Acute Coronary Insufficiency Due to Acute Hemorrhage: An Analysis of One Hundred and Three Cases

Mastér, Arthur M.; Dack, Simon; Horn, Henry; Freedman, Bernard I.; Field, Leonard E.

doi:10.1161/01.cir.1.6.1302

Cited by 51 publications

(9 citation statements)

References 43 publications

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“…16 The present study, by showing an increase in stenosis resistance as coronary pressure falls, provides an additional possible mechanism by which a fall in coronary pressure may result in decreased myocardial blood flow.…”

Section: Resultsmentioning

confidence: 55%

Effect of coronary arterial pressure on coronary stenosis resistance.

1980

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The effects of coronary pressure on coronary stenosis resistance were studied in 13 open-chest dogs. A noncircumferential stenosis was produced in the circumflex coronary artery by placing sutures into either side of the artery and invaginating a portion of the arterial wall by tying the sutures. Coronary pressure both proximal and distal to the stenosis and coronary flow were measured. Coronary pressure was lowered by 1) hemorrhage and 2) placing a snare proximal to the noncircumferential stenosis and tightening the snare. After hemorrhage, mean proximal coronary pressure fell from 100 i 5 to 56 ± 6 mm Hg (p < 0.01) and resistance across the noncircumferential stenosis increased from 0.56 i 0.13 to 1.3 ± 0.26 units (p < 0.05). After the snare was tightened, mean proximal coronary pressure fell from 110 ± 4 to 58 ± 4 mm Hg (p < 0.01) and resistance across the noncircumferential stenosis increased from 0.43 0.05 to 1.1 ± 0.25 units (p < 0.02). In a series of experiments, coronary pressure was raised by inflating a balloon in the proximal aorta. After the balloon was inflated, mean proximal coronary pressure increased from 95 i 7 to 129 5 mm Hg (p < 0.01) and resistance across the noncircumferential stenosis decreased from 2.34 0.56 to 2.05 + 0.46 units (p < 0.05). These changes in stenosis resistance were consistent with passive narrowing and distension of the stenotic segment caused by the changes in coronary pressure. Alterations in coronary pressure may therefore affect the severity of a coronary stenosis.

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Section: Resultsmentioning

confidence: 55%

Effect of coronary arterial pressure on coronary stenosis resistance.

1980

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“…Cardiac infarction may heal with endocardial scarring, but in endomyocardial fibrosis no lesions have been found in the major coronary arteries, and the distribution of the endocardial and of the myocardial fibrosis is unlike that found to result from cardiac infarction. The subendocardial distribution of the muscle lesions recalls the acute coronary insufficiency of severe anmmia (Master et al, 1950) but anemia has not been marked in our cases nor has it figured prominently in their past histories. The possible effects of the endocardial fibrosis and thrombosis on the arterio-luminal vessels has been mentioned.…”

Section: Pathogenesismentioning

confidence: 45%

The Pathology of Endomyocardial Fibrosis in Uganda

Davies¹,

Ball²

1955

Heart

198

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“…5 The purpose of this study is to present three years' experience (1954)(1955)(1956)(1957) at the Graduate Hospital of the 7 University of Pennsylvania with postoperative myocardial infarction and to discuss the predisposing and precipitating factors, clinical findings, early diagnosis, and possible methods of prevention and treatment. …”

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confidence: 99%

Postoperative Myocardial Infarction

Feruglio¹

1958

Arch Intern Med

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The recent literature concerned with postoperative myocardial infarction is limited to relatively few detailed reports.1-Advances in surgical and anesthetic procedures and the improvement in the pre-and postoperative care of the patient entail revision of the data of the older literature.Myocardial infarction is not an uncommon postoperative complication; it is particularly prevalent in the older age group. Recent data (1954, 1956)4,' suggest that myocardial infarction is responsible for 10% of the deaths following major operations in patients above the age of 60 years.The incidence may be even greater, since 9> necropsies indicate that the clinical diagnosis of myocardial infarction as the cause of sudden death is missed in about 50% of the cases.5 The purpose of this study is to present three years' experience (1954)(1955)(1956)(1957) at the Graduate Hospital of the 7 University of Pennsylvania with postoperative myocardial infarction and to discuss the predisposing and precipitating factors, clinical findings, early diagnosis, and possible methods of prevention and treatment.Thirty-five cases of postoperative myocardial infarction were selected after careful examination of the clinical records of approximately 21,000 patients (0.16%) who were subjected to major and minor surgery in the last three years. Most of these cases were clinically followed by one of us (S. B.). The diagnosis of myocardial infarction was established by clinical and electrocardiographic data. In six cases the diagnosis was confirmed by postmortem examination. Cases with questionable data or with clinical diagnosis not supported by electrocardiographic or autopsy control were excluded from this study. The data in each case were carefully reviewed from the standpoint of preexisting heart disease, type and length of operation, anesthesia, and the development of hypotensive episodes during operative surgery or in the immediate postoperative period. FindingsAge, Sex, and Preoperative Statys.-Twenty-two patients were men and 13 were women. Thirty of these patients were white; four were Negroes, and one was Chinese. They ranged in age sfrom 43 to 83 years, with an average age of 69 (Table 1). TABLE 1.-Age Distribution Age, Yr. Cases

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Acute Coronary Insufficiency Due to Acute Hemorrhage: An Analysis of One Hundred and Three Cases

Cited by 51 publications

References 43 publications

Effect of coronary arterial pressure on coronary stenosis resistance.

Effect of coronary arterial pressure on coronary stenosis resistance.

The Pathology of Endomyocardial Fibrosis in Uganda

Postoperative Myocardial Infarction

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