[Loading-induced ST-interval elevations in the case of normal coronary arteries. The angiographic demonstration of loading-induced coronary artery spasm].
In a 60-year-old man with exercise-dependent anginal symptoms, reversible ST segment elevations of maximally 0.8 mV occurred in the anterior chest leads during ergometric exercise at 75 W. Angiography excluded coronary artery stenoses. To demonstrate whether he had exercise-dependent vasospastic angina, angiography was performed during bicycle ergometry. At 75 W the typical symptoms recurred, accompanied by ST elevations in the ECG. At the same time, spasm in the region of the anterior interventricular branch was demonstrated angiographically; it disappeared at once after intracoronary injection of 200 micrograms nitroglycerin. The patient subsequently remained free of symptoms while taking isosorbide dinitrate (120 mg daily) and nifedipine (80 mg daily).
Duckeck
W
W
Kardiologische Abteilung, Universitäts-Krankenhaus Eppendorf, Hamburg.
Kupper
W
W
Schwarzkopf
H J
HJ
Bleifeld
W
W
D000787:Angina Pectoris / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D002908:Chronic Disease; D017023:Coronary Angiography; D003329:Coronary Vasospasm / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D004359:Drug Therapy, Combination; D004562:Electrocardiography; D005080:Exercise Test; D006801:Humans; D007548:Isosorbide Dinitrate / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000627:therapeutic use; D005082:Physical Exertion / Q000502:physiology*
D009543:Nifedipine; D007548:Isosorbide Dinitrate