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
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