RESUMO
Topographic and morphologic aspects of coronary atherosclerotic "protruding" lesions were investigated in 119 accidental deaths in males living in Mexico City. Morphology and topography varied according to the arterial trunk studied and age. Left anterior descending and circumflex lesions were almost always confined to the initial 5 cms and if a lesion was present after the 3rd cm there was always a proximal lesion. Right coronary lesions occasionally were found distally even in the absence of proximal lesions. Third decade lesions were usually not calcified. Stenosis if present was rarely multivascular. Some fourth decade lesions were calcified; plurivascular stenosis was present in some cases. Fifth decade lesions show sequential stenotic lesions in the same vessel; calcium and plurivascular stenosis were often observed. However the features observed in the 3rd decade could be observed in the older subjects. Reference is made to lesions which are found in both the left main trunk and the left anterior descending. Epidemiological and clinical applications related with preventive programs are mentioned.
Assuntos
Doença da Artéria Coronariana/patologia , Adolescente , Adulto , Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/prevenção & controle , Humanos , Masculino , México , Pessoa de Meia-IdadeRESUMO
The prevalence of microscopic atheroma in the proximal left anterior descending coronary artery was studied in thirty young males aged 20 to 29 years, living in Mexico City, who died in urban accidents. All of them were either unemployed or labor workers with a socioeconomical status considered to be representative of the majority of young males living in Mexico City. It was found that coronary atheroma was present in 11 of them (33%) with variable degrees of luminal obstruction. In two of them the luminal obstruction was greater than 75%. The prevalence found in this group was significantly different to that found in younger and older males who also died in accidents. Since the prevalence of coronary atheroma was not related to ventricular hypertrophy, valvular or congenital heart disease our findings indicate that in Mexico City as in other geographical regions, coronary atherosclerosis is not an unusual finding in males in the third decade of life, with a low socioeconomical status.