Myocardial ischemia in patients with fixed occlusive coronary artery disease secondary to vasospasm in the "normal" vessel.
Seven patients with significant fixed occlusive coronary artery disease had coronary artery spasm in a "normal" vessel. All patients had one or more episodes of rest angina and six had exertional angina as well. Four sustained previous myocardial infarction. During spontaneous angina, five patients had ST-segment elevation in the inferior electrocardiographic leads. One patient had ST-segment elevation in anterior leads. During angiography, spasm was demonstrated in the right coronary artery in three patients and in the left anterior descending coronary artery in one patient. This study emphasizes the interaction of fixed and vasospastic disease and has strong implications concerning the management of patients with ischemic heart disease.
D000328:Adult; D000787:Angina Pectoris / Q000150:complications; D017023:Coronary Angiography; D003327:Coronary Disease / Q000150:complications* / Q000175:diagnosis / Q000209:etiology; D003329:Coronary Vasospasm / Q000150:complications*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged