Coronary Artery Disease and Left Ventricular Function in Mitral Stenosis

¹ Fellow in Cardiology, Veterans Administration Hospital and Case Western Reserve University School of Medicine, Cleveland
² Cardiology Resident, University Hospitals, Case Western Reserve University School of Medicine, Cleveland
³ Chief, Cardiac Laboratory, Medical Service, Veterans Administration Hospital, and Assistant Professor of Medicine, Case Western Reserve University School of Medicine, Cleveland

Twenty-six men with mitral stenosis were studied to assess the importance of obstructive coronary disease in the production of symptoms and the effect upon left ventricular function. The patients were studied by cardiac catheterization including selective coronary arteriography and cineventriculography. Five patients (Group 1) showed severe obstructive coronary lesions, eight patients (Group II) had minor arterial changes and 13 (Group III) had normal vessels. Angina pectoris was confined to the first group who also demonstrated significant left ventricular dysfunction, the consequence of coronary disease. Left ventricular impairment was also found in a significant proportion of those patients without important obstructive coronary disease. In these patients the etiology of the myocardial impairment is poorly understood. Rheumatic involvement of the myocardium or the small coronary vessels has been suggested as an explanation.