title: Previously undiagnosed variant angina as a cause of chest pain after coronary artery bypass surgery.
abstract: Variant angina was diagnosed after coronary artery bypass surgery in six patients over a 22-month period. Although all six patients had at least occasional angina at rest preoperatively, all but one had predominantly exertional angina. After surgery, rest angina with transient ST-segment elevation appeared in all six after an asymptomatic interval of 1 week to 4 years. In two patients the involved artery had not been bypassed, in two patients it was perfused by a patent graft and in two patients the graft to the involved vessel was occluded. Treatment with calcium antagonist drugs (four cases) or isosorbide dinitrate (one case) eliminated symptoms; one patient spontaneously became asymptomatic. The diagnosis of variant angina should be considered when rest angina occurs after bypass surgery, particularly if exertional angina is absent and grafts are patent.
mesh_terms: D000328:Adult; D000787:Angina Pectoris / Q000150:complications*; D000788:Angina Pectoris, Variant / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D001026:Coronary Artery Bypass; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D012146:Rest; D013909:Thorax; D013997:Time Factors