[Coronary arteriography in patients with Prinzmetal's angina associated with ST elevations (author's transl)]

Among 1000 patients with coronary heart disease studied at rest and on exercise and by coronary arteriography, 17 had ST elevations during the anginal episodes. ST changes during exercise occurred in 16 patients, 12 of whom had spontaneous angina. One patient had ST changes only during spontaneous attacks at rest. Critical proximal lesions in the descending branch of the left anterior coronary artery were revealed by coronary arteriography in all 17 patients. Biplane ventricular cine-angiography revealed slight abnormalities in 12, normal pattern in the other five. It is thought that ST elevation during anginal attacks is caused by severe transmural ischaemia. Spontaneous attacks are thought to be due to additional functional narrowing, probably resulting from an increased vascular tone within the area of obstruction.