Coronary Disease: A Pathological Study

Snow, P.J.D.; Jones, A. Morgan; Daber, K. S.

doi:10.1136/hrt.17.4.503

Cited by 77 publications

(11 citation statements)

References 7 publications

(2 reference statements)

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“…21 Extensive collaterals may limit the extent of ventricular necrosis when infarction occurs. 22 Our data indicate that patients without prodromata more commonly have transmural infarction. Such lesions may well be larger than the nontransmural infarcts more likely to occur in the patient with prodromata.…”

Section: Discussionmentioning

confidence: 90%

Prodromata in Acute Myocardial Infarction

1969

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One hundred patients admitted to a coronary care unit with acute myocardial infarction were interviewed from a structured questionnaire to evaluate the incidence and significance of prodromal symptoms. Prodromata occurred in 65% of the subjects; this is the highest incidence ever recorded. Chest pain was the most common symptom. Characteristically it was recurrent and progressive. Patients with prodromata in contrast to those without warning are more likely to have an anterior or anterolateral infarction and the damage is more likely to be nontransmural than transmural. Prodromata have a striking relationship to pre-existing angina. Patients with angina rarely are hospitalized for acute infarction without warning. Emotional stress was not correlated with the definitive attack of cardiac infarction but was associated with the development of prodromata in some patients. These observations suggest that acute myocardial infarction is usually the culmination of a dynamic pre-coronary process.

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Section: Discussionmentioning

confidence: 90%

Prodromata in Acute Myocardial Infarction

1969

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“…Though we have no direct evidence in the present patients, these findings coincide with previous histological descriptions of fibrosis in these con-Logan-Sinclair, Wong, Gibson ditions. [6][7][8] There are a number of self-evident limitations to the clinical application of these results. The first is that absorption of ultrasound, and thus path length, is likely to have been a major factor affecting echo amplitude.…”

Section: Discussionmentioning

confidence: 99%

Clinical application of amplitude processing of echocardiographic images.

Logan-Sinclair¹,

Wong²,

Gibson³

1981

Heart

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“…Previous studies have, however, given conflicting results on the frequency of occlusion (Davenport, 1928;Barnes and Ball, 1932;Gross and Sternberg, 1939;Blumgart, Schlesinger, and Davis, 1940;Master et al, 1941;Master et al, 1944;Yater et al, 1948;Harrison and Wood, 1949;Snow, Morgan Jones, andDaber, 1955, 1956). Branwood and Montgomery (1956) reviewed some of these reports and described their own series of 101 cases, of which 61 had "recent myocardial infarction."…”

Section: Discussionmentioning

confidence: 99%

The Relation Between Myocardial Lesions and Coronary Artery Disease Ii. A Selected Group of Patients With Massive Cardiac Necrosis or Scarring

Mitchell¹,

Schwartz²

1963

Heart

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Our survey of the relation between cardiac lesions and coronary disease in an unselected necropsy sample (Schwartz and Mitchell, 1962) showed that large areas of necrosis or scarring were associated with severe coronary narrowing and with coronary occlusion. To study these lesions in more detail we have collected a further 64 patients with large lesions. The findings in these selected patients together with the 15 patients with large lesions from the random survey are reported here. MATERIAL AND METHODSDuring the period of study, when every tenth necropsy carried out on patients aged 35 and over at the Radcliffe Infirmary, Oxford, was being included in our unselected survey, we also collected the heart and great vessels from every patient who fulfilled one or more of the following criteria: a clinical history of (a) severe retrosternal chest pain lasting for more than an hour; (b) a sudden reduction in blood pressure, or the onset of cardiac failure or the development of an arrhythmia, for which no adequate clinical explanation could be found; or (c) sudden death in patients from whom no history was elicited and at necropsy, the organs, other than the heart, provided no explanation for the patient's death.In addition any patient with the following electrocardiographic findings was included: (a) patients with pathological Q waves, and (b) patients without pathological Q waves in whom serial records had shown changing ST-T patterns.If the external appearance of the heart of patients at necropsy demonstrated an area of ventricular discoloration and softening, often with an overlying pericarditis, or in the case of older lesions, an area of ventricular thinning, usually with an overlying pericarditis, they were included.By selecting for study all the cases in which a large lesion might be present, we hoped to collect a consecutive series of large lesions concurrently with the unselected, random sample.The hearts were injected, radiographed, fixed, serially sectioned on the bacon slicer, cleared, and finally examined histologically in exactly the same way as described for the unselected series. As in the unselected sample, the uncleared heart sections, the cleared sections, and the histological preparations were examined by the authors jointly, and the lesions were described and measured without any knowledge of the clinical, electrocardiographic, or arterial status of the patient: indeed they were examined concurrently with the random sample and, as all hearts were identified only by an experiment number, we had no knowledge of the mode of selection of the heart under examination. Where a large lesion was found, we assigned a histological age to it, on this preliminary "blind" examination, using the criteria described by Mallory, White, and Salcedo-Salgar (1939). RESULTSA. Composition of Series Of 70 hearts selected on the above criteria, 64 were found on examination to have large lesions, and it is these 64 together with the 15 patients with large lesions from the random survey, that we propose to discuss here.

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Coronary Disease: A Pathological Study

Cited by 77 publications

References 7 publications

Prodromata in Acute Myocardial Infarction

Prodromata in Acute Myocardial Infarction

Clinical application of amplitude processing of echocardiographic images.

The Relation Between Myocardial Lesions and Coronary Artery Disease Ii. A Selected Group of Patients With Massive Cardiac Necrosis or Scarring

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