Myocardial infarction is almost regularly associated with severe and widespread obstructive coronary artery disease. Recently, there have been some reports of myocardial infarction with normal of near normal coronary arteries on cineangiography. The following report concerns 6 cases (4% of a series of 142 consecutively studied patients with myocardial infarction) of myocardial infarction proved on clinical grounds with normal or near normal coronary arteries at coronary angiography obtained several months later. The clinical data was shown in Table 1 and Table 2. All 6 patients were male. Three were in the fifth, two in the sixth, and one in the seventh decade. Multiple risk factors were present in only one patient. Areas of localized dyskinesia or hypokinesia were demonstrated in five on the left ventricular cineangiography. The left ventricular end-diastolic pressure was greater than 12 mmHg in all 6 patients. One patient had hypertrophic cardiomyopathy and the remaining 5 patients had no underlying heart diseases. One patient had moderate congestive heart tailure. It is possible that prolonged, localized coronary artery spasm or platelet thrombi that subsequently resolved are a part of the pathogenic mechanism.
Blood Platelets ; Cardiomyopathy, Hypertrophic ; Cineangiography ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels* ; Dyskinesias ; Estrogens, Conjugated (USP) ; Heart ; Heart Diseases ; Humans ; Hypokinesia ; Male ; Myocardial Infarction* ; Risk Factors ; Spasm

To delineate the coronary anatomy and the left ventricular function during early myocardial infarction, coronary arteriography and left ventriculography were performed prospectively in 28(34%) of 83 patients who were admitted to the coronary care unit at Severance Hospital from November 1983 to August 1984 within 30 days(median : 14 days;range : 4 hours to 30 days) after the onset of symptoms. The frequency of total occlusion of the infarct related artery was evaluated in the time course of infarction. To prove spontaneous recanalization, 3 patients who had total coronary occlusion underwent serial study within 11-20 days after the first study. We categorized the patients into two comparable groups according to the infarction site, coronary angiographic findings, and age. Comparison of clinical and angiographic findings between each group was made. The following results were obained. 1) There were 23 patients with transmural myocardial infarction(82.1%) and 5 with nontransmural infarction(17.9%). Among 23 patients with transmural infarction, 14 had anterior infarction(60.9%) and 9(39.1%) inferior infarction. 2) The mean age was 51.3 years(range : 31-79 years). The ratio of male to female was 3.7:1. 3) Fifteen patients(53.6%) had one-vessel disease, 10(35.7%) two-vessel disease and 2(7.1%) three-vessel disease, One patient(3.6%) had insignificant disease(less than 50% reduction in luminal diameter). Nontransmural infarction had a tendency to be associated with higher prevalence of multivessel disease than transmural infarction(80% vs 34.8%). 4) In 23 patients with transmural infarction, 12(52.2%) had complete occlusion and 11(47.8%) incomplete occlusion of the infarct related artery. Three patients(13.0%) had subtotal occlusion(90-99%) and 4(17.4%) had lesions of 70-89% luminal diameter narrowing. Three patients(13.0%) had 50-69% lesions and the remaining 1(4.4%) had insignificant obstructive lesions. 5) Of the 23 patients with transmural infarction, 12 were studied within 14 days and 11 in 15-30 days after the onset of symptoms. The frequency of total coronary occlusion was significantly higher in the patients studied within 14 days of symptom onset vs those studied in the 15-30 days period(83.3% vs 18.2%;p<0.001). Serial studies of 3 patients with total coronary occlusion at the initial study demonstrated occurrance of spontaneous recanalization in 2 patients. 6) The left ventricular-ejection fraction was higher in the patients with nontransmural infarction, inferior infarction, and incomplete coronary occlusion(65+/-14%, 58+/-16% and 57+/-17%) than that of the patients with transmural infarction, anterior infarction, and complete coronary occlusion(51+/-15%, 47+/-14% and 46+/-13, p<0.05). But there was no significant difference in left ventricular ejection fraction between the young(<45 year) and the old(> or =45 year) age groups. And also 0-1 vessel disease and 2-3 vessel disease groups did not show significant difference in ejection fraction. The degree of congestive heart failure was more severe in the patients with anterior infarction than in those with inferior infaction. multi-vessel disease group was significantly older than 0-1 vessel disease group(55+/-8 yrs vs 46+/-12 yrs, p<0.05), and the young age group had a tendency to be associated with higher prevalence of single vessel disease. 7) As for the complications of angiocardiography in this study, there was ventricular finbrillation in 2 patients(7.1%) without mortality. It is concluded that coronary arteriography can be safely performed within one month after acute myocardial infarction;high prevalence of one-vessel disease in acute myocardial infarction in the Korean adult patients admitted to a general hospital;lower incidence of total coronary occlusion in the late time course of infarction due to spontaneous recanalization;better left ventricular function in the patient groups with nontransmural infarction, inferior infarction and incomplete coronary occlusion.
Adult* ; Angiocardiography ; Angiography ; Arteries ; Coronary Care Units ; Coronary Occlusion ; Female ; Heart Failure ; Humans ; Incidence ; Infarction ; Male ; Mortality ; Myocardial Infarction* ; Phenobarbital ; Prevalence ; Prospective Studies ; Stroke Volume ; Ventricular Function, Left

