[Unstable angina and single vessel stenosis of the anterior interventricular artery. Evaluation of the threatened myocardium. Therapeutic implications].
The authors report a special cases of precise evaluation of threatened myocardium during coronaro-ventriculography. Two elements provided this evaluation: 1) spasm in the tight stenosis of the middle part of the anterior interventricular artery with immediate left ventricular dyskinesia (EF: 37%, EDP/EVD: 1.74; EDV: 98 cc/m2). 2) Complete instantaneous recovery after injection of 2 mg of trinitrine into the left ventricle (EF: 69%, EDP/EVD: 4.33; EDV: 28 cc/m2). This loss, in the order of 50%, in the left ventricular function led us to perform an angioplasty (ACT) with success. A further clinical and angiographic stenosis, three months later, in this 72 years old patient with arteritis, led us to perform an aorto-coronary graft, rather than another ACT.
D000368:Aged; D000788:Angina Pectoris, Variant / Q000175:diagnosis* / Q000628:therapy; D000800:Angioplasty, Balloon; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000175:diagnosis* / Q000628:therapy; D003329:Coronary Vasospasm / Q000175:diagnosis*; D004562:Electrocardiography; D006801:Humans; D008297:Male; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000175:diagnosis*
Angor instable et sténose monotronculaire de l'artère interventriculaire antérieure. Appréciation du myocarde menacé. Implications thérapeutiques.