[Differential diagnosis of lesions of the left coronary artery trunk and multiple hemodynamically-significant stenoses of the coronary arteries]. / Differentsial'naia diagnostika porazheniia stvola levoi koronarnoi arterii i mnozhestvennykh gemodinamicheski znachimykh stenozov koronarnykh arterii.

Clinical manifestations were compared in coronary patients with different sites and spread of coronary atherosclerosis, in order to assess the feasibility of differential diagnosis of left coronary arterial (LCA) trunk lesions versus multiple coronary arterial stenoses. Four groups of patients were examined: isolated third- or fourth-degree LCA trunk stenosis (15 patients, group 1); third- or fourth-degree stenosis of the anterior interventricular branch (AIVB) and the circumflex branch (CB) (44 patients, group 2); third- or fourth-degree stenosis of AIVB, CB or the right coronary artery (RCA) (77 patients, group 3); and third- or fourth-degree stenosis of AIVB, CB, the diagonal branch or RCA (33 patients, group 4). The clinical condition of patients with isolated LCA branch lesions was much worse than that of patients with multiple coronary arterial stenosis. Differential diagnosis is based on the severity of the pain syndrome, the spread of ischemic zone on resting ECG, the scope of past myocardial infarction, stress tolerance and the magnitude of ST depression in response to exercise.