[Determining the vasospastic origin of stenocardia attacks on the basis of 24-hour ECG monitoring]

The pattern of anginal attacks was evaluated, using 24-hour ECG monitoring, in 67 patients with angina at rest, as compared to 60 patients with angina of effort. In most patients, ischemic ECG changes developed in the presence of unchanged heart rate at rest or heart rate increment of less than 0.25 of the daily peak, and disappeared as heart rate increased. A U-like pattern of ST displacement was noted. These features were found to be typical for the vasospastic mechanism of anginal attacks developing at rest. Therefore, the origin of anginal attacks can be identified by means of ECG monitoring.