Effort angina without coronary obstruction in a patient with Takayasu's aortitis: a case report.
Angina occurring in patients with Takayasu's aortitis is attributed to the narrowing of the coronary ostium and/or aortic regurgitation. We treated a patient with Takayasu's aortitis with effort angina, in whom there was no obstruction of the ostium or aortic regurgitation. Treadmill exercise stress test revealed significant ST depression in leads V4-6, II, III and aVF with chest pain. Examinations of lactate in coronary sinus as well as arterial blood suggested the occurrence of myocardial ischemia during atrial pacing. The DPTI/TTI index was decreased and the left ventricular end-diastolic pressure was increased during angina. It is considered that the reduced coronary perfusion pressure resulted from a low diastolic aortic pressure and the elevated left ventricular end-diastolic pressure decreased the DPTI/TTI index and contributed to the development of subendocardial ischemia.
D000328:Adult; D000787:Angina Pectoris / Q000097:blood / Q000209:etiology*; D000792:Angiography; D001025:Aortitis / Q000150:complications* / Q000188:drug therapy; D003327:Coronary Disease / Q000150:complications / Q000175:diagnosis; D004562:Electrocardiography; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007773:Lactates / Q000097:blood; D010146:Pain / Q000209:etiology; D005082:Physical Exertion; D011239:Prednisolone / Q000627:therapeutic use; D011868:Radioisotopes; D013382:Subtraction Technique; D013793:Thallium; D013909:Thorax
D007773:Lactates; D011868:Radioisotopes; D011239:Prednisolone; D013793:Thallium