RESUMO
In 936 coronary angiocardiographies we found 46 patients with muscular bands. This report concerns 23 patients in which a muscular band was the only coronary pathological finding. In all cases the muscular band was located at the anterior descending artery. The angiocardiographic features that distinguishes the muscular epicardial bands are pointed out. The muscular bands can produce myocardial ischemic changes. Eighty-two per cent had ischemic changes in the resting EKG. Stress tests were positive only when the systolic obstruction was greater than 70%. The ischemic changes were observed in the myocardial zone irrigated by the narrowed artery and in 60% of the cases were accompanied by malfunction of the ventricular wall. In a follow up period averaging 28 months, the majority improved with beta-blockers. Two remained with angina.
Assuntos
Doença das Coronárias/patologia , Vasos Coronários/patologia , Miocárdio/patologia , Antagonistas Adrenérgicos beta/uso terapêutico , Adulto , Idoso , Angiocardiografia , Angiografia Coronária , Doença das Coronárias/diagnóstico por imagem , Doença das Coronárias/tratamento farmacológico , Eletrocardiografia , Teste de Esforço , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
En 936 angiografias coronarias se encontraron bandas musculares en 46 pacientes.Este informe se refiere a 23 pacientes en los que la banda muscular era la unica alteracion coronaria.En todos ellos las bandas musculares estaban a nivel de la descendente anterior. Se senalan datos angiograficos que distinguen los trayectos intramurales de las grandes arterias, de los datos correspondientes a las bandas musculares epicardicas. Las bandas musculares pueden producir isquemia miocardica.El 82% presentaban cambios isquemicos en el electrocardiograma de reposo. Las pruebas de esfuerzo fueron positivas cuando la obstruccion sistolica era mayor del 70%. Los cambios isquemicos se presentaron en la zona miocardica correspondiente a la arteria estenosada por la banda muscular y en el 60% se acompanaron de disfuncion de la pared ventricular. Los pacientes fueron seguidos por un promedio de 28 meses. La mayoria mejoraron con tratamiento medico a base de betabloqueadores; dos quedaron con angor de esfuerzo