Document Detail

Coronary artery disease in patients dying from cardiogenic shock or congestive heart failure in the setting of acute myocardial infarction.
MedLine Citation:
PMID:  971375     Owner:  NLM     Status:  MEDLINE    
Pathological findings in the heart and particularly in the coronary arteries are reported from 70 patients dying from pump failure after acute myocardial infarction. Fifty of the patients had died in cardiogenic shock, the remainder from refractory congestive heart failure. Three-vessel disease (greater than or equal to 75% occlusion) was present in 68 per cent of the group with cardiogenic shock but in only 35 per cent of those with fatal congestive heart failure (P less than 0-02). In both groups there was an almost equal incidence (84% for cardiogenic shock and 80% for congestive heart failure) of severe disease (greater than or equal to 75% occlusion) over a long segment of the left anterior descending artery. However, there were differences between the two groups regarding the involvement of the other coronary arteries. Whereas patients with cardiogenic shock generally showed severe disease over a long segment in all coronary arteries, in 60 per cent of those with congestive heart failure there was only local severe narrowing of the right coronary artery with little or no narrowing of the peripheral part. Similarly, 60 per cent of those with congestive heart failure had less than 75 per cent narrowing in the left circumflex artery. These anatomical findings may be of relevance with regard to desirability of acute coronary bypass surgery in patients with pump failure after acute myocardial infarction.
F J Wackers; K I Lie; A E Becker; D Durrer; H J Wellens
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  British heart journal     Volume:  38     ISSN:  0007-0769     ISO Abbreviation:  Br Heart J     Publication Date:  1976 Sep 
Date Detail:
Created Date:  1976-12-03     Completed Date:  1976-12-03     Revised Date:  2009-10-27    
Medline Journal Info:
Nlm Unique ID:  0370634     Medline TA:  Br Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  906-10     Citation Subset:  AIM; IM    
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MeSH Terms
Acute Disease
Coronary Disease / complications*
Coronary Vessels / pathology
Heart Failure / etiology*,  pathology
Middle Aged
Myocardial Infarction / complications*,  pathology
Myocardium / pathology
Shock, Cardiogenic / etiology*,  pathology
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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