Stable Angina Pectoris: Contradictory Therapeutic Behavior by the Ortodoxy in Front of Ventriculographic Findings in Coronary-Myocardiopathy
Quintiliano H. de Mesquita, M.D.
In angiographic and ventriculographic studies the coronary atherosclerosis and its relationship with the coronary-dependent ventricular segment has been demonstrated with gradual and progressive distortion of ventricular silhouette. This deformation is caused by assynergic alterations which are characteristics of segmentar myocardial dysfunction indicating contractility deficiency state in the symptomatic stability phase - stable angina pectoris. Such ventriculographic alterations are also well appreciated through the echocardiography in the course of therapeutics preconized by the orthodox practice, persisting with the use of beta blockers or corrected by the heterodox practice with the beneficial use of cardiotonics which are supported by the Myogenic Theory of Myocardial Infarction, developed by us since 26 years ago. Cases of patients with 1, 2 or 3 atherosclerotic coronary arteries serve to indicate its effects on the ventricular silhouette and principally to emphasize, along the time, the intersegmentary confrontation consequences which are recorded by the ventriculographic picture, showing the pathological disharmony when only 1 coronary artery is involved and the pathological harmony when 2 or 3 coronary arteries are affected. According our concepts, the use of beta blockers due to its negative inotropic effect will develop generalized ventricular hypotonia and precarious annulment of intersegmentary confrontation. The result is showed after a certain time by means of the beta blockers failure to avoid myocardial infarction, cardiac insufficiency and sudden death. Consequently we think the use of beta blockers in the chronic coronary-myocardiopathy reflects a contradictory therapeutical approach by the orthodoxy in front of assynergic ventricular processes, well characterized by ventriculographic findings.
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