ABSTRACT
Several cases of transmural myocardial infarction and ventricular aneurysm caused by a blunt trauma of the chest have been reported. Nevertheless, the cases documented with coronary and ventricular angiography are very few. There has always been a debate over the etiological mechanism of such lesions. Since in some cases there was no evidence of coronary lesions, it was postulated that they were produced by direct myocardial contusion, but in other instances the evidence of coronary occlusion was angiographically and pathologically proved. We experienced a case of acute myocardial infarction with ventricular aneurysm secondary to nonpenetrating chest trauma by an umbrella tip and wish to report this unusual case, along with a review of the literature.
Subject(s)
Heart Injuries/etiology , Adult , Coronary Aneurysm/etiology , Humans , Male , Myocardial Infarction/etiology , Thoracic Injuries/etiology , Wounds, Nonpenetrating/etiologyABSTRACT
A patient with isolated left coronary ostial stenosis proved by coronary angiography is presented. Isolated left coronary ostial stenosis is a rare condition of unknown etiology. Unique clinical and angiographic profiles are discussed in detail with a review of the literature, along with a suggestion of a natural history distinct from that usually seen in atherosclerotic coronary diseases.
Subject(s)
Coronary Disease/etiology , Cardiac Catheterization , Coronary Disease/therapy , Female , Humans , Middle AgedABSTRACT
An analysis of 80 patients who had elective coronary arteriography within 6 months after hospital dismissal for acute myocardial infarction showed that approximately two-thirds had multivessel coronary disease. The study is consistent with others reported in the recent literature in suggesting that most patients who survive myocardial infarction have multivessel disease. High early and late post-myocardial infarction mortality is comparable to that described for patients with two- and three-vessel occlusive disease. Knowledge of specific coronary anatomy and left ventricular function is critical in assessing post-myocardial infarction prognosis. This information is also important in defining optimal medical or surgical treatment. Unfortunately, the severity of the subjective clinical syndrome does not correlate well with the degree of anatomic findings or the prognosis. Properly selected surgical intervention may be one approach to modifying the high post-myocardial infarction mortality, which has not changed materially in the past several decades.
