title: Exercise-induced S-T segment elevation in variant angina.
abstract: 3 patients with co-existing effort angina and Prinzmetal's variant angina are described, who had also 'atypical' manifestations of variant angina, i.e. chest pain and S-T segment elevation also during treadmill exercise testing. Because of these unusual manifestations the proper diagnosis was delayed and the patients continued with inappropriate therapy (propranolol and only low-dose nitrates). After the correct diagnosis of variant angina with 'atypical' manifestations was made, application of high-dose nitrates and nifedipine resulted in complete relief of symptoms. Repeat treadmill testing during this therapy did not provoke attacks of chest pain with S-T elevation.
mesh_terms: D000788:Angina Pectoris, Variant / Q000175:diagnosis* / Q000188:drug therapy; D003329:Coronary Vasospasm / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005080:Exercise Test; D006801:Humans; D007548:Isosorbide Dinitrate / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000627:therapeutic use; D005082:Physical Exertion
chemical_list: D009543:Nifedipine; D007548:Isosorbide Dinitrate