[Disputable thoracic pain with normal coronary arteries. Metabolic study]

The search for electrocardiographic, haemodynamic and above an metabolic criteria suggestive of "myocardial ischaemia" in the course of an atrial pacing test was found to be positive in three patients suffering from atypical thoracic pains, and in whom selective coronary arteriograms might be considered as normal. It appaear thus that the criterion of a normal coronary arteriography and a negative or unsignificant effort test is insufficient to discard the diagnosis of "myocardial ischaemia" when confronted with such pains habitually considered as anorganic. The accurate mechanism of these pains, probably identical to that or those of "angina with normal coronary arteriography" remains undecided.