In an asymptomatic patient, the first reference to the association of mitral valve prolapse and coronary fistula is described and a pathogenic connection discussed.
The product of heart rate and blood pressure, (HR x BP), index of the myocardial oxygen consumption, was evaluated on 37 individuals with ages of between 32 and 65 years; 24 had ischemic heart disease with a disease of 1, 2 or 3 vessels, and 13 had non-significant lesions of 1 vessel (less than 75%) or no coronary heart disease (CHD). From the HR x BP correlation with the study of the angiograms of the coronary arteries, we verified that there was no distinction between patients. with CHD with or without an ejection fraction less than 50% or, with or without disturbances of myocardial contractility, and normal individuals. Thus, we believe that in patients with CHD, an excessive increase in the oxygen requirements of the myocardium is not the sole pathogenic mechanism of ischemia.
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