title: Exact mechanisms contributing to instability and refractoriness to therapy in patients with unstable angina: coronary arteriographic evaluation.
abstract: Ninety one patients with unstable angina were evaluated by clinical and angiographic study. Of 91 patients, 42 (46%) responded poorly to the intensive medical treatment. Emergency coronary arteriography was then performed on these patients. The important pathoanatomical mechanisms contributing to instability of angina pectoris and/or refractoriness to the intensive medical treatment were observed in 19 of 42 patients (45%). These include: 1) More severe disease with left main lesion; 2) Refractory coronary spasm; 3) Coronary dissection; 4) Rapid progression of atherosclerosis; 5) Ulcerating plaque and 6) Coronary thrombus. Our results presented here suggest that an appropriate knowledge regarding pathophysiology might improve the approach to treatment.
mesh_terms: D000328:Adult; D000787:Angina Pectoris / Q000503:physiopathology*; D000789:Angina, Unstable / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy; D000790:Angiocardiography; D001026:Coronary Artery Bypass; D003331:Coronary Vessels / Q000473:pathology; D005260:Female; D006801:Humans; D007547:Isosorbide / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000627:therapeutic use; D005996:Nitroglycerin / Q000627:therapeutic use; D005082:Physical Exertion; D011379:Prognosis; D012146:Rest
chemical_list: D005996:Nitroglycerin; D009543:Nifedipine; D007547:Isosorbide