Ventriculography and coronary arteriography in the acutely ill patient. Complications, extent of coronary arterial disease, and abnormalities of left ventricular function

Of 99 patients who underwent 'emergency' diagnostic studies, 82 had 'unstable angina' (group A), 15 had recent myocardial infarction (group B), and 2 had intractable congestive heart failure due to acute mitral regurgitation (group C). Two cardiac and 2 local complications occurred either during the procedure or during the following 48 hr. There were no deaths or myocardial infarctions. Ten (12%) patients of group A had 'normal' coronary arteries and normal left ventricular function; 13, 26 and 33 patients had 1, 2, and 3 coronary arteries involved, respectively. Those with three vessel disease had a significantly higher left ventricular end diastolic pressure (LVEDP) and lower ejection fraction (EF) than those with one and two vessel disease. Those with previous myocardial infarction had a significantly higher incidence of reduced EF and of wall motion abnormalities than those without a previous myocardial infarction. All patients in group B had significant coronary arterial disease, and 80% (12) had abnormal left ventricular function. Their mean LVEDP and EF were significantly higher and lower, respectively, then those found in group A. In conclusion, acutely ill patients were studied with low risk. Most patients had three or two vessel disease. Abnormal left ventricular function was related to three vessel disease and to recent and old myocardial infarction.