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Experiences in 81 patients with variant angina were reviewed with the goal of determining which clinical features were associated with the greatest risk of angina-linked cardiac arrest (13 patients) or sudden unexpected death (9 patients). The risk of occurrence of one of these actually or potentially fatal events was approximately tripled by the presence(More)
We report clinical experience with the coronary vasodilator nifedipine in 127 patients with symptoms of myocardial ischemia associated with electrocardiographic or angiographic evidence, or both, of coronary-artery spasm. In the majority of patients conventional antianginal therapy including nitrates and beta-adrenergic blockers failed, and in one third of(More)
Echocardiography has been useful in the evaluation of congestive and hypertrophic cardiomyopathies. We present echocardiographic findings in seven patients with infiltrative cardiomyopathy due to amyloid. Cardiac amyloidosis was documented at autopsy in two patients, and the diagnosis was suggested by clinical, echocardiographic, tissue, or hemodynamic(More)
Anatomic studies have shown that the left bundle branch divides into three fascicles in most humans. Changes in the 12 lead ECG (electrocardiogram) due to conduction abnormalities of the left anterior fascicle and left posterior fascicle are now part of the standard repertoire of electrocardiographic interpretation. There are no standard criteria for(More)
The echocardiographic findings of eight patients with hypertrophic cardiomyopathy without outflow obstruction (HMC) and of 15 normal (Norm) individuals are presented. The characteristic features in HMC were: (1) interventricular septal width much greater than normal (HMC= 2.5 + 0.3 cm, Norm = 1.0 + 0.2 cm, P <0.005); (2) normal or only slightly increased(More)
Among 63 patients with Prinzmetal's variant angina, coronary arterial spasm responsible for attacks of variant angina was documented arteriographically in 9 patients. In each observed episode (11 attacks in nine patients), coronary spasm producing myocardial ischemia occurred at and was superimposed on a site of preexisting organic stenosis. Measurements of(More)
Available estimates of the ratio of wall thickness to luminal radius of human coronary arteries and certain geometrical assumptions were used to calculate the amounts of vascular smooth muscle shortening required to produce specific changes in luminal diameter for hypothetical "normal" and stenotic arteries. The results indicate that even modest mural(More)