Skip to main content
British Heart Journal logoLink to British Heart Journal
. 1975 Feb;37(2):182–191. doi: 10.1136/hrt.37.2.182

Occurrence of coronary ostial stenosis in a necropsy series of myocardial infarction, sudden death, and violent death.

V Rissanen
PMCID: PMC484099  PMID: 123464

Abstract

A postmortem coronary angiography technique employing aortic injection of contrast medium and double contrast visualization of the aortic bulb and large epicardial coronary trunks was applied to the study of coronary ostia in a series of 124 deaths from acute myocardial infarction and a series of 89 sudden deaths without recent infarction and 42 violent deaths. A stenosis of 50 per cent or more of the lumen was found in the right ostium in 45 per cent and in the left ostium in 8 per cent of infarct cases. The corresponding figures in sudden deaths were 37 per cent on the right and 4.5 per cent on the left side, and in violent deaths 7 per cent in the right ostium and none in the left. Most ostial stenoses were caused by coronary atherosclerosis. In 9 patients, two with a recent infarct and 7 sudden deaths, an ostial stenosis was the only stenosed site in the coronary arterial tree. Of theses 9 patients, 7 were known to have suffered from symptomatic heart disease during life, chest pain on effort and arrhythmias being the most common complaint.

Full text

PDF
182

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bellhouse B. J., Bellhouse F. H., Reid K. G. Fluid mechanics of the aortic root with application to coronary flow. Nature. 1968 Sep 7;219(5158):1059–1061. doi: 10.1038/2191059a0. [DOI] [PubMed] [Google Scholar]
  2. Bemiller C. R., Pepine C. J., Rogers A. K. Long-term observations in patients with angina and normal coronary arteriograms. Circulation. 1973 Jan;47(1):36–43. doi: 10.1161/01.cir.47.1.36. [DOI] [PubMed] [Google Scholar]
  3. Blankenhorn D. H. A study of the orifice of the human coronary artery. Proc Soc Exp Biol Med. 1967 Nov;126(2):418–420. doi: 10.3181/00379727-126-32464. [DOI] [PubMed] [Google Scholar]
  4. Boucek R. J., Takeshita R., Brady A. H. Microanatomy and intramural physical forces within the coronary arteries (man). Anat Rec. 1965 Nov;153(3):233–241. doi: 10.1002/ar.1091530303. [DOI] [PubMed] [Google Scholar]
  5. Eliot R. S., Bratt G. The paradox of myocardial ischemia and necrosis in young women with normal coronary anteriograms. Relation to abnormal hemoglobin-oxygen dissociation. Am J Cardiol. 1969 May;23(5):633–638. doi: 10.1016/0002-9149(69)90023-x. [DOI] [PubMed] [Google Scholar]
  6. Evans H. Postmortem angiography. A new medium and technique. Arch Pathol. 1967 May;83(5):479–484. [PubMed] [Google Scholar]
  7. Gensini G. G., Kelly A. E. Incidence and progression of coronary artery disease. An angiographic correlation in 1,263 patients. Arch Intern Med. 1972 May;129(5):814–827. [PubMed] [Google Scholar]
  8. HEGGTVEIT H. A. SYPHILITIC AORTITIS. A CLINICOPATHOLOGIC AUTOPSY STUDY OF 100 CASES, 1950 TO 1960. Circulation. 1964 Mar;29:346–355. doi: 10.1161/01.cir.29.3.346. [DOI] [PubMed] [Google Scholar]
  9. James T. M. Angina without coronary disease (sic). Circulation. 1970 Aug;42(2):189–191. doi: 10.1161/01.cir.42.2.189. [DOI] [PubMed] [Google Scholar]
  10. Judkins M. P. Selective coronary arteriography. I. A percutaneous transfemoral technic. Radiology. 1967 Nov;89(5):815–824. doi: 10.1148/89.5.815. [DOI] [PubMed] [Google Scholar]
  11. Manninen V., Rissanen V. T., Halonen P. I. Coronary ostium outside the aortic sinus. A factor in the aetiology of ischaemic heart disease? Adv Cardiol. 1970;4:94–98. doi: 10.1159/000387607. [DOI] [PubMed] [Google Scholar]
  12. NACHLAS M. M., SHNITKA T. K. Macroscopic identification of early myocardial infarcts by alterations in dehydrogenase activity. Am J Pathol. 1963 Apr;42:379–405. [PMC free article] [PubMed] [Google Scholar]
  13. Neill W. A., Kassebaum D. G., Judkins M. P. Myocardial hypoxia as the basis for angina pectoris in a patient with normal coronary arteriograms. N Engl J Med. 1968 Oct 10;279(15):789–792. doi: 10.1056/NEJM196810102791502. [DOI] [PubMed] [Google Scholar]
  14. SCHOENMACKERS J. DIE ANGIOMORPHOLOGIE DER KORONAROGRAMME. MORPHOLOGISCHE GRUNDLAGEN, GRENZEN DER DARSTELLUNG UND DEUTUNG. Fortschr Geb Rontgenstr Nuklearmed. 1965 Apr;102:349–368. [PubMed] [Google Scholar]
  15. SCHWARTZ C. J., MITCHELL J. R. The relation between myocardial lesions and coronary artery disease. I. An unselected necropsy study. Br Heart J. 1962 Nov;24:761–786. doi: 10.1136/hrt.24.6.761. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Silver M. D., Wigle E. D., Trimble A. S., Bigelow W. G. Iatrogenic coronary ostial stenosis. Arch Pathol. 1969 Jul;88(1):73–77. [PubMed] [Google Scholar]
  17. The pathological diagnosis of acute myocardial infarction: preliminary results of a WHO cooperative study. Bull World Health Organ. 1973;48(1):23–25. [PMC free article] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES