Two electrocardiographic patterns with or without transient T-wave inversion during recovery periods of variant anginal attacks.
Continuous electrocardiographic recordings during anginal attacks in patients with variant angina were reviewed. Twenty-seven attacks in 15 patients were associated with transient T-wave inversion during recovery periods of angina (type A), while in another 69 attacks in 28 patients there was no T-wave inversion (type B). In none of the patients was there an ischemic T-wave inversion during angina-free periods. Both the maximum elevation (0.79 +/- 0.57 mV) and duration (5.3 +/- 1.2 min) of ST-segment deviation of type A attacks were significantly higher and longer than those of type B (0.44 +/- 0.27 mV, 2.8 +/- 1.4 min). Ten patients who had both type A and type B attacks one time or the other were selected for further evaluation. In these 10, the duration of ST-segment elevation was significantly longer during type A attacks (5.2 +/- 1.2 min, n = 18) than during type B attacks (2.7 +/- 1.2 min, n = 20) but there was no significant difference in the maximum ST-segment elevation. Giant U-wave inversion appeared in 15% of the type A attacks, but never in type B. Therefore, the T-wave abnormality related to ischemic episodes in patients with variant angina seems to be associated with more severe ischemia of longer duration than milder episodes of transient ischemia.
D000328:Adult; D000368:Aged; D000788:Angina Pectoris, Variant / Q000503:physiopathology*; D003327:Coronary Disease / Q000503:physiopathology; D004562:Electrocardiography; D004874:Ergonovine; D006801:Humans; D008297:Male; D008875:Middle Aged; D005082:Physical Exertion; D012032:Refractory Period, Electrophysiological
D004874:Ergonovine