[Coronary angiography in patients with U wave inversion during coronary artery spasm].
During ergonovine-induced vasospastic angina, U wave inversion without significant ST segment deviation on the precordial electrocardiograms was documented in four patients. Coronary angiography revealed incomplete spastic obstruction of the left anterior descending artery without delayed filling and runoff in three patients. In the remaining patient, the proximal left anterior descending artery was totally occluded and there were well-developed collaterals from the non-spastic artery. Thus, ergonovine-induced U wave inversion was related to the presence of coronary vasospasm, and angiography demonstrated less severe myocardial ischemia in such patients than in cases with ST segment elevation or depression, which is usually associated with subtotal or total obstruction of a major coronary artery without adequate collaterals. In their clinical courses, two patients had episodes of angina with ST segment elevations or depressions. It was suggested that vasospastic angina with U wave inversion alone is one aspect of a continuous spectrum of vasospastic myocardial ischemia.
Masuda
T
T
First Department of Internal Medicine, Faculty of Medicine, Mie University.
Yamakado
T
T
Xu
K C
KC
Nakano
T
T
Takezawa
H
H
D000328:Adult; D000787:Angina Pectoris / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000503:physiopathology; D003097:Collateral Circulation; D017023:Coronary Angiography; D003326:Coronary Circulation; D003329:Coronary Vasospasm / Q000139:chemically induced / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004562:Electrocardiography; D004874:Ergonovine; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged
D004874:Ergonovine