A method which improves anatomo-clinical correlations in ischemic heart disease.

A study carried out on 595 unselected subjects aged 21-55 years who had died of accidental causes and on 56 selected patients who had died of myocardial infarction showed that the light microscopic examination of coronary branch vessels led to an obvious improvement of anatomo-clinical correlations in ischemic heart disease. These branch vessels included atherosclerotic plaques in 51% of unselected subjects 51-55 years old, dead of accidents and in 73% of selected patients dead of myocardial infarction. Severe stenotic plaques of possible clinical significance were found in 14% of subjects dead of accidents and in 48% of patients dead of myocardial infarction. In these cases the atherosclerotic involvement in the major coronary arteries (left anterior descending, circumflex and right coronary arteries) did not reach the level of possible clinical significance (greater than or equal to 75% reduction of the vessel diameter). Several examples emphasize the importance of stenotic lesions in the first diagonal, first septal, posterior descending, left marginal and right marginal vessels, as well as in the vessels supplying the sinoatrial and atrioventricular nodes for an adequate anatomo-clinical correlation in ischemic heart disease.