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Calcification of the left main coronary artery (LCA) was found, with an equal sex distribution, in 30 out of 145 patients (21%) at autopsy. A series comprising 68 males and 77 females in whom death resulted from myocardial infarction (111 cases) or ischaemic heart disease (34 cases). The condition is rare before the sixth decade but becomes more frequent after the seventh decade of life. The incidence was the same in lethal anterior and posterior infarction (15% and 16% respectively). It was more common in ischaemic heart disease (38%, p less than 0,005). Significant narrowing of the LCA was found in 26 cases (87%) but this was only less than 70% in 11 cases. When the total number of LCA stenoses (calcified and non calcified: 39 cases) was considered, only two thirds had associated calcification. This was, therefore, only a moderately sensitive index of LCA stenosis. Calcification, nearly always circumferential, was usually situated on the second portion of the LCA. Its division was involved in all cases, the calcification extending to the initial segments of the left anterior descending artery (LAD) and left circumflex artery (CX). Calcification of the LCA was always associated with calcification of the LAD, 78% of which had stenotic lesions. Calcification of the CX and right coronary arteries was practically constant, the average percentages of occlusion being 72% and 68% respectively. On anatomical criteria, myocardial revascularisation surgery could only have been proposed in about 20% cases, and this would only rarely have been total. It is concluded that calcification of the LCA usually corresponds at least anatomically, to severe, diffuse multivessel coronary artery disease.

The ECGs of 70 consecutive patients hospitalised for a first transmural myocardial infarction (MI) (28 anterior, 42 posterior) were analysed prospectively and systematically during the acute phase. Endocavitary electrophysiological studies (EEP) were performed on the 21st day. The following conclusions were drawn: --Sinus bradycardia in the acute phase was observed in 18 cases (26 p. 100). Its cause is uncertain and its occurrence has no relation to the site of infarction. The single case of sinoatrial block (SAB) was recorded in a patient with a posterior MI. --EEP were normal in 18 patients who had sinus bradycardia during the acute phase; EEP was clearly pathological in the case with SAB. --There was no statistical difference in the incidence of pathological EEPs (p greater than 0,05) in anterior (4 out of 28 patients) and posterior (5 out of 42 patients) MI.