzyme changes. The clinical course was characterized by several chest pain attacks; a transmural myocardial infarction occurred in four patients a few days after admission. Out of fifty-five patients, followed for a nineteen - months period, six died, thirty-one were asymptomatic and fourteen complained of angina. In the last group, chest pain was generally present before the non-transumural myocardial infarction. The ECG were within normal limits in thirty-seven patients. The coronarographic patterns found in fifteen patients are also described and discussed.
We thought chest pain associated with ST segment elevation during exercise test in patients with not significant coronary lesions could be related to coronary spasm. Three patients with mild coronary obstructive lesions underwent coronary arteriography during exercise test. In two patients this hypotesis was supported by angiographic documentation of the coronary spasm.
The clinical, electrocardiographic, coronarographic and hemodynamic findings in thirty-one patients with left coronary artery stenosis were compared with those noted in patients with critical stenoses in all the three branches only. It was not possible to distinguish between the two groups of patients by comparing these results, and coronary arteriography is still the only valid diagnostic procedure.