"Dual LAD" was defined as the early bifurcation of the proximal LAD into two vessels : a short LAD which remained in the anterior interventricular sulcus and does not reach the apex, and a long LAD which leaves the anterior interventricular sulcus only to return to the distal sulcus and continue to the apex. Recognition of "Dual LAD" is essential to prevent errors of interpretation of the coronary arteriogram and for planning of optimal surgical therapy. We report 2 cases of "Dual LAD" with the review of the literatures.
Coronary Vessels*

A patient had total occlusion of the left main coronary artery that was proved by coronary arteriography. Patients with total occlusion of the left main coronary artery have a varying clinical presentation and may have prolonged survival. In patients with good collaterals, left ventricular function may be preserved. This report reveiws the clinical and angiographic findings of a patient with occlusion of the left main coronary artery with symptoms of unstable angina pectoris but without congestive heart failure or EKG evidence of myocardial infarction.
Angina, Unstable ; Angiography ; Coronary Vessels* ; Electrocardiography ; Heart Failure ; Humans ; Myocardial Infarction ; Ventricular Function, Left

Coronary arterivenous fistula(CAVF) is an uncommon congenital coronary anomaly-Bilateral CAVFs that originate from both coronary arteries are very rare. Coronary arteriography performed in recent years has clarified the incidence and various features of this lesion. Baim et al.1) reported that only 5% of the coronary artery fistulas arose from bilateral coronary arteries. In this report, we present a case of bilateral coronary artery pulmonary artery fistulas associated with atypical chest pain.
Angiography ; Arteries* ; Chest Pain ; Coronary Vessels ; Fistula* ; Incidence ; Pulmonary Artery

Femoral head and neck fractures during the course of avascular necrosis are rare with only few reports in the English literature. Moreover, there are very few reports on an analysis of the patterns of these fractures. Four cases of femoral head fracture caused by minor trauma, which were quite different from the crescent fractures during the course of avascular necrosis were analyzed in regard to the underlying disease, causes, sites, types, directions, pattern of fractures and the injury mechanism of the fractures. The results are reported with special regard to the pattern of the stress fracture of the femoral head and neck during the course of avascular necrosis.
Fractures, Stress ; Head* ; Neck* ; Necrosis*

There has been no adequate diagnostic method for the diagnosis of intrascrotal lesions until recent days. Butafter the development of radionuclide testicular scan, early and relatively accurate diagnosis of the testicularlesions are possible. So the authors analyzed the 32 cases of patients who were examined by testicular scan andconfirmed by follow up study or operation, and the results are as follows; 1. These 32 cases consists of 13 casesod epididymitis, 7 cases of testicular torsion, 4 of cryptorchism, 2 of testicular tumor and etc. The over alldiagnostic accuracy is about 69%. 2. In epididymitis, the diagnostic accuracy is 85%(11/13) and the findings ofscan are increased perfusion in radionuclide angiogram and hot activity noted mainly in peripheral portion of thetesticle in static image. 3. In cases o testicular torsion, diagnostic accuracy is 86%(6/7). Acute torsion showsnormal perfusion in angiogram and round cold area instatic image. But in missed torsion, perfusion is increasedand round cold area wit surrounding hyperemia is noted in static image. Radionuclide testicular scan seems to benoninvasive, inexpensive, easily available and simple to perform with low gonadal radiation dose. So it can bevery useful as the first study in patients with acute testicular symptoms.
Cryptorchidism ; Diagnosis ; Epididymitis ; Follow-Up Studies ; Gonads ; Humans ; Hyperemia ; Male ; Methods ; Perfusion ; Spermatic Cord Torsion

Primary tumors of the heart are uncommon lesions that can mimic almost any type of cardiac disease. Over 90 per cent of myxoma which are the most common cardiac tumor occur in the atria, with 3 to 4 times as many occuring on the left as on the right. The development of nonivasive echocardiographic technique has made it possible to screen large numbers of patients with atrial myxoma with ease and safe. A 28 year old housewife was admitted because of dyspnea for 5 months. Clinical diagnosis of right atrial myxoma was made by echocardiography and right atrial angiocardiogram. Surgical resection was performed successfully. We presented a case of right atrial myxoma with a review of literatures.
Adult ; Diagnosis ; Dyspnea ; Echocardiography ; Heart ; Heart Diseases ; Heart Neoplasms ; Humans ; Myxoma*

The increasing use of intravenous polyethylene catheters has led to a growing incidence of accidental catheter breakage and migration of fragments into the central vascular system usually in the inferior vena cave, the right atrium, of the pulmonary artery. The most common complications were formation of a thrombus in the area of the foreign body, infection with endocarditis, and perforation of the heart. And so obviously the polyethylene catheter must be removed. In 1967, Massumi and Ross et al have been successful in removing a catheter fragment from the right atrum percutaneously with a snare device. With some modification as suggested by Curry, method of retrieving fragments of polyethylene catheters from the heart without chest surgery utilize wire snares or endoscopic forceps. This report describe the technique and its use in successfully managing these complications in four consecutive cases.
Catheters* ; Endocarditis ; Foreign Bodies ; Heart Atria ; Heart* ; Incidence ; Polyethylene ; Pulmonary Artery ; SNARE Proteins ; Surgical Instruments ; Thorax ; Thrombosis

No abstract available.
Echocardiography, Transesophageal* ; Mitral Valve*