RESUMO
Background and Objectives: This research study has been carried out to study the various morphological changes in the heart in medicolegal autopsies and to compile data for the frequency of heart diseases found in autopsy cases. Methods: The present study comprised 430 medicolegal autopsy cases. Details of the cases were entered in a proforma prepared for the study. The heart was fixed in 10% formalin, and then, opened along the flow of blood. The findings were based on gross and microscopic examinations. Results: Out of 430 adult hearts, 211 (49.0%) cases showed 253 cardiac lesions; 35 (8.1%) cases of coronary atherosclerosis and 196 (45.5%) aortic atherosclerosis were noted; 7 cases of ischemic lesions (1.6%) were identified; 12 (2.7%) cases of hypertrophy; 2 cases of valve calcification; and 1 of cardiomyopathy were noted. Conclusion: In the present study, among medicolegal autopsies, atherosclerotic disease was the most frequently encountered lesion followed by hypertrophy. The incidence of atherosclerosis was found to be 47.6%. This study shows the high prevalence of atherosclerosis in the population.
RESUMO
Objetivo Avaliar correlação entre alterações do segmento ST indicativas de isquemia miocárdica, detectadas pela monitorização eletrocardiográfica ambulatorial, e os achados da cinecoronariografia. Métodos Cinqüenta pacientes, 48 homens, com idades entre 20 e 73 (média 49 ± 13) anos, divididos em três grupos: I) assintomático (16 pacientes, 32%); II) precordialgia atípica (15 pacientes, 30%); e III) angina (19 pacientes, 38%). Procedeu-se à monitorização eletrocardiográfica ambulatorial por período de 24 horas, utilizando-se o sistema Cardiac Care Units (Compass TM). Os pacientes que apresentaram alterações do segmento ST, compatíveis com isquemia miocárdica transitória foram submetidos à cinecoronariografia. Quando esta foi considerada normal, o estudo foi complementado pela ecocardiografia e pelo teste de esforço. Resultados A presença de doença coronária ateroesclerótica (lesões obstrutivas ou fluxo lento) foi constatada em 24 (48%) pacientes. Em 26 (52%) pacientes, as artérias coronárias se apresentaram normais. Dentre esses, em 18 (36%) a ecocardiografia mostrou alqum tipo de afecção ou alteração anatômica (hipertrofia ventricular esquerda, prolapso da valva mitral, hipertrofia septal não obstrutiva, miocardiopatia dilatada). O ecocardiograma foi normal em 8 (16%) pacientes, dos quais em 5 (10%), o teste de esforço foi negativo, entre os quais 1 paciente (2% ) apresentava ponte miocárdica para a artéria descendente anterior, 2 (4%) alterações sintomáticas do segmento ST, e outros 2 paci entes (4%) eram assintomáticos...
Purpose To determine the usefulness of an ambulatory electrocardiographic monitoring system, in identifying atherosclerotic coronary artery disease among symptomatic and asymptomatic patients, through a comparison of ST-segment depression with angiographic findings. Methods Fifty patients, 48 men, with the mean age 49 ± 13 years (range 20 to 73), presenting ST-segment depression, were submitted to coronary angiography, complemented by echocardiogram and exercise testing, when the angiography was considered normal. According to the symptoms patients were divided into three groups: Iasymptomatic (16-32%); II¾ atypical chest pain (15-30%); and IIIangina (19-38%). The Cardiac Care Units(Compass TM) system was used for the ambulatory electrocardiographic monitoring.Results Twenty-four patients (48%) had significant atherosclerotic coronary artery disease documented angiographically. Twenty-six patients (52%) had normal coronary arteries by angiography: 18 (36%), presented some pathology demonstrated by echocardiographic studies (left ventricle hypertrophy, mitral valve prolapse, non-obstructive septal hypertrophy, dilated cardiomyopathy). Eight patients (16%) had normal echocardiograms, and in (6%) the exercise test was positive and in the other 5 (6%) negative. One of those patients (2%), with negative exercise test, had a myocardial bridge over the anterior descending branch of the left coronary artery, 2 patients (4%) presented symptomatic episodes of ST depression, and 2 other patients (4%) were assymptomatic...