title: [Cold-induced angina pectoris--threatening myocardial ischemia or psychoautonomic dysfunction?].
abstract: 10 male patients with angina pectoris and a history of increased severity of angina under cold conditions were investigated. The coronary angiograms of all patients showed severe stenoses of coronary arteries. Observations were made by continuous ECG monitoring (Holter ECG) during rest and exercise under normal (room temperature) and cold conditions (-6 degrees C). In addition to ECG changes only anginal attacks occurring spontaneously were of interest in this study. Therefore, the patients were not informed about the purpose of the investigation. In spite of a history of increasing angina during exposure to cold, no patient spontaneously complained of cardiac symptoms while changing from a normal to a cold environment. In none of the patients did exposure to cold lead to ECG alterations such as arrhythmias or ST-segment depression. There was no significant difference in ST-segment changes during and after exercise under normal or cold conditions. The history of cold intolerance in patients with angina pectoris is a nonreproducable, nonspecific parameter. We conclude that angina pectoris under cold conditions is not due to myocardial ischemia, but is very likely to be induced by psychovegetative factors.
mesh_terms: D000328:Adult; D000787:Angina Pectoris / Q000175:diagnosis*; D003081:Cold Climate / Q000009:adverse effects*; D003327:Coronary Disease / Q000175:diagnosis*; D004562:Electrocardiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D005082:Physical Exertion
vernacular_title: Kälteinduzierte Angina pectoris--bedrohliche Myokardischämie oder psychovegetative Fehlreaktion?