RESUMEN
The value of two-dimensional echocardiography (2DE) in the diagnosis of proximal left main coronary artery disease was assessed in 63 patients in whom 2DE was performed and interpreted before coronary angiography. The diagnosis of coronary artery disease depended on two groups of criteria, one group based on the lumen of the artery and the other, on the arterial wall. Eighty three pre cent of the investigations were interpretable. The bifurcation of the left main coronary artery was visualised in 23% of cases. 2DE was positive in 8 of the 10 cases (80%) in which coronary angiography showed stenosis of the left main coronary or the very proximal part of the left anterior descending arteries. There were two false negative results (20%). When coronary angiography did not show left main coronary stenosis (42 cases), 2DE was also negative in 39 cases (92%); there were 3 false positive results (7%), one due to calcification and other two to errors in appreciation of the criteria of stenosis. These results show that 2DE is useful before coronary angiography in identifying cases of possible left main stem or proximal left anterior descending disease providing the diagnostic criteria of coronary stenosis are strictly observed.