Speculative Considerations about Some Cardiology Enigmas

Abstract

Background: Enigmas often lead to hypotheses and speculations. For this reason, especially for the sake of the reader's motivation, we opted for the plain discussion of some cardiology enigmas.

Objective: The present text was aimed to discuss speculatively some cardiology enigmas.

Method: Text was freely designed in the context of coronary artery and heart valve diseases.

Results: The results were presented as the combination enigma/hypothesis. 1) The absence of arteriosclerosis in intramyocardial coronary arteries/ endothelium-myocardial interaction (crosstalk); 2) The unique and always confirmed superior evolution of the internal thoracic artery as coronary graft/ higher NO basal release 3) The prophylactic left internal thoracic artery graft in mildlystenosed coronary lesions/need of more accurate functional imaging techniques; 4) The high incidence of perioperative atrial fibrillation in patients with coronary artery disease/atrial ischemia associated to left circumflex coronary lesions; 5) The handling of disease-free saphenous vein grafts at the time of reoperation/biological serendipity with graft vein segments; 6) The possible aortic stenosis protection against coronary artery disease/ endothelium-myocardium interaction (crosstalk) improving NO release.

Conclusion: The discussed topics associated with their respective speculative hypothesis remain as enigmas, but would become motivations for investigations.

Keywords: Coronary artery disease; arteriosclerosis; atrial fibrillation; cardiology enigmas; controversies; heart valve disease.