[Image of the month. Myocardial bridging...].

Myocardial bridging, often congenital, is an aberrant relationship between epicardial coronary segments and the myocard, usually affecting the interventricular artery. Although often asymptomatic, this coronarographic detection (milking effect by systolic compression) has been associated with ischaemia, rhythm disturbances or sudden death. Different treatments may be considered, from pharmacological intervention to surgery, and above all, percutaneous angioplasty with stenting.

[Abnormal origin of the left coronary artery from the pulmonary artery trunk; a fortuitous discovery in a 52 year-old man].

Anomalous origin of the left coronary artery from the pulmonary artery is a rare congenital abnormality but with a very poor prognosis at birth. Myocardial ischaemia, infarction and sudden death are common. Cases diagnosed in adulthood are exceptionally rare.

Ibopamine in very severe congestive heart failure: pilot haemodynamic invasive assessment.

The acute effects of ibopamine, a new, orally active dopaminergic agent, were assessed invasively in 8 patients with congestive heart failure (NYHA Class IV). The cardiac Index increased (P less than 0.01) and preload and afterload decreased (P less than 0.

Assessment of myocardial sympathetic activity in coronary heart disease.

We measured adrenaline, noradrenaline and dopamine beta-hydroxylase in arterial and in coronary sinus blood in 14 patients with coronary artery disease, at rest and under pacing-induced ischemia. Pacing increased the concentrations of adrenaline and noradrenaline in both arterial and coronary sinus blood. The origin of the adrenaline increase appears to be extramyocardial.

[Results of long term surgical treatment of isolated stenosis of the left descending coronary artery].

The results of medical and surgical management of isolated stenosis (greater than or equal to 50%) of the left anterior descending artery were compared retrospectively in a series of 124 consecutive patients. 57 patients were managed medically (Group I). 28 (49%) presented with angina and 36 (63%) with a previous myocardial infarction.

[Interventricular septum. Angiographic and echocardiographic correlations].

The diastolic thickness of the interventricular septum was measured by echocardiography and by biventricular angiography in 48 patients (40 male, 8 female) with age ranging between 15 and 67 years (average 44.4 years). These patients were classified in four groups according to clinical and paraclinical parameters:--normal subjects (29 cases),--patients with concentric hypertrophy (5 cases),--patients with asymmetrical septal hypertrophy without obstruction (4 cases),--patients with hypertrophic cardiomyopathy with obstruction under basal conditions or under stress (10 cases).

[Congenital absence of the circumflex artery. Association with an infarction without coronary disease].

A 31 year old man had a congenitally absent circumflex coronary artery, one of the least described of all the congenital abnormalities of the coronary arteries. Before confirmation of the diagnosis, an ectopie circumflex artery was excluded by the two angiographical signs observed by Page and by non-selective coronary arteriography. This abnormality was thought to have played a role in myocardial infarction in this young patient without coronary risk factors and with no obvious coronary artery narrowing on coronary arteriography.