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Coronary arterial spasm as a cause of exercise-induced ST-segment elevation in patients with variant angina
Insights
Exercise can trigger coronary arterial spasm in patients with variant angina pectoris, leading to chest pain and ST-segment elevation. This study documents the link between physical exertion and coronary artery spasms in these individuals.
Area of Science:
- Cardiology
- Clinical Medicine
Background:
- Variant angina pectoris is characterized by chest pain and transient ST-segment elevation.
- The role of exercise in triggering coronary arterial spasm in this condition requires further elucidation.
Observation:
- Four patients with variant angina pectoris presented with reproducible exercise-induced chest pain and ST-segment elevation.
- Coronary arteriography confirmed arterial spasm during exercise in three patients.
- Intravenous ergonovine maleate administration induced spasm in one patient.
Findings:
- Exercise is a significant trigger for coronary arterial spasm in patients diagnosed with variant angina pectoris.
- The induced spasms directly correlate with anginal pain and ST-segment elevation observed during physical exertion.
Implications:
- These findings highlight the importance of considering exercise as a precipitating factor for coronary arterial spasm in variant angina.
- Understanding this relationship can aid in developing targeted management strategies for affected individuals.
Abstract:
Four patients with variant angina pectoris exhibited reproducible exercise-induced chest pain and ST-segment elevation. Coronary arterial spasm was documented with arteriography during exercise-induced ST-segment elevation (three patients) or after intravenous administration of ergonovine maleate (one patient). Our observations show that in patients with variant angina exercise can trigger coronary arterial spasm, thus inducing anginal pain and ST-segment elevation.