[Clinical, angiographic and therapeutic aspects of variant angina (author's transl)]

A report is given on seven patients with Prinzmetal's variant angina. Rest angina occurred in all patients. In contrast, exertional angina was observed only on patients with significant (greater than 70%) coronary stenosis. Likewise, electrocardiographic changes (negative T) were only demonstrable in patients with severe coronary obstruction. The coronary angiogram was normal in one patient, demonstrated insignificant lesions in two and significant stenosis in four cases. In patients with insignificant coronary lesions obstructive coronary spasm was provoked by ergonovine maleate and this group responded well to a combination of nifedipine and isosorbide dinitrate therapy. The patients with significant coronary stenosis were free from pain after coronary bypass surgery; one of these suffered a perioperative anterior myocardial infarction. On the basis of these observations promising therapy is possible if the coronary morphology is known.