TITLE

IDIOPATHIC HYPERTROPHIC SUBAORTIC STENOSIS IN PATIENTS WITH CORONARY ARTERY DISEASE--IMPORTANCE OF RECOGNITION AND PRINCIPLES OF MANAGEMENT

AUTHOR(S)
Oran, E.; Gupta, S.; Yeo, B.; Nandi, A. C.; Koh, W.; Lauterstein, J.; Potter, R.; Manoli, A.; Piccone, V. A.
PUB. DATE
October 1973
SOURCE
Angiology;Oct1973, Vol. 24 Issue 9, p538
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Idiopathic hypertrophic subaortic stenosis (IHSS), generally reported in the young and middle-aged, was found with unexpected frequency in older patients being evaluated for coronary disease. The possibility of coexisting IHSS is usually overlooked when coronary artery disease has been proven by coronary. arteriography. Because IHSS can mimic coronary artery disease the diagnosis is difficult and can only be proven by catheterization. Recognition of the two diseases is critical. The symptoms are similar and drugs used to treat coronary disease may aggravate the cardiac problem of IHSS during medical treatment, endanger successful termination of cardiopulmonary bypass, and cause post-operative heart failure and death in surgical patients undergoing bypass operations for coronary artery disease. Operative or post-op- erative management of coronary surgical patients with sympathomimetic amines, nitrates or digitalis, may cause unexplained fatalities if both conditions have not been recognized preoperatively. In this report, eight patients with concomitant coronary arterial stenosis and IHSS, diagnosed clinically as coronary artery disease and sent for pre-op- erative evaluation for possible revascularization procedures, are presented. Three patients successfully underwent coronary bypass operations with con- siderable amelioration of anginal complaints. Hemodynamic studies and the principles of operative and post-operative management have been discussed.
ACCESSION #
16360163

 

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