Mitral valve prolapse and coronary artery spasm.
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Biomedical subjects
Publications and source records attributed to T O Cheng.
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Five cases of hypoplasia of the descending thoracic and/or abdominal aorta as a rare cause of hypertension are presented. Similarities and dissimilarities between this lesion and classical coarctation of the aorta are discussed. Management of the resulting hypertension is usually medical, as surgical therapy is extremely difficult due to the diffuse involvement of the entire aorta and its branches.
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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.
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A patient with the familial syndrome of Q-T prolongation, ventricular arrhythmias, and syncope was effectively treated with amiodarone.
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Two patients with cardiomegaly and congestive heart failure were found to be grossly hypocalcemic secondary to previously undiagnosed hypoparathyroidism. The cardiac failure was refractory to digitalis preparations and diuretics but responded dramatically when specific therapy restored the serum calcium to normal. The mechanism of congestive heart failure in hypocalcemia is discussed, and their association constitutes one form of reversible cardiomyopathy which should be kept in mind when a patient fails to respond to conventional antifailure therapy.