Noninvasive And Invasive Demonstration Of Spontaneous Regression Of Coronary Heart Disease
Circulation 62(4): Oct 1980; 888-896
View Original Source →Abstract
Spontaneous regression of a left anterior descending coronary artery lesion was diagnosed by noninvasive testing (stress electrocardiography and thallium-201 myocardial imaging) and confirmed on selective coronary angiography in a 46-year-old man. The patient’s clinical improvement, normalization of stress ECG and thallium-201 imaging, together with the loss of collateral filling, confirm that the regression is genuine. This case provides evidence that regression of coronary atherosclerosis can occur in man.
Case Details
Personal Characteristics
46-year-old white male lawyer, non-smoker since 1975, family history of myocardial infarction and diabetes mellitus
Clinical Characteristics
Acute dyspnea, chest tightness, presyncope, exertional chest pain, serum triglyceride and cholesterol levels slightly increased, arcus senilis, an s4 gallop, a soft apical systolic murmur, anterior perfusion defect in thallium-201 myocardial images
Remission Characteristics
Clinical improvement, normalization of stress ecg and thallium-201 imaging, loss of collateral filling
Treatment & Mechanisms
Proposed Remission Mechanisms
Increased physical activity, dietary changes (eating less meat and dairy products), lifestyle changes (reducing law practice)
Clinical Treatment
ß blockade in the form of timolol, 5 milligrams three times daily
Non-Clinical Treatment
Increased physical activity, dietary changes, lifestyle changes
Additional Notes
Patient discontinued medication due to side effects. Patient elected for a nonsurgical approach after the pros and cons of aortocoronary bypass were explained.