[The role of a spasm of the coronary arteries in the pathogenesis of acute myocardial infarct and in the development of sudden coronary death]. / Rol' spazma venechnykh arterii serdtsa v patogeneze ostrogo infarkta miokarda i v razvitii vnezapnoi koronarnoi smerti.

Based on the clinical experience and clinicoanatomic correlations, the authors suggest the role of hemorrhage and rupture of atherosclerotic patches in the pathogenesis of sudden coronary death. Proceeding from long-term follow-up studies of patients suffering from CHD, the necessity is substantiated of the regular use of beta-adrenoblockers which significantly reduce the rate of sudden death both in the acute and chronic phases of CHD, particularly in patients with a history of myocardial infarction. Taking into consideration the multifactorial nature of the pathogenesis of acute occlusion of coronary arteries, it is suggested that in addition to the preventive administration of beta-adrenoblockers, thrombolytic agents in combination with antiaggregation remedies and calcium antagonists should be prescribed, especially in cases of arterial pressure rises.

[The cerebrocardiac syndrome]. / Tserebrokardial'nyi sindrom.

The authors describe case histories of patients with brain involvement--extensive brain strokes with blood breakthrough to the ventricles. The development of myocardial lesions (from extensive hemorrhages to the heart muscle till the development of large myocardial infarction) attests to the possibility of centrally caused disorders of coronary circulation. It is necessary to note that the development of myocardial lesion is masked, as a rule, by the clinical picture of a grave brain stroke and is not adequately detectable at ECG studies. It is believed that the development of hemorrhages in the myocardium is consequent on the reperfusion syndrome, whereas formation of myocardial infarction is the result of the spasm of the coronary arteries.