Inégalité de la température cutanée dans l’infarctus du myocarde et I’angine de poitrine

Doret, J.P.; Ferrero, Carmen López

doi:10.1159/000165069

Cited by 9 publications

(2 citation statements)

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“…Peripheral vasoconstriction has been held to be responsible for referred cardiac pain by Roberts (1945) and has been demonstrated by variations of cutaneous temperature (Doret and Ferrero, 1951). An analogous mechanism is known to be responsible for the trophic lesions in the upper limb which are well-recognized clinical sequelae of acute cardiac pain and myocardial infarction (Askey, 1941;Kehl, 1943;Johnson, 1943;Steinbrocker, Spitzer, and Friedman, 1948;Hilker, 1949;Chitwood, 1950;Swan and Henderson, 1951).…”

Section: Discussionmentioning

confidence: 99%

Cutaneous Petechiae in Fatal Coronary Artery Disease

Gerlis¹

1958

J Clin Pathol

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In the clinical recognition of myocardial ischaemia, the nature and distribution of the referred pain which frequently accompanies it are of considerable diagnostic importance. Unfortunately in cases of sudden death there may be no such history and not always is an unequivocal fatal cardiac lesion found, such as a recent or ruptured infarct, or an acute occluding lesion of a coronary artery. In some there is little to indicate why or how the patient actually died, as the only cardiac lesions found are of long standing. The fatal disturbance is often of function rather than of structure and in such cases the post-mortem diagnosis of acute coronary insufficiency is made by implication rather than observation.In seven necropsies on cases of acute coronary death cutaneous petechiae were observed at sites commonly associated with referred pain of cardiac origin (Fig. 1). No such lesions were observed in any deaths not of coronary origin. These petechiae were all outside the area of cutaneous post-mortem hypostasis and in no case w as there any evidence of generalized haemorrhagic disease. It is suggested that this sign may be of diagnostic significance in the post-mortem diagnosis of coronary insufficiency. There appears to be no previous description of similar observations in cases of coronary heart disease either before or after death. Case 2.-A man of 64 years who had led a healthy and active life as a pedlar was found dead in bed the day after he experienced a sensation of being unwell, accompanied by pain in the chest and abdomen, although these did not restrict his usual activities.There was a localized area of fine recent petechiae on the right side of the chest extending as a horizontal band 71 cm. long and 5 cm. wide just below the right nipple and fading out over the right border of the sternum. The lungs showed acute oedema. The heart was not enlarged. A solitary subepicardial petechia was present in the atrioventricular groove near the right cardiac border. The right coronary artery showed a region of atheromatous stenosis at a point 1 cm. from the origin. Distal to this there was a segment of complete occlusion by a thrombus extending for 2 cm., and histological examination showed acute haemorrhagic extravasation into the adventitia overlying this occluded portion. The myocardium showed no evidence of acute infarction.Case 3.-This 37-year-old blacksmith was found to have an enlarged heart and an atypical bundle-branch block at the age of 29. In the subsequent two years he had several attacks of "blackout " which were preceded by pain in the tips of the fingers of the left hand which spread up into the left arm, and terminated in unconsciousness. There was no history of convulsive fits. During the last two years of his life he suffered from palpitations. Three days before death in April, 1953, he had increasing dyspnoea and epigastric pain radiating to the back between the shoulder blades, upwards into both sides of the neck, and down the inner sides of both arms. Clinical examination showed severe shock ...

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Section: Discussionmentioning

confidence: 99%

Cutaneous Petechiae in Fatal Coronary Artery Disease

Gerlis¹

1958

J Clin Pathol

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“…In addition to the sympathetic nervous system acting as afferent fibres there is also evidence of a disturbance of the sympathetic system in the area where the pain is felt. Doret and Ferrero (1951) have shown that there is a fall in temperature in this area after a cardiac infarct. Patients also describe sensations in this area which they distinguish from the cardiac pain and describe a feeling of coldness and a sensation of draught on the left side.…”

Section: Lesions Distant From the Shouldermentioning

confidence: 95%