Right Coronary Arterial Spasm Causing Prinzmetal ' s Variant ~ n ~ i n a *
نویسنده
چکیده
percent had systemic emboli. Conclusions from this large series were: 1) atrial fibrillation is the main cause of systemic embolism; 2) embolism is as common with mitral regurgitation as with mitral stenosis; 3) mitral valve calcification predisposes to operative emboli; 4 ) atrial appendage size has no influence on the occurrence of systemic embolism. Review of the literature has not revealed a reported case of peripheral migration of the mitral valve. That this may occur with endocarditis and aneurysm formation of the mitral valve is easily appreciated when the pathogenesis of valve aneurysm formation is r e ~ i e w e d . ~ As a result of valvulitis, granulation and scar tissue are exposed to a constantly maintained intraventricular pressure with dilatation and protrusion of the valve into the left atrium. The aneurysm may obstruct the mitral orifice producing mitral stenosis or perforate, causing incompetence. Perforation of the aneurysm allows embolization of valve fragments, vegetations and clots. The aneurysms characteristically involve the anterior leaflet of the mitral valve, particularly in the presence of aortic reg~rgitation.~ The serious hemodynamic changes attendant with acute mitral regurgitation due to bacterial endocarditis demand judicious medical management directed to control of congestive heart failure and sterilization of the infective process. Prompt surgical intervention must be considered if response to the measures is not achieved. The prudence of removing the nidus of infection as well as hemodynamic correction by surgical means is well documented.7-0
منابع مشابه
Luminal Narrowing During Coronary Arterial Constriction
New York, McGraw-Hill, 1970, p 156 44. Prinzmetal M, Kennamer R, Merliss R, Wada T, Bor N: Angina pectoris. I. A variant form of angina pectoris. Am J Med 27: 375, 1959 45. Dhurandar RW, Watt DL, Silver MD, Trimble AS, Adelman AG: Prinzmetal's variant form of angina with arteriographic evidence of coronary arterial spasm. Am J Cardiol 30: 902, 1972 46. Oliva PB, Potts DE, Pluss RG: Coronary art...
متن کاملCoronary artery spasm associated with variant angina pectoris.
i) Pain occurs at rest; 2) the discomfort is not related to physical activity or emotional stress; 3) generally, it is longer in duration and more severe; 4) instead of ST segment depression, typical of classic angina, the electrocardiogram shows a transient acute monophasic injury current with reciprocal changes in the standard leads. The ST segment elevation subsides when the pain disappears....
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3 Silverman ME, Flamm MD: Variant angina pectoris-Anatomic &ding and pmgno8tic implications. Ann Intern Med 75:339,1971 4 Prinzmetal M, K m e r R, Merliss R, et al: Angina pedwis I. Variant form of angina pectoris. Am J Med 27:375, 1959 5 Hart NJ, Silverman ME, King SB: Variant angina pedwis caused by coronary artery spasm. Am J Med 356:e69, 1974 6 Oliva PB, Potts DE, Pluss RC: Coronary arteria...
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a case of angina pectoris and in the experimental animal. Angiology. 1962;13:550-553. Guazzi M, Polese A, Fiorentini C, Magrini F, Bartorelli C. Left ventricular performance and related haemodynamic changes in Prinzmetal's variant angina pectoris. Br Heart J. 1971;33:84-94. Dhurandhar RW, Watt D, Silver M, Trimble A, Adelman A. Prinzmetal's variant form of angina with arteriographic evidence of...
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A case of Prinzmetal variant angina with transient complete atrioventricular block and syncopal episodes following an anteroseptal myocardial infarction is described. The syncopal attacks were not prevented by demand cardiac pacing and were presumably caused by transient severe ischaemia of the left ventricle, with a consequent reduction in cardiac output. The left ventriculogram showed a large...
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