[Walk-through phenomenon in angina pectoris: long-term study (10 years) of 10 patients]

The long-term results of ten patients (nine male, one female) are reported, who during their initial examinations (1977) complained of the classical symptoms of a "walk-through phenomenon" (WTPH). All patients showed typical signs of coronary insufficiency in the exercise-ECG and in the wedge pressure response during exercise. Nine patients (mean age 49 years) had documented myocardial infarctions, one suffered from coronary heart disease without infarction. In seven patients coronary angiography was performed. 10 months after the beginning of the WTPH, four patients continued to show signs of ischemia during exercise after anginal symptoms had disappeared. In the other six patients the ischemia disappeared together with the loss of AP. 10 years after the first examination nine patients are still alive. One patient died in 1981 due to a subsequent infarction of the posterior wall. Three of four patients who underwent aorto-coronary bypass operation (ACB) are now without signs of ischemia during exercise. The fourth patient with ACB suffered a re-infarction in 1982. None of the other five patients are still suffering from WTPH. Exercise tolerance decreased in one and increased in three patients, all being limited by typical AP showing signs of ischemia. In the group of WTPH-patients, the low morbidity and mortality is remarkable. However, in all patients WTPH appears to be apparent only in the first few months after onset. Thereafter, WTPH changes to classical stable AP.