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Coronary vasospasm in angina pectoris.

A Maseri, A Pesola, M Marzilli

Lancet (London, England)

|April 2, 1977

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Vasospastic angina, characterized by coronary artery spasms, is common in patients with angina at rest. Angiography during attacks revealed localized vasospasm, often causing occlusion, particularly with S-T segment elevation.

Area of Science:

Cardiology
Diagnostic Imaging

Background:

Recurrent angina at rest can be caused by coronary artery vasospasm.
Atherosclerotic coronary artery disease is a common finding in patients with angina.

Purpose of the Study:

To investigate the prevalence and characteristics of vasospastic angina during anginal attacks.
To correlate coronary artery vasospasm with electrocardiographic changes and atherosclerotic burden.

Main Methods:

Coronary angiography was performed in thirty patients during 34 angina attacks (spontaneous or ergonovine-induced).
Electrocardiographic (ECG) changes (S-T segment elevation or depression) were recorded during attacks.
Control angiograms assessed the degree of atherosclerotic obstruction.

Main Results:

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All patients with S-T segment elevation showed localized vasospasm, frequently causing complete coronary occlusion.
Patients with S-T segment depression had double or triple vessel disease, with vasospasm not causing complete occlusion.
Vasospastic angina was found to be common when specifically investigated.

Conclusions:

Vasospastic angina is a significant cause of angina at rest, particularly when associated with S-T segment elevation.
Coronary artery vasospasm can manifest differently depending on the ECG findings and underlying coronary artery disease severity.