Variant angina pectoris: investigation of indexes of sympathetic nervous system function.
One thousand forty-five spontaneous episodes of S-T segment elevation were observed in three patients over a total of 72 days of continuous electrocardiographic monitoring. Eighty-nine percent of episodes were asymptomatic; chest pain tended to occur with episodes longer than 3 minutes, and ventricular ectopy occurred almost exclusively with symptomatic episodes. Nitroglycerin regularly relieved angina or S-T elevation, or both. Plasma and urinary catecholamines and their metabolites were normal. Episodes of variant angina were not associated with a generalized increase in sympathetic outflow because serum catecholamine levels at the onset and termination of the S-T abnormalities were not elevated. Controlled trials of propranolol showed no significant beneficial effect. Propranolol significantly increased the length of episodes of S-T elevation in one patient, increasing ventricular irritability. The overall course of variant angina was quite variable, with spontaneous and long-lasting remissions, necessitating cautions interpretation of clinical trials.
D000787:Angina Pectoris / Q000503:physiopathology*; D000788:Angina Pectoris, Variant / Q000188:drug therapy / Q000503:physiopathology*; D001794:Blood Pressure; D002346:Carotid Sinus / Q000503:physiopathology; D002395:Catecholamines / Q000097:blood / Q000652:urine; D003080:Cold Temperature; D004326:Drinking; D004562:Electrocardiography; D005080:Exercise Test; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000652:urine; D007537:Isometric Contraction; D008991:Monitoring, Physiologic; D005996:Nitroglycerin / Q000627:therapeutic use; D011433:Propranolol / Q000627:therapeutic use; D012007:Rectum / Q000503:physiopathology; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D014636:Valsalva Maneuver; D014680:Veins / Q000503:physiopathology
D002395:Catecholamines; D006897:Hydroxyindoleacetic Acid; D011433:Propranolol; D005996:Nitroglycerin