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Selective coronary arteriography: arteriographic patterns in coronary heart disease
Insights
Coronary arteriography in 88 patients reveals diffuse coronary heart disease, often affecting multiple vessels. Previous myocardial infarction correlated with higher obstruction rates, while angina with normal ECG showed milder lesions.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Vascular Medicine
Background:
- Coronary heart disease (CHD) presents with varied clinical manifestations.
- Understanding the extent of coronary arteriographic abnormalities is crucial for patient management.
Purpose of the Study:
- To review the severity and distribution of coronary arteriographic abnormalities in patients with clinical evidence of CHD.
- To correlate arteriographic findings with different clinical presentations of CHD.
Main Methods:
- Sones' technique was used for coronary arteriography in 88 patients.
- Patients were categorized into four groups based on myocardial infarction and angina symptoms, with or without electrocardiogram abnormalities.
Main Results:
- Diffuse arteriographic abnormalities were common, with 84 patients showing involvement of at least two coronary vessels.
- Patients with prior myocardial infarction had the highest rate of complete coronary artery obstruction.
- Angina patients with normal resting ECGs exhibited the least severe obstructive lesions.
Conclusions:
- Diffuse coronary arterial tree involvement is typically present at the onset of CHD symptoms.
- The severity of arteriographic abnormalities appears independent of symptom duration.
- Coronary arteriography is essential for assessing the extent of disease in CHD patients.
Abstract:
The severity and distribution of coronary arteriographic abnormalities have been reviewed in 88 patients with clinical evidence of coronary heart disease who were studied by Sones' technique. The patients were divided into four groups: myocardial infarction without angina, myocardial infarction with angina, angina with normal resting electrocardiogram, angina with abnormal resting electrocardiogram.Arteriographic abnormalities were generally diffuse throughout the coronary circulation, and at least two vessels were involved in 84 patients. Although the frequency of lesions was similar in the four groups of patients, those with previous myocardial infarction had the highest incidence of complete obstruction. Patients with angina and a normal resting electrocardiogram showed the least severe obstructive lesions. The severity of the arteriographic abnormalities was independent of the duration of clinical symptoms, and it appears that diffuse involvement of the coronary arterial tree is usually present when symptoms develop.