Coronary arteriographic patterns in right sided endomyocardial fibrosis associated with schistosomiasis

Selective coronary cineangiography was performed in 7 patients [4 males and 3 females, mean age was 35 +/- 10 years] with right-sided endomyocardial fibrosis [EMF] to study the coronary arterial patterns in this disease. The diagnosis of EMF was confirmed by typical clinical, radiologic, echocardiographic, hemodynamic, and angiographic features of right-sided EMF. They all had Schistosoma mansoni infestation with schistosomal hepatic fibrosis. Epicardial coronary arteries were free of disease. However, the following abnormalities were seen on coronary arteriography: Vascular blush was unexceptionally present in every patient within the distribution of right ventricular and posterior descending branches of right coronary artery [RCA]; right/left myocardial contrast washout time ratio was markedly increased [range 1.6 - 2.4]; abnormal course of RCA running almost transversely throughout its whole course; hugely dilated right atria received proportionately rich blood supply by stout tortuous and elongated branches mainly from the circumflex and sinus node arteries. Atrial branches from RCA contributed less significantly. RCA was dilated and dominant in 6/7 patients. Left coronary system was absolutely normal. Extensive fibrosis of the right ventricle and the hugely dilated right atrium associated with right sided EMF lead to secondary changes in the coronary arterial patterns of these chambers

Precardial ST segment depression in patients with acute inferior myocardial infarction is highly correlated with dipyridamole induced left ventricular dyssynergy outside the infarct zone

The purpose of this study was to determine the correlations between precordial ST segment depression appearing during acute inferior myocardial infarction, and Dipyridamole induced left ventricular wall motion abnormalities detected by two dimensional echocardiography. Thirty patients with acute inferior myocardial infarction were allocated into two groups [15 patients each] based on the presence [group A] or absence [group B] of precordial ST segment depression. Group A patients had higher serum creatin kinase activity than group B [1340 +/- 235 vs 825 +/- 114 IU/L mean +/- SD respectively P<0.001]. Left ventricular dyssynergy, defined as akinesia or dyskinesia, occured within the infarct zone [inferior segments] more frequently in group A than group B[15/15 vs 10/15 respectively P<0.001]. Dipyridamole infusion induced left ventricular dyssynergy within regions outside the infarct zone in 12/15 patients of group A [4inferoseptal,4anteroseptal,4anterior]. Dipyridamole did not induce any regional dyssynergy outside the infarct zone in any patient of group B [P< 0.001]. Precordial ST segment depression in patients with acute inferior myocardial infarction reflected, in this study, Dipyridamole induced left ventricular dyssynergy outside the infarct zone with 100% sensitivity and 83% specificity. Our data are in favour of the theory that precordial ST segment depression in acute inferior myocardial infarction indicates myocardial ischemia and not due to reciprocal electrophysiologic changes

Effects of a mixture of progesterone and estrogen on the histology of the ovary and oviduct of lactating albino rat

Administration of a mixture of progesterone and estrogen to lactating albino rats revealed persistence of different stages of follicles. Most of these follicles underwent degeneration. Hyperlasia of ovarian stromal cells was also noticed. The oviducts revealed proliferation of the lining epithelium

Clinical review of unstable angina pectoris

This study included 62 patients [42 males and 20 females] with the diagnosis of unstable angina. Acute myocardial infarction occurred in 15% of patients and acute mortality rate was 3%. Advanced age and a previous myocardial infarction favored a complicated in-hospital course [myocardial infarction and/or sudden death]. Patients with persistent and recurrent chest pain after admission and those with frequent arrhythmias were more prone to complications. Multiplicity of risk factors were more evident in the group of patients with a worse short-term prognosis