Ischemia and reperfusion during intermittent coronary occlusion in man. Studies of electrocardiographic changes and CPK release.

The course of 357 balloon inflations performed during 38 angioplasties for single-vessel coronary artery disease was prospectively studied using continuous ECG recording. Ischemic ECG changes appeared during 91 percent of the inflations at a mean of 20 +/- 8 seconds after inflation and resolved in 97 percent of those at a mean of 11 +/- 5 seconds after deflation. Elevation of the plasma CPK level was found in six patients who had ischemic ECG changes for at least 7.

Unstable angina: the significance of ST segment elevation or depression in patients without evidence of increased myocardial oxygen demand.

We evaluated 46 patients with unstable angina (UA), who showed no significant changes in heart rate, blood pressure, and double product (as evidence of increased oxygen demand) during episodes of chest pain. Coronary angiography was performed in all patients during the same hospitalization. Of 26 patients with UA and ST depression (group A), 10 had left main coronary artery disease (CAD) and eight had left main equivalent CAD.

Complete occlusion of the left main coronary artery: successful surgical management by myocardial revascularization.

Isolated total occlusion of the left main coronary artery was demonstrated on coronary cineangiography in a 50-year-old woman with a progressive anginal syndrome. Aortocoronary saphenous vein graft bypass was performed. Six weeks after operation the patient was free of symptoms and postoperative coronary angiography showed the graft to be patent.