[A clinicopathologic study of atrial infarction complicating left ventricular posterior myocardial infarction].
Among a series of 400 consecutive autopsy cases we performed a clinicopathologic study of atrial infarction in 46 autopsy-proven cases, which had acute or old left ventricular (LV) myocardial infarction. We used blocks taken from both atrial appendages, the region of the sinus-node, the lateral wall of the right atrium, the posterior wall of the right atrium, and the posterolateral wall of the left atrium. Atrial infarction was identified in 13 (28%) of 46 cases with LV posterior infarction which was caused by lesions of the right coronary artery; 10 cases were right atrial infarction and 3 were both right and left atrial infarction. Among 13 cases in which the acute phase of ventricular infarction could be followed, 3 cases exhibited transient atrial fibrillation. Of these 3 cases, 2 had atrial infarction. The mean stenotic index of the proximal right coronary artery was 4.3/5 in the 13 cases of atrial infarction, 3.2/5 in 17 cases of acute necrosis or scar and 3.1/5 in 16 cases without ischemic atrial lesions. Most of the atrial infarction was found in the right atrium; 10 in the right atrial appendage, 8 in the right atrial lateral wall, 3 in the region of the sinus node and the left atrial posterolateral wall, 2 in the right atrial posterior wall, and one in the left atrial appendage. In conclusion, the incidence of atrial infarction was unexpectedly high (28%) in LV posterior infarction caused by lesions of the proximal right coronary artery, particularly in severe stenosis or obstruction.
Chida
K
K
Divisions of Cardiology, Tokyo Metropolitan Geriatric Hospital.
Ohkawa
S
S
Maeda
S
S
Kuboki
K
K
Imai
T
T
Watanabe
C
C
Ueda
K
K
Shimada
H
H
Sugiura
M
M
D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000209:etiology; D003331:Coronary Vessels / Q000473:pathology; D005260:Female; D006325:Heart Atria / Q000473:pathology; D006352:Heart Ventricles / Q000473:pathology; D006439:Hemodynamics; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000150:complications / Q000473:pathology* / Q000503:physiopathology