Coronary hypertonia and angina

Area of Science:

• Cardiology
• Vascular Physiology

Background:

• Unstable angina can be associated with coronary artery abnormalities.
• Coronary artery spasm is a potential cause of ischemic events.

Purpose of the Study:

• To investigate the role of coronary hypertonia in a patient presenting with unstable angina.
• To elucidate the mechanism of variant angina in the presented case.

Main Methods:

• Clinical observation of a patient with unstable angina.
• Reproduction of symptoms including electrocardiographic changes and lactate production via atrial pacing.
• Coronary arteriography before and after nitroglycerin administration.

Main Results:

• Coronary hypertonia was observed in the patient.
• Atrial pacing successfully reproduced the clinical picture, electrocardiographic changes, lactate production, and coronary hypertonia.
• Coronary arteriogram showed diffuse spasm relieved by nitroglycerin, indicating normal coronary arteries without spasm after treatment.

Conclusions:

• Left coronary artery hypertonia (spasm) was identified as the cause of variant angina and subendocardial ischemia in this patient.
• The study highlights the importance of identifying coronary artery spasm in the etiological diagnosis of angina.
• Pharmacological management with nitroglycerin effectively relieved the coronary spasm.