The article deals with the prognostic role of tortuosity of main branches of coronary arteries in the development of chronic myocardial ischemia and acute coronary circulation disorders in patients without any angiographic signs of atherosclerotic lesions of the vascular wall. The angiographic data from examination of these patients indicated the presence of left ventricular contractility disorders and signs of left ventricle aneurism. The evidence in favor of impaired prognosis of ischemic heart disease in patients with hemodynamically significant atherosclerosis of coronary bed in combination with tortuosity of coronary arteries were presented. The progression of atherosclerotic lesion of the vascular wall probably reduce the role of such configurational anomaly of arteries as factor of coronary failure development but it does not eliminate its clinical significance.
