POST MORTEM, CORONARY ARTERIOGRAPHIC, CLINICAL AND ELECTROCARDIOGRAPHIC FINDINGS IN 80 PATIENTS INVESTIGATED WITH CORONARY ARTERIOGRAPHY

. A coronary arteriographic investigation has been made of 492 patients, most of whom had different cardiac diseases. Eighty patients died during an observation period from 1 1/2 up to about 7 years. In 45 patients a postmortem investigation was made. Comparison between arteriographic and post mortem findings in the arteries and the myocardium, as well as the study of other clinical facts at or before the time of investigation, led to the following conclusions. 1 A coronary arteriogram of good quality gives a reliable picture of the intraluminal condition in the big predominantly epicardial coronary arteries. 2 An occlusion or critical obstruction of the coronary arterial stems are in the majority of hearts combined with myocardial disease in the form of old infarction scar or local, patchy fibrosis. 3 Coronary arteriography is of good help to demarcate a group of patients with diffuse non-atherosclerotic, myocardial disease. 4 Early changes of atherosclerotic coronary artery disease seem to be rather evenly distributed among the big coronary arteries. In the living patients the majority of severe obstructions are present in the right and the left descending artery. This distribution is probably due at least partly to the selection of patients in the study. 5 Roughly half of all myocardial infarctions can be clinically traced. 6 The results emphasize that angina pectoris, clinical picture of myocardial infarction and abnormal Q waves in the ECG are not synonymous with coronary heart disease. This may be particularly true in hospitalized patients, who may overrepresent non-atherosclerotic heart diseases, leading to symptoms and signs shared by the atherosclerotic, coronary heart disease.