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Coronary arteriography and left ventriculography during spontaneous and exercise-induced ST segment elevation in
Insights
This study shows coronary artery spasm in variant angina patients during spontaneous and exercise-induced episodes. Exercise can trigger angina attacks similar to those occurring naturally, demonstrating coronary artery spasm.
Area of Science:
- Cardiology
- Diagnostic Imaging
Background:
- Variant angina, characterized by coronary artery spasm, can manifest during rest or exertion.
- Understanding the triggers and manifestations of variant angina is crucial for effective patient management.
Abstract:
The present study is an angiographic demonstration of coronary artery spasm during both spontaneous and exercise-induced angina in three patients with variant angina. In each case, clinical, ECG, coronary angiographic, and left ventriculographic observations were made at rest, during spontaneous angina, and during exercise-induced angina. The character of chest pain was similar during spontaneous and exercise-induced episodes. ST segment elevation was present in the anterior ECG leads during both episodes. The left anterior descending coronary artery became partially or totally obstructed during both types of attacks. When coronary spasm was demonstrated during both types of attacks, left ventriculography disclosed akinetic or dyskinetic wall motion in the area supplied by the involved artery. In those patients with reproducible exercise-induced ST segment elevation and chest pain, thallium-201 scintigraphy showed areas of reversible anteroseptal hypoperfusion. Thus in selected patients exercise-induced attacks of angina were similar to spontaneous episodes.