[Clinical aspects, diagnosis, therapy and course of unstable angina pectoris]

It is reported on 27 patients aged 32-77 years with an unstable angina pectoris, including coronary spasm. All patients showed an anamnesis of less than 3 months, nearly the half of less than 24 hours. The resting electrocardiogram during the attack was pathological in 22 patients, 7 patients showed a Prinzmetal reaction and 11 patients showed intermittent ventricular dysrhythmias. The exercise electrocardiogram in the stable phase was pathological in 16 of 17 patients. Of 23 patients who underwent a selective coronary angiography with laevocardiography 9 patients each showed a disease of one vessel and three vessels, respectively, and 5 patients a disease of two vessels. Only nearly 50% of the patients could be stabilized medicamentously (nitrates, calcium antagonists, rarely beta-blockers). In three patients still during the unstable phase a surgical revascularization was carried out, in 11 patients after stabilization. Five patients suffered an early infarction; one of them died. Altogether, the unstable angina pectoris is even nowadays to be regarded as a clinical picture with a relatively bad prognosis, which demands rapid action.