Coronary spastic angina in middle-aged women: a psychosomatic disorder?
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Biomedical subjects
Publications and source records attributed to O Hakim.
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In a 55-year-old man, attacks of spontaneous angina were associated with dizziness and syncope. Holter ECG monitoring disclosed evidence of sinus node dysfunction. Dizziness and syncope were corrected by a permanent ventricular demand pacemaker. Coronary cineangiography showed spontaneous, severe, diffuse spasm in a dominant left coronary artery and localized spasm in a nondominant right coronary artery. The patient died of pump failure shortly after cardiac catheterization. An autopsy disclosed only minimal coronary atherosclerosis. This patient's condition shows that (1) coronary spasm may cause sinus node dysfunction, dizziness, and syncope, (2) severe spasm that involves all the coronary artery branches may be fatal, and (3) severe spasm occur in minimally diseased coronary arteries confirmed by pathologic examination.
To determine the effect of ptosis surgery on the astigmatic refractive error in pediatric patients, we assessed 88 eyes postoperatively at 3, 6, and 12 months. Thirty-six eyes of unilateral cases were used as controls. There was an overall increase in average astigmatic refractive error of the study group by 0.30 diopters, while the control group decreased 0.15 D. Thirty-six percent of study eyes changed by more than 0.75 D. Results were similar for both fascia lata slings and levator resections. Those patients older than 4 years showed an increase in average cylinder (0.50 D), while those younger than 4 years decreased their average cylinder (0.20 D). Careful monitoring with postoperative refractions is required in pediatric ptosis patients.