71 – O cardiotônico na sindrome intermediária coronária, Mesquita, QHde, Baptista, CAS, Mari, SM, Monteiro, JTC, Grossi, MCBM, Rev Bras Med (Cardiologia), 1983;2:317-23
Contribuição inédita à literatura mundial.
Summary:
There were
185 intermediate coronary syndrome patients, 10 treated at home and the others
hospitalized at the Coronary Care Unit of the Matarazzo Hospital, who were
administered cardiotonics: Strophanthin (150 pts.); Digitalis (39 pts,); 5
patients were treated with Proscilaridine (4 pts.) and Digitalis (1 pt.) by
oral route. These patients were divided into 3 groups according to the coronary
antecedents: Group I: previous myocardial infarction, 43 patients: Group II
stable angina pectoris, 49 patients: Group III: no antecedents, 93 patients.
Phisiopathologically,
the intermediate coronary syndrome is interpreted as recurrent from a myogenic
process evolving to a myocardial infarction, characterized by episodes of
primary regional myocardial failure and secondary myocardial ischemia.
Electrocardiographically
and enzimatically the intermediate coronary syndrome is characterized by
inexpressive aspects, but favorably influenced by the cardiotonic.
A sampling
of 22 patients pertaining to the above mentioned Groups was studied
angiographically and ventriculographically.
Special
emphasis was put on Groups II and III, with no myocardial infarction in there
antecedents, because they seem to give strength to the myogenic theory of
myocardial infarction, by means of the registers of patients with total obstruction
of 1, 2 or 3 coronary arteries by chronic atherosclerosis without myocardial
infarction, and also patients without any coronary angiographic lesions, or
else with severe stenotic coronary lesions, but pervious and threatened with
myocardial infarction.
During the
hospitalization phase slight arrhythmic but transient disorders were registered
in 38 patients (20,5%).
The
immediate and successful results obtained with administration of cardiotonics
were: cessation of the episodes of unstable angina pectoris, exceptionally only
the incidence of myocardial infarction (0,5%, 1 patient out of 185 pts.), and
no case of lethal exit.