Spontaneous coronary artery dissection is a rare event, felt to be caused by intimal disruption and formation of a false lumen in the vessel wall. Compression of the true lumen by intramural hematoma may result in obstruction to blood flow, myocardial ischemia, infarction, and ultimately, death. We report the first instance (to our knowledge) of survival in a man with spontaneous dissection of the left anterior descending coronary artery.
Summary:The noninvasive assessment of the severity of aortic stenosis is difficult. A recent description of systolic flutter of aortic valve leaflets as a screening test for severe aortic stenosis was applied to a group of patients who had undergone catheterization. As opposed to the previous report, we found this an inaccurate, nonspecific, and insensitive aid for the differentiation of significant versus nonsignificant aortic stenosis; and feel that its validity should be studied further before wide application.
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