The haemodynamic response to ST segment changes during coronary arteriography.
Contrast media are known to cause electrocardiographic and haemodynamic changes during coronary arteriography. There is a tendency to proceed with repeated coronary arteriography unless patients develop chest pain, bradycardia or hypotension. We have related the changes in the ST segment to changes in left ventricular end-diastolic pressure, measuring pulmonary arterial diastolic pressure with a transducer tipped catheter. Twenty-five patients were studied, 15 patients with coronary arterial disease, 2 with syndrome X, 3 with coronary arterial spasm (and underlying coronary disease) and 5 normal controls. In control patients, no changes in the ST segment or pulmonary arterial diastolic pressure were recorded. Patients with syndrome X developed ST segment depression in the absence of changes in pulmonary arterial diastolic pressure. Those with coronary arterial spasm and underlying coronary disease developed ST segment depression and a rise in pulmonary arterial diastolic pressure following most injections. In coronary arterial disease, both painful and silent ST segment depression was noted with a rise in pulmonary arterial diastolic pressure. In some instances, a summation effect arose with repeated injections. Major disturbances in the ST segment may occur during coronary arteriography and result in elevation of left ventricular filling pressure.
Levy
R D
RD
National Heart Hospital, London, U.K.
Fox
K M
KM
D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology*; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D003329:Coronary Vasospasm / Q000000981:diagnostic imaging / Q000503:physiopathology; D003331:Coronary Vessels / Q000473:pathology; D003971:Diastole; D003974:Diatrizoate Meglumine / Q000008:administration & dosage; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D006801:Humans; D008991:Monitoring, Physiologic; D011651:Pulmonary Artery / Q000502:physiology*
D003974:Diatrizoate Meglumine