[Non-q-wave myocardial infarction: a 31 cases descriptive study]

The frequency of non-Q wave myocardial infarction is permanently increasing. In this retrospective study, we have tried to establish the clinical features, the prognosis and the therapeutic possibilities in this entity. We have studied the clinical history, the physical examination data, the results of the different explorations and the short and long term general course in 31 patients with a non 0 wave myocardial infarction. The main feature of this acute coronary syndrome is the preservation of the myocardial fonction [normal in 64% of the patients]. Concerning the angiograhic finding, we note a high prevalence of severe coronary damages particulary of the stenosis of the left main coronary artery [13,5%] ; but also an important proportion of normal coronary angiographies [20%]. In addition to the known factors associated with a poor prognosis in coronary artery disease, we insist on the severity of the initial depression of the ST-segment. The prognosis of the non Q wave myocardial ifarction is better at the initial phase than that of the "transmural infarction". However, it becomes similar or worse at the long term general course. The important progress in the prognosis markers and in the anti-thrombotic and interventional therapies may maintain at the long term course the good initial prognosis

[ type III aortic dissection. Diagnosis, outcome, contribution of the endovascular therapies to their management - a case report]

The dissection of the descending aorta is a serious affection regarding to its mortality and its complications. It becomes chronic after the 14 Th day following the first signs of dissection. The authors report the case of a 55 years old patient who has presented a type III dissection diagnosed at the chronic period. The persistance of the pain has indicated the implantation of a stent at the intimal tear. This new endovascular treatement of the aorta diseases is a promising and less invasive alternative to the surgical treatement. It may reduce the morbidity and the mortality of this pathology but it needs an accurate and performant imaging techniques

[Aortic stenosis interest of echocardiography with dobutamine]

The stress echocardiography with dobutomine confirms her increasing value for the patients with severe aortic stenosis and left ventricular dysfonction in a diagnosis concept by selecting the true severes stenoses and revealing stenoses overestimated by the low fow, and especially prognosis by means of the stratification of the operatory risk and the search for a contractile reserve which represent the guarantee of a survival per and postoperaloire satisfactory. As regards asymptomatic aortic stenosis the times of intervention are in reevaluation, the compliance valvulaire represente reliable means which needs confirmation for a prophylactic indication for surgery