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[X syndrome. Angiographic findings]
G Nava López1, C Monteverde, R Jauregui
1Hospital de Cardiología Luis Méndez del Centro Médico Nacional del Instituto Mexicano del Seguro Social.
Archivos Del Instituto De Cardiologia De Mexico
|May 1, 1989
Summary
Coronary artery spasm is a primary cause of ischemic heart disease without atherosclerosis. Treatment with calcium antagonists led to favorable outcomes in most patients, with many becoming asymptomatic.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Coronary artery spasm is a frequent cause of ischemic heart disease (IHD) when coronary atherosclerosis is absent.
- Other potential causes of IHD like cardiomyopathy and valvular heart disease were excluded.
Purpose of the Study:
- To investigate the characteristics and outcomes of patients with IHD attributed to coronary artery spasm.
- To evaluate the efficacy of calcium antagonists in managing this condition.
Main Methods:
- Studied 23 patients (15 males, 8 females; mean age 47) with angina and myocardial ischemia but no coronary atherosclerosis.
- Utilized cardiac cineangiography, intracoronary ergonovine testing, ECG, stress tests, and thallium-201/technetium-99 scintigraphy.
- Assessed outcomes over a two-year follow-up period.
Main Results:
- Cardiac cineangiography revealed no atherosclerosis but showed reduced contrast medium progression, indicating increased coronary resistance.
- Unstable angina (UA) was diagnosed in 21 patients, and myocardial infarction (MI) in 2.
- Calcium antagonist treatment resulted in a favorable prognosis: 18 patients became asymptomatic, four had stable angina, and one had persistent unstable angina.
Conclusions:
- Coronary artery spasm is a significant cause of IHD in the absence of atherosclerosis.
- Calcium antagonists are effective in managing IHD caused by coronary artery spasm, leading to improved patient outcomes.