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[New-onset stenocardia: the detection of clinical variants of ventricular arrhythmia]
Insights
New onset angina patients with unstable symptoms and coronary spasm face higher risks of dangerous ventricular arrhythmias. Early detection and risk stratification are crucial for managing these high-risk patients.
Area of Science:
- Cardiology
- Electrophysiology
- Internal Medicine
Background:
- Angina of new onset (ANO) represents a critical period for cardiovascular events.
- Understanding the risk factors for ventricular arrhythmias in ANO is essential for patient management.
Purpose of the Study:
- To investigate the occurrence of ventricular arrhythmias in patients with angina of new onset (ANO).
- To analyze the correlation between acute myocardial ischemia and ventricular arrhythmias in ANO patients.
- To identify specific ANO variants associated with a higher risk of severe ventricular arrhythmias.
Main Methods:
- 24- and 48-hour Holter electrocardiographic monitoring were performed on 130 patients with ANO.
- Selective coronarography was conducted on all participating patients.
- Ventricular arrhythmias (extrasystoles, ventricular tachycardias) were analyzed in relation to acute myocardial ischemia.
Main Results:
- Ventricular tachycardia was more frequent in unstable ANO compared to stable angina.
- Patients with signs of coronary spasm exhibited more ventricular tachycardia than those without.
- The combination of unstable angina and coronary spasm presented the highest risk for severe ventricular arrhythmias.
Conclusions:
- Unstable angina with coronary spasm is a high-risk variant of ANO.
- Risk stratification for ventricular arrhythmias in ANO should consider both angina stability and coronary spasm.
- Further research may explore targeted interventions for high-risk ANO patients.
Abstract:
A total of 130 patients with angina of new onset (ANO), i.e. first three months after the onset of anginal attacks, were investigated by means of 24- and 48-hour Holter's electrocardiographic monitoring. All the patients underwent selective coronarography. Ventricular arrhythmias (isolated and paired extrasystoles, ventricular tachycardias) and their correlation to acute myocardial ischemia were analysed. Ventricular tachycardia was more common in unstable ANO, as compared to stable angina, and in patients with signs of coronary spasm, as compared to anginal patients showing no such signs. The combination of unstable angina with signs of coronary spasm is the least favorable ANO variant in terms of the risk of grave ventricular arrhythmias.