Congenital coronary artery-cardiac chamber fistulae: Report of two cases.

Two cases of coronary arteriovenous fistulae are reported. In the first case, the right coronary artery (RCA) drained into the right ventricular outflow tract, and the distal RCA filled through a branch of the left anterior descending coronary artery. In the second case, the RCA drained into the right atrium and filled through a branch of the left circumflex artery.

Variations in coronary artery anatomy: Normal versus abnormal.

We offer a comprehensive classification of coronary artery anomalies, together with angiographic examples of each entity. Minimal requirements for normality include the following criteria: (1) the dual aortic origin is from right and left coronary ostia; (2) the course of the right coronary artery follows the right atrioventricular groove; (3) the course of the left coronary artery follows the left atrioventricular groove and anterior interventricular groove; (4) the posterior descending branch originates from either the right or left coronary artery; (5) the major coronary branches flow epicardially; and (6) the coronary arteries terminate at the myocardial capillary level. This conception of "normal" coronary arteries has determined the classification of abnormalities presented here.

Disturbances in cardiac rhythm caused by the removal of temporary pacemaker wires.

The effects of temporary pacemaker wire removal on cardiac rhythm were studied in 22 open-heart surgery patients who had temporary pacemaker wires implanted at the time of chest wall closure. During wire removal, 16 patients developed premature ventricular contractions (PVCs), most commonly occurring as single PVCs, and less often as ventricular couplets. The authors recommend that external pacemaker wire removal be accompanied by electrocardiographic monitoring or at least by a short period of careful clinical observation.

Recurrent myocardial infarction in a patient with Prinzmetal's angina and normal coronary arteries.

A 55-year-old man was referred for the evaluation of frequent chest pain and syncope. While in the hospital, he experienced severe chest pain accompanied by transient ST segment elevation and a slight elevation of cardiac enzyme levels. Multiple coronary arteriograms were recorded at various times during an interval of 2 months.

Unusual findings of asymmetrical septal hypertrophy associated with calcification of the interventricular septum: Case report.

A patient with aortic regurgitation, stenosis, and calcification of the septum is reported. Results of echocardiography revealed asymmetrical septal hypertrophy without other features of idiopathic hypertrophic subaortic stenosis. There was no subaortic obstruction evident on cardiac catheterization and angiography.

SUCCESSFUL CLOSURE OF POST-TRAUMATIC CAROTID-JUGULAR ARTERIOVENOUS FISTULA COMPLICATED BY CONGESTIVE HEART FAILURE AND CEREBROVASCULAR INSUFFICIENCY.

This report describes a patient who received a traumatic injury of the neck 28 years prior to admission to this institution. He had required multiple hospitalizations, along with medications for congestive heart failure. After ligation of a large arteriovenous fistula and replacement of a 3 cm segment of the left common carotid artery with an 8 mm double-velour graft, the patient was greatly improved.

OBLITERATIVE RESTRICTIVE ENDOMYOCARDIAL FIBROSIS: A SURGICAL APPROACH.

Restrictive cardiomyopathies have been variously classified and interpreted. Although their etiologic and anatomic features may vary, their common denominator is indicated by restrictive hemodynamic behavior of either the left or right ventricle or both. This report describes a case in which such restriction was caused by obliterative endomyocardial fibrosis of unknown etiology.

TRANSIENT ISCHEMIC EVENTS OF THE HEART (ANGINA PECTORIS).

In an attempt to clarify some of the controversy regarding the concepts of myocardial ischemia, various cardiac pathologies are presented to demonstrate several of the unusual mechanisms involved in the causes of transient ischemic events of the myocardium. A review of the literature is presented, with a discussion of the current approach to managing these unusual clinical conditions.

SEGMENTAL AORTITIS AND AORTIC INCOMPETENCE.

An unusual case of a middle-aged male with segmental aortitis and aortic incompetence is described. To our knowledge, only 13 cases have been previously described in the literature, but only two have had anatomopathological confirmation. Aortic incompetence is a rare manifestation of segmental aortitis.