[Unstable angina and infarction without Q wave treated with verapamil: value of the early exercise test].
Twenty patients aged 56.8 +/- 10 years, hospitalised for unstable angina (12 cases) or infarct without Q wave (8 cases) were treated with IV heparin, aspirin and oral verapamil. The clinical syndrome was controlled by verapamil in 16 cases out of 20 (80% of cases) at the dosage of 360 mg/d in 14 patients and of 480 mg/d in two. An exercise ECG, limited by symptoms, was obtained in 18 patients (90%) between the 8th and 12th day. Coronary arteriography was considered to be indicated in three sets of circumstances: recurrence of angina resistant to nitroglycerin, positive exercise ECG with verapamil, persisting despite triple therapy or strongly positive exercise ECG (total duration less than or equal to 6 minutes). An infarct complicated the early course in 4 patients (20%): twice following angioplasty, once following exercise ECG (spastic angina) and once during triple therapy (refractory angina). Hospital and mid-term (18 +/- 6 months) mortality was nil. With verapamil, the absence of recurrence of angina together with a negative exercise ECG enabled the identification of a large group of patients (40%) with a low risk of a subsequent major accident and in whom early and routine coronary arteriography is probably not indispensable.
Leroy
G
G
Service de Cardiologie, Centre Hospitalier de Saint-Germain-en-Laye.
Ghadanfar
M
M
Guyon
P
P
Richecoeur
J
J
Halphen
C
C
Stoltz
J P
JP
Haiat
R
R
D000328:Adult; D000368:Aged; D000789:Angina, Unstable / Q000188:drug therapy*; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy*; D011379:Prognosis; D012008:Recurrence; D013997:Time Factors; D014700:Verapamil / Q000627:therapeutic use*
D014700:Verapamil
Angor instable et infarctus sans Q traités par vérapamil: intérêt de l'épreuve d'effort précoce.