[Spasm of organically altered coronary arteries]

The paper is concerned with 11 patients with an angiographically recorded spasm at the site of the coronary artery stenosis. In the 2 patients, the spasm was spontaneous, whereas in the 9, it was provoked by ergometrine. None of the patients had a typical clinical picture of Prinzmetal's angina pectoris, but all the cases were characterized by exacerbation of coronary heart disease, which was manifested by repetition and increase of the intensity of attacks of angina pectoris at rest. The data of the repeated ergometrine tests, during which the ECG was recorded indicate that in the majority of the patients, the ability to respond by spasms toward ergometrine administration disappeared as the clinical condition was stabilized, but some of the patients preserved this ability despite therapy with calcium antagonists. If 2 or 3 coronary vessels were involved, spasm developed but in one of the vessels. This is indirect evidence for the fact that during multiple stenosing of the coronary arteries, the reactivity of one of the stenoses plays the leading part in the genesis of the disease exacerbation.