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[Electro- and echocardiographic changes during an angina attack in an ergometrine pharmacological test]
Insights
Ischemic heart disease patients with ST-segment elevation during angina showed more pronounced left ventricular dilation and reduced contractility. Early myocardial ischemia may manifest as diastolic dysfunction without contractility changes during exercise.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Ischemic heart disease (IHD) poses a significant global health burden.
- Understanding the cardiac manifestations of ischemia is crucial for timely diagnosis and treatment.
Purpose of the Study:
- To investigate the echocardiographic differences in left ventricular function during anginal attacks.
- To correlate electrocardiographic (ECG) changes with cardiac structural and functional alterations in patients with IHD.
Main Methods:
- Echocardiography was performed on 29 patients with IHD and 3 with neurocirculatory dystonia.
- Analysis focused on left ventricular dimensions and contractility during anginal episodes.
- ECG findings (ST-segment elevation or depression) were correlated with echocardiographic data.
Main Results:
- Left ventricular dilation and decreased contractility were more significant with ST-segment elevation compared to ST-segment depression during angina.
- Ergometry-induced angina without ECG changes revealed disturbed diastolic filling but preserved contractility.
- These findings suggest early ischemic myocardial changes.
Conclusions:
- The severity of left ventricular dysfunction during angina correlates with specific ECG changes.
- Diastolic dysfunction without impaired contractility may indicate early myocardial ischemia.
- Echocardiography is valuable in assessing cardiac function during ischemic events.
Abstract:
The authors examined 29 patients with ischemic heart disease and 3 patients with neurocirculatory dystonia. According to the results of echocardiography it was found that dilatation of the left ventricle and decrease in its contractility were more pronounced when the anginous attack was attended by a rise of the ST segment on the ECG than when it was attended by depression of the ST segment. During an ergometry-induced anginose attack with no changes on the ECG the diastolic filling of the left ventricle was disturbed but its contractility did not change, which evidently points to early manifestations of ischemic changes in the myocardium.