Valenzuela Outlook Said to Be Favorable : Angels: Rare condition sometimes restricts blood flow to heart, but doctor is hopeful medication will allow him to pitch again.

By HELENE ELLIOTT

June 19, 1991 12 AM PT

TIMES STAFF WRITER

MILWAUKEE — An angiogram performed Tuesday on Angel pitcher Fernando Valenzuela determined he has a rare condition that restricts blood flow to the heart.

Dr. Larry Santora, who oversaw the procedure at St. Joseph Hospital in Orange, said the outlook for Valenzuela is favorable despite what he called myocardial bridging of the left anterior descending artery. He said Valenzuela might pitch again in a few weeks if he responds to medication.

Myocardial bridging is a birth defect involving an artery that is supposed to be entirely on the surface of the heart but instead burrows into the muscle for a short distance, usually for only about two centimeters and at a depth of just a few millimeters.

The artery burrows underneath only when the heart is constricting. Since blood flows when the heart is relaxing, not constricting, it shouldn’t obstruct any flow and therefore should not cause heart problems, according to Dr. Joel Manchester, director of cardiology at Hoag Hospital in Newport Beach.

Santora emphasized that Valenzuela was not in any danger.

“We did find that one artery, when the heart contracts, would be crimped,” Santora said. “It’s probably a small bend in the muscle that overlies the heart in that area . . .

“Most people that have the condition get along quite well. Pitchers usually don’t reach the heart rates you do on a treadmill.”

Santora said he found no evidence of hardening of the arteries leading to the left-hander’s heart. Valenzuela will be treated with a mild beta blocker, which he said is intended to “decrease the heart rate at high levels of exercise so the heart muscle doesn’t squeeze as forcefully around the artery.”

Santora said that while the beta blocker is the same type of medication given to Loyola Marymount basketball player Hank Gathers, the athletes’ conditions are in no way alike. Gathers collapsed and died during a game in February of 1990.

“Hank Gathers had problems with abnormal heart rhythm but Frank doesn’t have any heart rhythm symptoms,” Santora said. “It’s a whole different problem.”

Santora said the angiogram was performed because Valenzuela’s response to a treadmill test last week was “markedly different” from one taken in 1990 when Valenzuela was with the Dodgers. The test, last Thursday, led the Angels to place Valenzuela on the 15-day disabled list. He is eligible to be activated June 28.

Dan O’Brien, Angel senior vice president, said, “I’m encouraged. I have to be encouraged, certainly more so than I was a week ago.”

Valenzuela, 30, is 0-2 in two starts with a 12.15 earned-run average. After being released by the Dodgers in late March, the Angels signed him to a minor league contract in May. He made three minor league starts before making his Angel debut June 7 in a 5-0 loss to the Detroit Tigers.

In his second start last Wednesday, he was routed by the Milwaukee Brewers, giving up five earned runs in 1 2/3 innings.

Manchester said Valenzuela’s condition causes no heart problems in most patients.

“Only in an exceptional case does it have any clinical significance as far as symptoms or restrictions on activities,” Manchester said. “I have never in my experience seen a case of myocardial bridging that I thought was clinically significant.”

He compared the problem to a minor crack in a wall that does not threaten a building’s integrity.

But Dr. Jonathan Tobis, chief of cardiology at UCI Medical Center in Orange, said that heart doctors don’t fully understand the significance of the abnormality and don’t always agree on how to treat it. In some extremely unusual cases, myocardial bridging has been identified as impeding the flow of blood and therefore causing heart disease. But most people with the fairly rare syndrome seem to live healthy lives with no chest pain or problems, he said.

“The clinical significance is not clear,” he said. “I don’t think there is a good consensus in cardiology today about what the significance of this is.”

Times Staff Writer Marla Cone contributed to this story.

Fernando Valenzuela’s Heart Ailment

The abnormality found in Fernando Valenzuela--called myocardial bridging--is considered a minor, although rare, defect. An artery, which supposed to remain on the surface of the heart, instead tunnels a little bit into the heart muscle. The artery involved in Valenzuela’s case is the left anterior descending artery. His tests found no narrowing or hardening of the arteries and his doctor concluded no surgery is necessary.

PUMPING BLOOD

When the heart relaxes and pumps blood, the artery stays open, and blood moves normally. When the heart constricts, the artery is pinched, and blood flow is reduced.

Source: Dr. Jonathan Tobis of UCIMC and Dr. Joel Manchester of Hoag Memorial Hospital