RESUMO
The presence of rigid coronary arterial segments was detected during a survey for coronary atherosclerosis in men who died of violent causes. These lesions which traditionally are considered of non-clinical significance, in the absence of stenosis are probably responsible of the clinical and electrocardiographical abnormalities as seen in patients with "normal" coronary arteries using coronary angiography, the best current procedure for the detection of isolated coronary atherosclerosis. We propose these lesions are to be considered as functional lesions and consequently that these lesions should be considered by both, the pathologist and the clinician. Our hypothesis is to be tested in the near future when new diagnostic advances with the possibility of detection of coronary pathology in vivo, appear. The prevalence of these abnormalities in different age-groups as well as the topography are presented. The concordance of these lesions with coronary stenosis is also presented.
Assuntos
Doença da Artéria Coronariana/patologia , Acidentes , Adolescente , Adulto , Autopsia , Constrição Patológica/patologia , Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/prevenção & controle , Estudos Transversais , Humanos , Masculino , México , Pessoa de Meia-IdadeRESUMO
The severity and prevalence of coronary and aortic atherosclerosis was studied in 174 subjects who died from violent causes in Mexico City. As in other geographic areas, fatty streaks were found early in life (12 years old). Fibrolipid plaques were present in the thoracic aorta at age 15 and at age 19 in the abdominal segment. Complicated lesions were detected in the aorta after age 25. Because of the obvious clinical significance we looked for severe aortic lesions in the abdominal bifurcation. The prevalence of severe lesions in the bifurcation was 0 between 15 to 24 years and raised to 23.3% in the 45-54 age group. A moderate correlation was found between the severity of coronary and aortic lesions. The discordance most often found was the presence of severe coronary lesions without severe aortic involvement.