[A case of chronic recurrent pulmonary embolism complicated with effort angina pectoris]

A 50-year-old man was admitted to our hospital because of shortness of breath and an oppressive feeling in his chest on exertion. As a result of examinations including pulmonary-angiography, pulmonary perfusion scan and phlebogram, we diagnosed the case as chronic recurrent pulmonary embolism due to deep vein thrombosis. Later on, the patient showed an abnormal reaction on treadmill exercise test, and revealed redistribution at the anteroseptal and the inferior wall on thallium exercise test. We performed coronary angiography and diagnosed the case as angina pectoris (seg. 1 was total occlusion, segs. 2 and 3 were filled with bridge collateral, seg. 7 was 75% stenotic lesion). We evaluated the acute effect of vasodilators on pulmonary and systemic hemodynamics. The effect was beneficial in that it improved the hemodynamics. On account of this we thought a reversible condition was presented, and we administered these drugs to this patient.