[Congenital coronary-left ventricular fistulae. Review of the literature]. / Les fistules congénitales coronaro-ventriculaires gauches. Revue de la littérature.

Congenital communications of fistulae between coronary arteries of aortic origin and the left ventricle present two types of anatomo-coronarographic appearance, in accordance with embryological theories: single fistulae and multiple or micro-fistulae. These fistulae are marked by the absence of a continuous murmur and they can be distinguished from each other by their clinical expression: either a picture of aortic incompetence or signs of coronary insufficiency: these are the conclusions from a review of 62 cases in the literature.

[Echocardiographic diagnosis of obstructive myocardiopathies: study of the systolic anterior motion of the mitral valve and septal hypertrophy as compared with the hemodynamic and mechanographic findings. Evolution under medical treatment]. / Diagnostic échocardiographique des myocardopathies obstructives: étude de l'avancée mitrale systolique et de l'hypertrophie septale par comparaison avec les données hémodynamiques et mécanographiques. Evolution sous traitement médical.

Characteristic echocardiographic features of hypertrophic obstructive cardiomyopathy were recorded in 24 patients, all of whom had asymmetric septal hypertrophy and systolic anterior motion of the mitral valve (SAM) at rest or after pharmacodynamic stimulation. The relationship between outflow tract obstruction and SAM was assessed by comparison with data obtained at cardiac catheterisation and external mechanography: SAM seems to be a non-specific phenomenon and may be recorded in cases of hypertrophic cardiomyopathy without obstruction during pharmacodynamic stimulation. In forms with obstruction, SAM and the severity of obstruction increase with the degree of spetal hypertrophy. The increased contractility of the left ventricular posterior wall appears to be an important factor in the mechanism of SAM which can be prevented by betablockade in moderate or labile forms. When SAM is permanent, whatever the gradient recorded, it is a sign of anatomical deformation of the left ventricle and may be an additional indication for cardiac surgery.

[Systolic strangulation of the anterior interventricular artery : a rare cause of myocardial ischaemia (author's transl)]. / L'étranglement systolique de l'artère inter-ventriculaire antérieure : cause rare d'ischémie myocardique.

The relationship between myocardial ischaemia and the muscular bridge over the anterior interventricular artery with systolic strangulation has now been demonstrated. This forms part of the aetiology of angina pectoris with radiologically "normal" coronary arteries. A case is reported where the severity of the clinical picture justified surgery to divide the muscular bridge, without touching the underlying artery. The course has been satisfactory, with a two years follow-up.

[Myocardial infarction and heterozygous sickle cell anemia. Apropos of 2 cases]. / Infarctus du myocarde et drépanocytose hétérozygote. A propos de 2 cas

Thromboses are a classical complication of sickle cell disease in the severe homozygous form. In the heterozygous individual, although the risk of severe thromobotic episodes is small, it must nevertheless be recognised. The authors report two cases of myocardial infarction in patients whose coronary arteries were relatively free from atherosclerosis; they were young men, with the heterozygous form of sickle cell disease AS. The part played by inheritance, the factors favouring vascular occlusion, and the possibility of preventing such episodes are all discussed.