[Quantitative morphologic studies of so-called dynamic, eccentric coronary stenoses in cases of acute coronary death].

The residual normal wall segment of an eccentric stenosis of the coronary artery can reduce the residual lumen by spastic contraction of the media. Such dynamic coronary artery stenoses may consequently cause or intensify myocardial ischemia or may lead to sudden coronary death due to dysrhythmia. In 39 cases of sudden coronary death, the histological cross section of extramural coronary arteries were measured by planimetry after postmortem coronary angiography. Of a total of 382 stenoses wit more than 45% narrowing, 178 (48.6%) were of the eccentric kind. These eccentric stenoses of the coronary artery were localized in the RIVA in 48%. On average, 4.5 eccentric stenoses were found in each case of coronary death. Eccentric stenoses with round (49.4) or elliptically situated (35,3%) restenoses was on average 30.5% of the residual lumen wall. The quantitative findings show that the high percentage of eccentric stenoses with a larger normal wall segment is of functional significance with regard to acute coronary deficiency. The morphological description and evaluation of the coronary sclerosis should also take into consideration the kind of stenosis.