title: Effort angina pectoris without electrocardiographic changes in coronary disease patients: correlations between scintigraphic and coronary angiographic findings.
abstract: The absence of electrocardiographic changes during angina is an unusual occurrence. In 15 male patients with exercise-induced angina, the electrocardiogram failed to show the usual ischemic ST-T changes. The exercise thallium-201 myocardial imaging was employed as indicator of the ischemia and the results were correlated with coronary angiographic findings. The exercise thallium-201 myocardial imaging showed an exercise-induced reversible defect in 14 patients and a fixed defect in the remaining 1. Out of 15 patients, 13 had defects involving the infero-apical, posterior and postero-lateral segments. The coronary angiography, performed in all patients but 2, showed single-vessel coronary artery disease in 8 patients and double-vessel disease in 5. A significant circumflex or right coronary artery stenosis was found in all cases except 1; 2 patients had a coexistent left anterior descending coronary artery stenosis and 1 an isolated stenosis of this vessel. It is concluded that the myocardial scintigraphy is useful to assess the ischemic myocardial origin of chest pain in the absence of ST-T changes. The silence of the electrocardiogram might be due to the production of ischemia in not well explored areas, such as the inferior and posterior myocardial segments, and possibly to a smaller extension of ischemia.
mesh_terms: D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis*; D006328:Cardiac Catheterization; D002932:Cineangiography; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis*; D004562:Electrocardiography; D005080:Exercise Test; D006801:Humans; D008297:Male; D008875:Middle Aged; D011868:Radioisotopes; D013793:Thallium
chemical_list: D011868:Radioisotopes; D013793:Thallium