Valley Heart Associates Medical Group, Inc.

immediate therapy

To the Editor: Perhonen et al1 estimate changes in the left ventricular (LV) diastolic rest volume before and after bed rest. By definition, diastolic rest volume is that volume which exists at zero transmural …

Figure 1. A 74-year-old man presented with a one-week history of exertional angina and dizziness. Treadmill testing showed deep, prolonged depression of the ST segment and hypotension at a low level of exercise. During urgent cardiac catheterization, the 6-French diagnostic catheter recorded severe pressure damping during cannulation of the ostium of the left coronary artery. A single anteroposterior angiogram was quickly obtained before the catheter was removed. The angiogram showed severe stenosis of the left main coronary artery (arrow) and a total absence of contrast reflux despite forceful injection by hand. Since the left coronary artery was dominant and provided . . .