Clinical syndrome of variant angina with normal coronary arteriogram.
We compared patients with variant angina (ST-segment elevation during pain) who had normal or near normal coronary arteriograms (Group 1) with 20 in whom variant angina occurred in the presence of obstructive coronary lesions (Group 2). A long history of nonexertional angina without angina of effort or previous infarction was the rule in Group 1, whereas recent-onset unstable angina preceded by effort angina and infarction predominated in Group 2 (P less than 0.001). Normal electrocardiograms at rest, with ischemic ST-segment elevation in the inferior leads, and ischemia-induced heart block and bradycardia, characterized Group 1, whereas abnormal electrocardiograms, ischemic involvement or fibrillation were more common in Group 2 (P less than 0.001). Variant angina with normal coronary arteriogram generally has a benign course and is probably unrelated to atherosclerosis.
D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000000981:diagnostic imaging*; D000788:Angina Pectoris, Variant / Q000000981:diagnostic imaging* / Q000503:physiopathology; D000792:Angiography; D001161:Arteriosclerosis / Q000503:physiopathology; D017023:Coronary Angiography; D003326:Coronary Circulation; D004562:Electrocardiography; D005260:Female; D006327:Heart Block / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009130:Muscle, Smooth / Q000503:physiopathology; D009203:Myocardial Infarction / Q000503:physiopathology; D005082:Physical Exertion; D013035:Spasm / Q000503:physiopathology; D009626:Terminology as Topic; D014693:Ventricular Fibrillation / Q000503:physiopathology