[Possible pathogenetic mechanisms of spontaneous stenocardia attacks]

Study of changes in the electrocardiogram during spontaneous attacks of angina pectoris has shown that out of 80 patients examined, 78 (98.6%) patients with angina pectoris at rest manifested ischemic-type changes in the end part of the ventricular complex of the ECG, whereas in 81% of the patients, rhythm and conduction abnormalities were recorded in addition. It has been established that during a spontaneous angina pectoris attack, the degree of an increase in the double product was lower while the degree of the ischemic depression of the ST segment was greater than during threshold load. Apparently, the reduction of the coronary blood flow rather than a dramatic increase in myocardial oxygen requirement plays the leading part in the pathogenesis of spontaneous attacks of angina pectoris.